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Impact of Variants, Epidemiological Trends, and Comorbidities on Hospitalization Rates of Unvaccinated Children in Brazil: A Retrospective Study (2020-2022)
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  • DANIELLE DIAS CONTE,
  • Rai Watanabe Silva,
  • Ana Cunha Chaves,
  • Felipe Lei,
  • Ana Perosa,
  • Gabriela Barbosa,
  • Nancy Cristina Bellei
DANIELLE DIAS CONTE
Universidade Federal de Sao Paulo

Corresponding Author:daniellediasconte@gmail.com

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Rai Watanabe Silva
Universidade Federal de Sao Paulo
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Ana Cunha Chaves
Universidade Federal de Sao Paulo
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Felipe Lei
Universidade Federal de Sao Paulo
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Ana Perosa
Sao Paulo Federal University
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Gabriela Barbosa
Universidade Federal de São Paulo
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Nancy Cristina Bellei
Federal University of São Paulo
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Abstract

This retrospective study aimed to investigate the impact of the emergence of new variants and the epidemiological scenario on hospitalization rates of unvaccinated children (0-12 years) in Brazil. The study included 1,614 children admitted to a hospital between March 2020 and December 2022, with only 101 (6.3%) of them testing positive for COVID-19 via RT-PCR. The frequency of COVID-19 cases increased from 7.5% in 2020 to 9.3% in 2022 with the emergence of the Omicron variant. Children over five years old with comorbidities accounted for the majority of cases (69% [70/101]). Sickle cell anemia was the most frequent comorbidity (20%), and flu disease (36% [36/101]) and decompensation of underlying disease (33% [33/101]) were the main reasons for hospitalization. Co-infection was detected in 11% of cases, with RSV being the most common viral pathogen (71%). Hospital readmission occurred in 26% of cases, with a higher frequency in children over five years old. The death rate was 2.2%, with comorbidities such as cystic fibrosis and congenital heart disease as risk factors. These findings emphasize the need to prioritize vaccination with monovalent Omicron XBB for high-risk groups, including children over five years old with comorbidities, to mitigate the impact of new variants and reduce severe disease outcomes.
29 Sep 2023Submitted to Influenza and other respiratory viruses
30 Sep 2023Submission Checks Completed
30 Sep 2023Assigned to Editor
20 Nov 2023Reviewer(s) Assigned
10 May 20241st Revision Received
20 May 2024Submission Checks Completed
20 May 2024Assigned to Editor
17 Jun 2024Review(s) Completed, Editorial Evaluation Pending
20 Jun 2024Editorial Decision: Revise Major
14 Aug 20242nd Revision Received
19 Aug 2024Submission Checks Completed
19 Aug 2024Assigned to Editor
30 Aug 2024Reviewer(s) Assigned
30 Aug 2024Review(s) Completed, Editorial Evaluation Pending
05 Sep 2024Editorial Decision: Accept