Here’s What Experts are Seeing in Kids During the Omicron Wave

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  • In recent weeks, COVID-19 cases in children have increased by 64 percent.
  • But a large percentage of hospitalized children are being treated for other health conditions and are incidentally testing positive upon routine COVID-19 testing. 
  • Experts recommend getting kids vaccinated if they are old enough and masking and social distancing for kids too young to be vaccinated.

A record number of children have recently been hospitalized with COVID-19 in recent weeks as the Omicron variant has spread.

COVID-19 cases in children have recently increased by 64 percent.

But looking closer at the data, health officials note that many of these kids are not in the hospital because of COVID-19. Many hospitalized children are being treated for other health conditions — including broken bones and conditions such as appendicitis — and are incidentally testing positive upon routine COVID-19 testing. 

This has likely caused hospitals to overcount the number of pediatric COVID-19 hospitalizations, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, announced last week.

Still, coronavirus cases are increasing among children. While severe illness from COVID-19 in children remains rare — even with Omicron — the rapid and significant increase in cases alarms pediatricians as more cases will inevitably lead to more hospitalizations.

“Some factors that could be contributing include increased transmissibility of the Omicron variant; more COVID testing available and being performed, including home testing; and more people indoors due to cooler weather,” Dr. Zachary Hoy, a pediatric infectious disease specialist at Nashville Pediatric Infectious Disease in Tennessee, told Healthline. 

How does this wave compare to previous waves?

Dr. John McGuire, chief of the Division of Pediatrics Critical Care Medicine at Seattle Children’s Hospital, says his hospital has seen a steep increase in patients in the COVID-19 special isolation unit. Still, the current wave appears no more severe than previous waves. 

“Our SIU patient volumes are in line with previous highs, and COVID patients still comprise a small proportion of all total inpatients we’re seeing,” McGuire said. 

Many of the kids who test positive for COVID-19 in the hospital were not admitted for the disease but rather for other health issues, McGuire said. They incidentally tested positive during routine screening. 

McGuire says the severity of COVID-19 illness at Seattle Children’s Hospital appears to be lower than what was seen with the Delta variant. 

The vast majority of COVID-19 cases right now are believed to be caused by Omicron. Omicron is thought to cause milder illness than previous variants like Delta. Still, it is more contagious and therefore infects more people, says Dr. Magna Dias, a pediatric hospitalist with Yale Medicine.

Though a smaller percentage of kids who contract Omicron may end up hospitalized, the sheer volume of cases has resulted in more kids being hospitalized. 

“There are a lot more kids that are infected right now, and so even though less percent are getting admitted, we have more admitted patients who are sick,” Dias said. 

Children’s Hospital of Philadelphia is experiencing a significant increase in COVID-19 patient admissions.

“Our COVID admissions include both patients who are positive for COVID infection as well as those who are hospitalized for a different reason and happen to have an exposure to COVID,” says Sara Townsend, infection prevention and control manager at Children’s Hospital of Philadelphia. 

The recent increase in pediatric hospitalizations at CHOP outpaces what they typically see this time of year. 

How are children hospitalized for COVID-19 treated?

Dias says many children hospitalized for COVID-19 are experiencing croup-like symptoms, bronchiolitis, and dehydration. 

“For patients that are hospitalized, some need just IV fluids for dehydration,” says Dias, noting this is more common with babies. 

Other children with COVID-19 have trouble breathing and require oxygen, steroids, or the antiviral remdesivir. 

“Most do very well and go home in a few days. Unfortunately, some go to the ICU. But we have been fortunate to not have any deaths thus far. We have excellent protocols, and kids are resilient,” Dias said. 

What is the main takeaway for parents and kids?

The general message is most kids can get sick with COVID-19 and recover quickly, Dias said.

Most kids will remain asymptomatic or develop only mild symptoms, and those who are hospitalized do well. 

In general, younger children tend to fare better, according to Hoy.

“Children under 5 have fewer complications from COVID and are not hospitalized as often as older children or teenagers,” Hoy said. 

Still, a small percentage of children who develop COVID-19 will have trouble breathing or develop signs of dehydration. 

“It’s not just a cold,” Dias said. 

Because case numbers are so high now, Dias recommends families follow safety protocols that can help limit the spread of COVID-19. 

Mask in crowded settings, minimize exposure to high-risk environments, and obtain testing for symptomatic children, McGuire advised. 

If your children are sick, even with a cold, do not send them to school or day care, as this could allow the virus to spread even more. 

Pediatric infectious diseases specialists also strongly advise parents to get their eligible children vaccinated. 

Only 22 percent of kids ages 5 to 11 are vaccinated. 

“We have seen very few hospitalizations for COVID-19 in vaccinated children. Vaccination appears to be highly protective against severe COVID-19 disease in all age groups, including children, and is highly recommended for eligible age groups,” McGuire said. 

The bottom line:

A record number of children have recently been hospitalized with COVID-19. Still, health officials say many of these kids are not in the hospital because of COVID-19 but instead incidentally tested positive when admitted for other health issues. Still, due to the sheer volume of pediatric COVID-19 cases right now, children’s hospitals across the country are seeing an increase in kids being hospitalized for COVID-19. Severe illness in kids remains rare, and even hospitalized kids tend to recover well. Still, others require intravenous fluids, steroids, and antivirals. Doctors recommend that families mask up, avoid crowded spaces, and get all eligible kids vaccinated. 

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