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In adults, the delta variant is
reported to be more transmissible than the alpha variant, with a 2·26-times
higher risk of hospitalization. Children have a
significantly lower risk of severe disease, hospitalization, or death due to
COVID-19 than adults. There are, however, little
data on disease severity in children infected with different variants. The
COVID Symptom Study (Zoe App) reported similar symptom burden (median four
symptoms vs five symptoms), illness duration (median 5 days
for both variants), and hospitalization (2·0% vs 2·2%) in a
small cohort of 694 and 706 children aged 5–17 years infected with the alpha
and delta variants, respectively. This study undertaken in England compares hospitalization and fatality rates in a national
cohort of children (aged ≤15 years) with genotype-confirmed SARS-CoV-2
infection due to the alpha or delta variants over a 9-month period when the two
variants caused sequential pandemic waves in England.
In conclusion, the low
hospitalization rates in children with alpha and delta variant infections
confirmed by genotyping should reassure parents, clinicians, and policymakers of the low risk of severe COVID-19 in children. Delta variant infections have,
however, resulted in more childhood hospitalizations than alpha. Further
studies are needed to distinguish between incidental infections and
hospitalization for severe COVID-19, especially in children, where the former
is common, and the latter is rare. COVID-19 vaccines have been shown to reduce
the risk of hospitalization and severe COVID-19 in adults and adolescents. Similar
studies are needed to assess the risk of severe COVID-19 in children infected
with more recent and emerging variants.
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