Across successive waves of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOCs), there was a decrease in intensive care unit (ICU) admissions across ages, while ventilatory and oxygen support varied by age, according to a study published online Aug. 21 in JAMA Pediatrics.

Yanshan Zhu, from the University of Queensland in Australia, and colleagues examined whether the dominant circulating SARS-CoV-2 VOCs were associated with differences in COVID-19 severity in hospitalized children (younger than 18 years) using data obtained from nine countries during three time frames. Timeframes (T) 1, 2, and 3 were defined to represent periods of dominance by the ancestral virus, pre-omicron VOCs, and omicron, respectively.

Data were included for 31,785 hospitalized children and adolescents. The researchers found that for children younger than 5 years, there was a reduction in ICU admission across successive SARS-CoV-2 waves (T3 versus T1: risk ratios [RRs], 0.56 and 0.61 for <6 months and 6 months to <5 years, respectively); no reduction was seen in ventilatory support or oxygen therapy. In children aged 5 years to <18 years, there were decreases in ICU admission, ventilatory support, and oxygen therapy across SARS-CoV-2 waves (T3 versus T1: RRs, 0.39, 0.37, and 0.47, respectively).

“These findings highlight the importance of considering different pediatric age groups when assessing disease severity in SARS-CoV-2,” the authors write.

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