‘Cicada’ variant and children: What pediatric hospitals are seeing

While early research suggests the “Cicada” SARS-CoV-2 variant may infect children more easily than adults, children’s hospitals do not appear to be experiencing significant surges in cases or admissions.

An analysis of data from New York City shows children are about five times more likely to contract BA.3.2 compared to other strains. Separate research from South Africa suggests the variant is most effective at infecting children between ages 3 and 15.

Experts have offered several possible theories to explain this trend. Children’s immune protection from prior infections and vaccines may fade more quickly than adults’, or the variant’s genetic makeup may make it better suited to infect younger immune systems. Another possible explanation is that children may simply have had fewer total exposures to COVID-19 over the course of the pandemic, leaving them with less immunity.

Four things to know:

1. Karen Acker, MD, a pediatric infectious disease specialist at NewYork-Presbyterian Komansky Children’s Hospital of New York, said evidence of children’s heightened COVID-19 risk is still limited.

“Thus far, this variant appears to be more prevalent in children than adults, but it is unclear if children are truly more susceptible than adults,” she told NewYork-Presbyterian’s Health Matters.

2. Dr. Acker said the New York City-based hospital is seeing a small uptick in COVID-19 cases, but children are not being hospitalized with severe infections. Citywide COVID-19 data helps explain this trend. While children ages 4 and under accounted for the highest proportion of emergency department visits among all age groups, they still represented only 0.76% of all visits in the week ending April 11. This figure is up slightly from 0.62% in January.

3. Meanwhile, Nationwide Children’s Hospital in Columbus, Ohio, told Becker’s on April 17 that it is not experiencing an increase in COVID-19 cases or hospitalizations.

4. Twenty-five states have found the variant in wastewater samples as of mid-February. While the variant has significant spike protein mutations that help it evade antibodies, it has not become dominant globally or rapidly overtaken other strains in countries where it has been detected. “Whether or not it will go on to become very dominant here remains to be seen. I think we have some evidence to suggest it might not,” Ericka Hayes, MD, senior medical director of infection prevention at Children’s Hospital of Philadelphia, told KYW News Radio.

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