Thread by @DrCindyMDuke

For the pediatricians & parents out there, see 🧵 & stay on alert. Get your eligible Littles vaccinated & ensure that everyone who is eligible in your circle vaccinates/boosts, masks & takes all precautions.

NB: this is a preprint. Omicron ID’d in Nov.

medrxiv.org/content/10.110…

This study describes the rapid rise in pediatric COVID-19-associated hospitalizations in Tshwane District in the Gauteng Province of South Africa – one of the first known epicentres of the new Omicron variant of the SARS-CoV-2 virus.

The study describes the clinical picture & outcomes in children in the current wave of SARS-CoV-2 Omicron variant infections by incorporating data from 42 hospitals at all levels of care in a large district w/in the South African health system.

Providing a broad overview on how the Omicron variant affects the pediatric population, the clinical picture as well as the steep increase in pediatric positivity rates & hospitalizations are described in detail from the perspective of a large South African health district.

This study provides novel pediatric data to assist global preparation for the impact of the Omicron variant in the pediatric setting.

During the six-week period 6,287 paediatric (≤19 years) COVID-19 cases were recorded in Tshwane District, of these 462 (7.2%) were hospitalized in 42 hospitals (18% of overall admissions).

The number of pediatric cases was higher than in the prior 3 waves, uncharacteristically preceding adult hospitalisations. Of the 75 viral specimens sequenced from the district, 99% were Omicron.

Detailed clinical information obtained from 139 of 183 (76%) admitted children (≤13 years; including all public sector hospitalizations) indicated that young children (0-4 years) were most affected (62%).

Symptoms included fever (47%), cough (40%), vomiting (24%), difficulty breathing (23%), diarrhea (20%) and convulsions (20%). Length of hospital stay was short (mean 3.2 days), and in 44% COVID-19 was the primary diagnosis.

Most children received standard ward care (92%), with 31 (25%) receiving oxygen therapy. Seven children (6%) were ventilated; four children died, all related to complex underlying co-pathologies. All children and majority of parents for whom data were available were unvaccinated.