Comparing clinical, laboratory, and epidemiological features of COVID-19 variants during different pandemic waves among children in Ukraine

Tetiana Harashchenko; Tetiana Umanets; Tetiana Kaminska; Lapshyn Volodymyr; Yurii Antypkin

Tetiana Harashchenko Department of Respiratory Diseases and Allergy in Children, State Institution – Institute of Pediatrics, Obstetrics and Gynecology named after Academician O.M. Lukyanova, National Academy of Medical Sciences of Ukraine, Kyiv
Tetiana Umanets Department of Respiratory Diseases and Allergy in Children, State Institution – Institute of Pediatrics, Obstetrics and Gynecology named after Academician O.M. Lukyanova, National Academy of Medical Sciences of Ukraine, Kyiv
Tetiana Kaminska Department of Pediatrics, CNE Kyiv City Children’s Clinical Infectious Disease Hospital, Kyiv
Lapshyn Volodymyr Department of Respiratory Diseases and Allergy in Children, State Institution – Institute of Pediatrics, Obstetrics and Gynecology named after Academician O.M. Lukyanova, National Academy of Medical Sciences of Ukraine, Kyiv
Yurii Antypkin Department of Respiratory Diseases and Allergy in Children, State Institution – Institute of Pediatrics, Obstetrics and Gynecology named after Academician O.M. Lukyanova, National Academy of Medical Sciences of Ukraine, Kyiv

Keywords: COVID-19, waves, children, variants, SARS-CoV-2

Abstract

Background The SARS-CoV-2 virus, the causative agent of the coronavirus disease (COVID-19), mutated during its replication and spread among the population. These mutations led to new viral variants, which differed in their characteristics and manifestations, contributing to the wave-like progression of the COVID-19. The Centers for Disease Control and Prevention classified variants based on the public health risk include variants of interest such as ? and ?, variants of concern including ?, ?, ?, ?, ?, variants of high consequence, and variants being monitored.

Objective To conduct a comparative analysis of the demographic, clinical, epidemiological, radiological, and laboratory characteristics of hospitalized children with COVID-19 during different waves of the disease.

Methods A cohort study was conducted involved 337 children aged one month to 18 years who were hospitalized with laboratory-confirmed COVID-19 between 2020 and 2023 in Ukraine.

Results During wave 3 (W3), wave 5 (W5) and wave 6 (W6), children under 3 years of age were hospitalized more frequently. The severe course of disease predominantly occurred during W3 period, with 47.3% cases demonstrating severe symptoms such as respiratory failure, bilateral pneumonia, and significant changes in laboratory parameters, including white blood cell count, erythrocyte sedimentation rate, D-dimer, and procalcitonin. One fatal case was reported during W3. The duration of hospitalization was longest for children in the W3 group. A moderate course of the disease was significantly more prevalent among hospitalized children in the first wave (77.78%, P<0.05), characterized by interstitial changes in the lungs, elevated C-reactive protein, and platelet levels. Fever and intoxication syndrome were reported with similar frequency during all waves of COVID-19.

Conclusion Our study demonstrates the dynamic changes in manifestations and the progression of the disease across different variants of concern of SARS-CoV-2. The most severe cases of COVID-19 was observed during the third wave which predominated by the ? (Delta) strain.

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