ArticleScientific reports2025
Clinical manifestations and severity of COVID-19 caused by Omicron among paediatric patients aged 0-17 years in Italy.
Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
SARS-CoV-2 Omicron variant evolved into multiple sub-lineages, some showing increased transmissibility and immune evasion. Despite decreased risk of severe disease, paediatric hospitalization rose. However, factors influencing clinical outcomes remain unclear. A total of 458 whole-genome Omicron sequences from patients 0-17 years, diagnosed with SARS-CoV-2 at Bambino Gesù Children's Hospital (January-December 2023) were analysed. Clinical features, disease severity and circulating variants were assessed. Phylogenetic analysis was performed, and logistic regression identified factors associated with hospitalization. Among patients, 249 (54.4%) were male, with median age 0.6 years. Comorbidities were present in 105 (22.9%) patients, mainly immunocompromised (21.0%). Infections were predominantly from XBB (75.0%), JN.1 (12.4%), BA.5 (7.4%) and BA.2 (5.2%) clades. Upper respiratory infections predominated (73.8%), followed by asymptomatic (17.2%) and lower respiratory infections (4.6%), with nine patients having ≥ 1 co-infection. Comorbidities and lower respiratory infections were positively associated with hospitalization, while upper respiratory infections showed a negative association. Given the recent shift to RGN integrin-binding motif in Omicron sub-lineages, leading to altered pathogenesis, its presence was evaluated, revealing a predominance of RGN (N = 378, 84.6%). In conclusion, COVID-19 severity in paediatric patients was primarily driven by comorbidities and co-infections, while milder cases in healthy children may be associated with RGN integrin-binding motif.
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