SARS-CoV-2 variants of concern in children and adolescents with COVID-19: a systematic review

Objectives
Infections by SARS-CoV-2 variants of concern (VOCs) might affect children and adolescents differently than earlier viral lineages. We aimed to address five questions about SARS-CoV-2 VOC infections in children and adolescents: (1) symptoms and severity, (2) risk factors for severe disease, (3) the risk of infection, (4) the risk of transmission and (5) long-term consequences following a VOC infection.

Design
Systematic review.

Data sources
The COVID-19 Open Access Project database was searched up to 1 March 2022 and PubMed was searched up to 9 May 2022.

Eligibility criteria
We included observational studies about Alpha, Beta, Gamma, Delta and Omicron VOCs among ≤18-year-olds. We included studies in English, German, French, Greek, Italian, Spanish and Turkish.

Data extraction and synthesis
Two reviewers extracted and verified the data and assessed the risk of bias. We descriptively synthesised the data and assessed the risks of bias at the outcome level.

Results
We included 53 articles. Most children with any VOC infection presented with mild disease, with more severe disease being described with the Delta or the Gamma VOC. Diabetes and obesity were reported as risk factors for severe disease during the whole pandemic period. The risk of becoming infected with a SARS-CoV-2 VOC seemed to increase with age, while in daycare settings the risk of onward transmission of VOCs was higher for younger than older children or partially vaccinated adults. Long-term symptoms following an infection with a VOC were described in

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SARS-CoV-2 Omicron variant infection was associated with higher morbidity in patients with cirrhosis

Dufour et al highlighted that the effect of COVID-19 in patients with cirrhosis is derived from the prevaccination era and suggested that the impact of Omicron infection in patients with cirrhosis needs to be elucidated.1 We agree with the author that previous studies have reported significant morbidity and mortality in patients with cirrhosis infected with SARS CoV-2 in the prevaccination era.2–7 To our knowledge, no studies have assessed the impact of Omicron infection in patients with cirrhosis. Therefore, we aimed to compare the outcomes of Omicron infection among patients with cirrhosis and without cirrhosis. We retrospectively included non-cirrhotic (NC) patients and patients with cirrhosis from 1 January 2022 to 1 March 2022 diagnosed with Omicron infection. Omicron BA.1 variant was identified based on the S-gene dropout on the reverse transcriptase PCR test. In the absence…

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Correction

Bellusci L, Zahra FT, Hopkins DE, et al. Durability of Immunity Is Low Against Severe Acute Respiratory Syndrome Coronavirus 2 Omicron BA.1, BA.2, and BA.3 Variants After Second and Third Vaccinations in Children and Young Adults With Inflammatory Bowel Disease Receiving Biologics. Gastroenterology 2022;163:1672–1675.

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COVID-19 vaccine effectiveness and community prevalence of Alpha, Delta and Omicron variants in patients with cirrhosis

We read with interest about the prognostic significance of liver function abnormalities in SARS-CoV-2 infection.1 2 Although patients with underlying cirrhosis have an increased risk of death following COVID-19, mRNA vaccine administration is associated with an excellent reduction in mortality.3 4 We aimed to determine the association of the prevalence of the Alpha, Delta and Omicron variants and effectiveness of the BNT162b2 or 1273-mRNA vaccines among participants with cirrhosis. We performed a test-negative case–control study of participants with cirrhosis in the Veterans Outcomes and Costs Associated with Liver disease cohort, who had a SARS-CoV-2 PCR between 1 February 2021 and 21 January 2022.5–7 Participants with a positive PCR were considered as cases, and others, as controls. Propensity score (PS) matching was used to match cases and controls, with PS of being a case derived from…

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Cohort profile: Nga Kawekawe o Mate Korona | Impacts of COVID-19 in Aotearoa – a prospective, national cohort study of people with COVID-19 in New Zealand

Purpose
The COVID-19 pandemic has had significant health, social and economic impacts around the world. We established a national, population-based longitudinal cohort to investigate the immediate and longer-term physical, psychological and economic impacts of COVID-19 on affected people in Aotearoa New Zealand (Aotearoa), with the resulting evidence to assist in designing appropriate health and well-being services for people with COVID-19.

Participants
All people residing in Aotearoa aged 16 years or over, who had a confirmed or probable diagnosis of COVID-19 prior to December 2021, were invited to participate. Those living in dementia units were excluded. Participation involved taking part in one or more of four online surveys and/or in-depth interviews. The first wave of data collection took place from February to June 2022.

Findings to date
By 30 November 2021, of 8735 people in Aotearoa aged 16+ who had COVID-19, 8712 were eligible for the study and 8012 had valid addresses so were able to be contacted to take part. A total of 990 people, including 161 Tāngata Whenua (Māori, Indigenous peoples of Aotearoa) completed one or more surveys; in addition, 62 took part in in-depth interviews. Two hundred and seventeen people (20%) reported symptoms consistent with long COVID. Key areas of adverse impacts were experiences of stigma, mental distress, poor experiences of health services and barriers to healthcare, each being significantly more pronounced among disabled people and/or those with long COVID.

Future plans
Further data collection is planned to follow-up cohort participants. This cohort will be supplemented by the inclusion of a cohort of people with long COVID following Omicron infection. Future follow-ups will assess longitudinal changes to health and well-being impacts, including mental health, social, workplace/education and economic impacts of COVID-19.

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