Evidence map›Paper›PMID 42469668›Full record

ArticleBMC infectious diseases2026

Impact of SARS-CoV-2 variants and demographic factors on COVID-19 severity in pediatric patients.

Thomas T Barter, Dejerianne Ostrow, Carly Weaver, John C Wood, David Warburton, Matthew Deardorff, Xiaowu Gai, Jennifer Dien Bard, Sindhu Mohandas

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC infectious diseases, 2026. 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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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Thomas T BarterDivision of Infectious Disease, Children's Hospital of Los Angeles, 4650 Sunset Blvd, Los Angeles, CA, 90027, USA.
Dejerianne OstrowDepartment of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA, 90027, USA.
Carly WeaverDivision of Infectious Disease, Children's Hospital of Los Angeles, 4650 Sunset Blvd, Los Angeles, CA, 90027, USA.
John C WoodKeck School of Medicine, University of Southern California, 3551 Trousdale Parkway, Los Angeles, CA, 90089, USA.
David WarburtonMaria Fareri Children's Hospital, Valhalla, NY, USA.
Matthew DeardorffKeck School of Medicine, University of Southern California, 3551 Trousdale Parkway, Los Angeles, CA, 90089, USA.
Xiaowu GaiDepartment of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, 53226, USA.
Jennifer Dien Bard *Keck School of Medicine, University of Southern California, 3551 Trousdale Parkway, Los Angeles, CA, 90089, USA.
Sindhu Mohandas *Division of Infectious Disease, Children's Hospital of Los Angeles, 4650 Sunset Blvd, Los Angeles, CA, 90027, USA. smohandas@chla.usc.edu.

Funding

OTA-21-015A Post-Acute Sequelae of SARS-CoV-2 Infection Initiative: NYU Langone Health Clinical Science Core, Data Resource Core, and PASC Biorepository CoreOT2HL161847 · NHLBI · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI GROSS, RACHEL SHARON, HORWITZ, LEORA · 2021 to 2025
$651.0M
NHLBI NIH HHS OT2 HL161847NIH HHS OT2HL161847
6 · The paper itself

Abstract

backgroundFactors that influence pediatric COVID-19 severity remain incompletely understood, particularly related to the impact of viral and host factors. Understanding the factors contributing to the severity of presentation can impact clinical approaches and management. This study examined the associations between SARS-CoV-2 variants, demographic factors, and COVID-19 severity in a large diverse pediatric population.

methodsWe conducted a retrospective cohort study at a large freestanding Children's Hospital (Children's Hospital Los Angeles) from March 2020 through April 2024 including 14,292 patients aged 0-25 years who tested positive for SARS-CoV-2. Viral variants were determined by whole genome sequencing in 6,939 patients (48.6%). COVID-19 severity was classified as mild, moderate, or severe based on hospitalization requirements and need for respiratory support following the World Health Organization Criteria. Disease severity comparisons were made between different viral variants and demographic factors using multinomial logistic regression.

resultsAmong 14,292 patients, 53.8% were male with median age 5.2 years. Racial/ethnic distribution was 63.0% Hispanic/Latino, 21.4% White, 9.3% African American, and 6.3% Asian. Compared with pre-Omicron variants, Omicron was associated with increased odds of moderate (odds ratio [OR], 2.85; 95% CI, 2.31-3.52; P < 0.001) and severe disease (OR, 3.95; 95% CI, 3.01-5.18; P < 0.001). White patients had lower odds of moderate (OR, 0.81; 95% CI, 0.67-0.98) and severe disease (OR, 0.82; 95% CI, 0.64-1.05) compared with non-White patients. Age-race interactions were significant, with different severity patterns across racial groups as age increased.

conclusionsOur findings suggest that both viral variants and host demographic factors contribute meaningfully to pediatric COVID-19 severity. Understanding these interactions would support a more tailored approach to pediatric COVID-19 that considers the impact of viral variants and host demographic factors.

Indexed as

COVID-19SARS-CoV-2AdolescentAdultChildChild, PreschoolFemaleHumansInfantInfant, NewbornLos AngelesMaleRetrospective StudiesSeverity of Illness IndexYoung AdultCOVID-19 SeverityGenome sequencingHealth disparitiesPatient demographicsPediatricsSARS-CoV-2Viral variants

Identifiers

PMID42469668
PMCPMC13660046

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.