The rate of hospitalization among infants may be increased by the greater need for evaluation in young infants with fever, prematurity, the propensity for very young children to develop viral co-infection, and ineligibility for vaccination, among other factors 24, 17, 19. Similarly, a study of hospitalization rates among children aged 0-17 years found that COVID-19–associated hospitalization rates among children and adolescents during the Omicron period were four times as high as rates during the peak of the Delta period, and children aged 0-4 years experienced the largest increase in hospitalization rates 23. Studies have found that age may also be associated with risk of severe illness, and an evaluation of surveillance data from children aged >7 days and <18 years reported that infants made up a disproportionate number of severe acute COVID-19 cases 22. Studies have found that some underlying medical conditions including obesity diabetes cardiac, lung, and neurologic disorders and medical complexity increase the risk of severe outcomes from COVID-19 17, 18, 19, 20, and having more than one pre-existing comorbidity is associated with an increased risk of severe illness 18, 21. Most children with SARS-CoV-2 infection experience asymptomatic or mild illness, but some children are at risk of developing severe illness, including hospitalization, admission to an ICU, placement on invasive mechanical ventilation, and death 16. Severity and Underlying Medical Conditions Testing for SARS-CoV-2 should be considered, even in children with mild symptoms. The signs and symptoms of COVID-19 in children can be similar to those of other infections and noninfectious processes, making symptom-based screening for identification of SARS-CoV-2 in children particularly challenging 15. Some case studies conducted during high levels of Omicron variant transmission have reported a substantial increase in croup during a decline in the prevalence of all other respiratory viral pathogens known to cause croup 13, 14. The most common symptoms of COVID-19 in children are fever and cough, but many children can experience sore throat, rhinorrhea, headache, fatigue, shortness of breath, or gastrointestinal symptoms, including nausea, vomiting, or diarrhea 9, 10, 11, 12. Studies performed during high levels of Omicron variant transmission reported a median incubation period of 3 - 4 days 7, 8. She also said kids should stay home from school and get tested if they feel sick, or if they had a direct exposure to someone who tests positive for COVID.A study conducted during high levels of Delta variant transmission reported a mean incubation period of 4.3 days, but the mean incubation periods of other variants, including Alpha and Beta, was 5 days 6. She said to limit exposure to COVID in younger people it’s important for everyone who is eligible to get vaccinated, wear a mask, observe social distancing and wash hands frequently. While the vaccination rate in New Jersey is among the highest in the nation, states like Alabama and Mississippi, where more kids are hospitalized, have significantly lower vaccination rates.įisher said the increased number of positive cases in kids is probably due to a combination of the Delta variant being very contagious, and the fact that more testing is being performed in Jersey She said all Garden State hospitals have been told to let the Health Department know how many patients they have and how many empty beds they have that are staffed appropriately for children. “So far the good news is, at least in New Jersey, the children, although they’re getting infected, they’re not getting severe disease,” she said. “We have not seen any kind of surge but just because we haven’t seen it yet doesn’t mean we aren’t planning for it.” She stressed while positive cases are rising, serious illness is still quite rare. Meg Fisher, a pediatric infectious disease expert and advisor to New Jersey Health Commissioner Judith Persichilli, said Delta is highly transmissible and “we do track how many cases by age, and in younger people we are seeing increased incidence of disease."
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