I hope everyone had a happy holiday weekend– Juneteenth, Father’s Day, and Summer Solstice!

Question: Is the Alpha variant more dangerous for children?

Answer:  Accumulating evidence indicates that the Alpha variant (B.1.1.7) does not result in more severe disease outcomes among children as compared with the original variant.  Basically, because Alpha is more transmissible, children may be more likely to get infected and transmit the virus to others, but accumulating evidence indicates that infection with Alpha is no more dangerous to children than infection with the original variant.  Note: Alpha is more dangerous for adults!  Read on for details.

We know that Alpha variant (B.1.1.7) is ~50% more transmissible than the original variant.  We also know that it is associated with more severe outcomes among adults.  Previous research indicates that B.1.1.7 infection does not result in more severe disease among children.  These initial findings have been further corroborated by a paper published last week in BMJ, Risk of hospital admission for patients with SARS-CoV-2 variant B.1.1.7: cohort analysis.  Following a group of 839,278 patients diagnosed with COVID-19 between late-November 2020 and late-January 2021, the study authors identify: who was infected with Alpha vs. non-Alpha; who was admitted to the hospital; and whether hospital admissions differed by variant type, adjusting for other background factors.  Researchers found that risk of hospital admission* was higher if an individual was infected with Alpha– adjusted hazard ratio of hospital admission was 1.52 (95% confidence interval 1.47 to 1.57).  They found that this risk was modified by age– people younger than 20 years old had no increased risk of hospitalization, people ages 20-29 had some increased risk, and people ages 30+ had the highest increased risk (Figure 1).  This study indicates that Alpha variant does not result in more severe outcomes among children and adolescents.  Note: “The adjusted absolute risk of hospital admission within 14 days was 4.7% (95% confidence interval 4.6% to 4.7%) for patients with SGTF variants [Alpha] and 3.5% (3.4% to 3.5%) for those with non-SGTF variants.”    

Figure 1. Risk of hospital admission by age and variant type (from BMJ)