Fuyong JIAO1*, Lei MA1, and Karim Elakabawi2
1 Children Hospital of Shaanxi Provincial People’s Hospital, Xi’an, China
2 Cardiology Department, Benha University, Egypt
*Corresponding Author: Fuyong JIAO, Children Hospital of Shaanxi Provincial People’s Hospital, Xi’an, China.
Received: January 10, 2022; Published: July 29, 2022
Citation: Fuyong JIAO., et al. “Global Prevalence and Global Burden of Omicron Infection in Children”. Acta Scientific Paediatrics 5.8 (2022): 28-31.
Children, as a special group, have not yet developed their cellular and humoral immune functions and are vulnerable to viral infection. With the continuous discovery of novel coronavirus variant strains, it is particularly important to strengthen the prevention and treatment of omicron infection in children.
Keywords: Global Prevalence; Global Burden; Omicron Infection; Children.
Omicron variants of spike proteins are characterized by at least 30 amino acid substitutions, three small deletions, and one small insertion. Notably, 15 of the 30 amino acid substituents are in the receptor binding domain (RBD). There are also changes and deletions in other genomic regions. Omicron varieties include the Pango lineage B.1.1.529, ba.1, ba.2, and Ba.3. As of December 23, BA.1 accounted for 99% of the sequence, ba.3 was missing 69-70 in spike protein, while BA.2 was not. Understanding of B.1.1.529 is still developing, but the lineage is more diverse, with 69-70 deletions in about half of all current sequences [1-3].
Available evidence consistently suggests that the Omicron strain has a significant transmission advantage over the Delta strain. In countries and regions where community transmission of the Omicron strain has occurred, it has spread significantly faster than that of the Delta strain, doubling in 2 to 3 days. As described in a WHO technical brief published on 17 December 2021 [4], immune escape following prior infection or vaccination has played an important role in the rapid increase in Omicron cases.
It is not clear whether infection with the Omicron variant is associated with disease severity. Preliminary information from South Africa suggests that Omicron variant infection has no abnormal symptoms and some patients are asymptomatic. Data from earlier studies in South Africa, the United Kingdom and Denmark suggest that the omicron strain causes a lower risk of hospitalization than the Delta strain.
Currently, no data are available to assess the ability of serum neutralization of Omicron variants in vaccinated or previous SARSCOV-2 infected persons. Spike proteins are the main targets of vaccine-induced immunity. The Omicron variant contains more changes in the spike protein than the other variants. Based on the number of substitutions, the location of these substitutions, and data from other variants with similar spike protein substitutions, a significant reduction in serum neutralization activity is expected in vaccinated or previously infected individuals, which may indicate reduced protection against infection. Laboratory and epidemiological studies are therefore needed to assess the impact of Omicron variants on vaccine effectiveness and breakthrough infections, including in individuals receiving booster doses. However, it is expected that COVID-19 vaccination will continue to provide hospitalization and death protection, with vaccines playing a key role in controlling the COVID-19 pandemic.
No virus-specific data are available to assess whether monoclonal antibody therapy will retain efficacy against the Omicron variant. Data on the full spectrum of spike protein changes are needed to understand the impact on therapeutic drugs such as monoclonal antibodies.
On 24 November 2021, a new variant of SARS-COV-2, B.1.1.529, was reported to the World Health Organization (WHO). The new variety was first identified in specimens collected in Botswana on 11 November 2021 and in South Africa on 14 November 2021. On 26 November 2021, WHO named B.1.1.529 Omicron as a “mutant of concern” (VOC). As of 22 December, the Novel Coronavirus variant omicron strain has been detected in 110 countries and regions. The European Union’s health agency, the ECDC, has expressed serious concern that the variant could significantly reduce the effectiveness of coronavirus vaccines and increase the risk of reinfection. However, the exact impact has not been determined. The rapid growth rate of omicron infection is thought to be due to a combination of increased transmissibility and the ability to evade immunity (i.e., immune evasion) conferred by previous infection or vaccination [5]. Data from laboratory and epidemiological investigations suggest that the role of immune evasion is greater than that of increased transmissibility; Immunity conferred by previous infection or vaccination may be reduced compared to delta, but cannot be completely overcome [6,7]. The data also showed that people who received the vaccine or received a booster dose or had a previous infection may have greater protection against Omicron.
The clinical severity of Omicron infection will strongly influence its impact on future hospitalizations and deaths. Early data suggest that Omicron infection may not be as severe as other variants. However, data on clinical severity are still limited. Even if the proportion of infections associated with severe outcomes is lower than in previous variants, the absolute number of severe outcomes is likely to be large, given the likely increase in the number of infections.
Who pointed out in the briefing that as of December 22, novel coronavirus variant Omicron had been detected in 110 countries and regions, all in five continents, and the cumulative number of global cases had exceeded emormously. As of 20 December 2021, omicron has been detected in most states and territories in the United States and is rapidly increasing its proportion of novel Coronavirus pneumonia cases. Omicron is now the dominant strain circulating in the United States, reaching all 50 states and Washington, D.C. As of Monday, the UK had reported 45,145 cases of the omicron strain. Omicron has been recognised as the dominant mutation in the UK. Omicron accounts for 75% of new cases in the US and 20% in the UK. On 28 December, the Israeli Ministry of Health announced that the number of cases of the Omikron strain had reached 1,741. France now has a total of 347 cases of the omicron strain, although medical researchers say the actual number of cases is much higher. Cases of the omicron mutant strain were found in Russia in December, but all of the cases came on flights outside the country and have been quarantined. According to the European Centre for Disease Control and Prevention, 28 countries in the European Union have reported cases of the omicron strain. Omicron is expected to replace Delta as the main variant in some other countries in the European region in early 2022 [8]. In addition to Zimbabwe, omikron cases have been reported in Lesotho, Namibia, Botswana, Kenya, Malawi, democratic Republic of Congo, Rwanda and Mauritius.
The number of omikron infections reported in India has risen to 578 as of Monday. As infections from the omikron variant surge, there are growing calls in India to push ahead with booster shots and vaccinate children. Japan, South Korea and Thailand have all seen local transmission cases of Omikron, and the number of cases is gradually increasing. At present, Cases of omicron infection have been reported in Hong Kong and Taiwan. In Tianjin and Guangdong province of China, the Novel coronavirus strain of omicron variant was detected in recent confirmed COVID-19 cases imported from abroad.
The Omicron variant probably originated in South Africa and was already dominant there. Children with a previously low prevalence of Novel coronavirus pneumonia suddenly become seriously ill and have to be hospitalized. In South Africa, the emergence of the Omikron variant led to a significant increase in the number of young children hospitalized. Scientists and public health officials say it is unclear whether young children are vulnerable to the new variant. The number of novel Coronavirus positive tests in children aged 10 to 14 is also increasing. Twelve children were admitted to a hospital in Soweto, three of them requiring oxygen. At another hospital, 10 children have also been admitted to the Paediatric Novel Coronavirus isolation unit, one of whom required oxygen after being confirmed. However, in South Africa, the tendency for children to become ill after exposure to the presence of Omikron variants is not widespread, and it is unclear whether children are more likely to undergo more severe Omikron treatment. German virologists predict a “euromicron wall” of infections will emerge in the coming weeks without knowing how badly children and adults will be affected. Omicron is a novel coronavirus variant. After infection, the typical clinical symptoms are fever, dry cough and fatigue. Some people may suffer from decreased or loss of smell and taste function, and a small number of people may also suffer from nasal congestion, runny nose, sore throat, vomiting and diarrhea. However, clinical observations have found that patients infected with the Omicron strain usually have mild or no symptoms, with no severe or fatal cases. Researchers at the University of Hong Kong found that the Omicron variant replicates more rapidly (70 times faster) in the human bronchi than the Delta virus variant and the original SARS-COV-2 virus [9]. In contrast, Omicron variants replicate relatively slowly in the lungs. This replication pattern is thought to explain the milder clinical manifestations in patients infected with the Omicron variant. But the nature of the strain remains to be seen. The clinical manifestations of children are not typical, including vomiting, diarrhea and other gastrointestinal symptoms or only poor response, tachypnea, etc.
According to the epidemiological and clinical manifestations, the diagnosis of suspected Novel Coronavirus pneumonia is consistent with that of novel Coronavirus pneumonia. Meanwhile, the novel coronavirus nucleic acid is positive detected by real-time fluorescence RT-PCR, and the virus gene sequencing is highly homologous with the Omicron variant strain. Refer to this guideline for novel Coronavirus diagnostic tests and the use of antigen tests [10]. The diagnostic accuracy of conventional PCR and antigenbased rapid diagnostic tests (AG-RDT) did not appear to be affected by Omicron; The relative sensitivity of AG-RDT is being studied. Most Omicron variants have been reported to include deletion of the S gene, which may result in S target gene failure (SGTF) in some PCR assays. Therefore, this S gene target deletion (SGTF) can be a marker of Omicron. However, at least one subset of the sample needs to be sequenced for confirmation, as this deletion is present in other variants (such as subsets of Alpha and Gamma and Delta).
Depending on the genetic changes in Omicron, some treatments may still be effective, while others may Poor results. But the vaccine, mask, and test trilogy remain our three weapons against Omicron.
The use of appropriate masks, social distancing, indoor ventilation, avoidance of clusters and hand hygiene remain key to reducing the transmission of the Novel Coronavirus, even in cases of mutation.
Vaccines remain the best public health measure to protect populations from Corona Virus Disease 2019 (COVID-19), slow transmission and reduce the likelihood of new mutations.
COVID-19 vaccines are highly effective in preventing serious illness, hospitalizations and reducing mortality; The United States Centers for Disease Control and Prevention. The CDC recommends that everyone age 5 and older protect themselves against COVID-19 by getting a full vaccination. So far, Delta remains the main vaccine variant that is very effective, and the vaccine may have some efficacy against Omicron [4], especially in preventing serious complications and reducing mortality.
Masks protect against all Novel Coronavirus variants. CDC recommends that masks continue to be worn in public indoor Settings in areas of high or high community transmission, regardless of vaccination status; The CDC advises people on things like mask types.
Tests can confirm COVID-19. Two types of tests can be used to test for present infections: nucleic acid amplification test (NAAT) and antigen test; Individuals can use COVID-19 virus testing tools to determine specific types of testing, such as additional tests to determine if the infection was caused by Omicron; Self-testing can be done at home or anywhere, is easy to use and produces results quickly. The Institute of Virology, China CDC has established a specific nucleic acid test for the Omicron variant strain and continues to conduct genome surveillance for possible imported cases. Effective measures that individuals are advised to take to prevent infection include staying at least 1 meter away in public places, wearing a mask, opening Windows for ventilation, keeping hands clean, coughing or sneezing into elbows or tissues, getting vaccinated, and avoiding poorly ventilated or crowded places.
Rest in bed, strengthen supportive treatment, ensure adequate calories. To maintain the stability of the internal environment, that is, to maintain the balance of water and electrolyte, to maintain the balance of intestinal microecology. Intensive psychotherapy for older children.
There are currently no effective antiviral drugs for children. Aerosol inhalation of recombinant human interferon α -2B can be tried. The efficacy and safety of oral lopinavir, ritonavir tablets or intravenous infusion of ribavirin are unknown, and should be used with caution according to the condition and the balance of advantages and disadvantages.
If there is evidence of secondary bacterial infection, antibiotics should be used in time.
Domestic guidelines recommend oxygen inhalation, mechanical ventilation and other respiratory support and circulation support, anticoagulant therapy, blood purification, ECMO, and the use of glucocorticoid or gamma globulin when necessary. Children’s cardiopulmonary compensation ability is weaker than adults, more sensitive to hypoxia, oxygen therapy and mechanical ventilation indications should be appropriately relaxed; Routine use of lung extension is not recommended for children with severe and critical cases. Data on the severity of the condition, including hospitalization, the need for oxygen, mechanical ventilation or death, remain limited. Interleukin-6 blockers and corticosteroids are expected to remain effective in the management of severe and critically ill patients because they reduce the host’s inflammatory response to the virus. Preliminary in vitro data from abroad suggest that some monoclonal antibodies developed for novel Coronavirus may reduce the neutralization of Omicron.
Tianjin released the TCM Prevention and Treatment Plan for COVID-19 (Trial Version 5), which provides TCM prevention and treatment plans for close contacts, treatment of asymptomatic infected persons, treatment of confirmed cases, and rehabilitation of confirmed cases during recovery for clinical reference.
Close contact prevention program Children’s prescription: Qingqing children’s drink.
Xuanfei Baidu granule, Lianhua Qingwen capsule (granule), etc.
The overall risk associated with the new Omicron variant therefore remains very high for a number of reasons. First, the global risk of COVID-19 remains high, and second, Omicron is spreading faster in communities than Delta, which could lead to a further surge of cases with serious consequences. Our understanding of Omicron is still evolving. At present, novel Coronavirus pneumonia has become a major new infectious disease in the world. Novel Coronavirus continues to mutate, and the newly discovered Omicron strain poses a great challenge to the public health system in all countries. Due to the unique physiological characteristics of children, the whole body system is in dynamic change, the development of cellular immunity and humoral immunity is not perfect, vulnerable to pathogen infection, more attention should be paid to strengthen the prevention and treatment of children omicron infection. Therefore, families, schools and society must work together to cope with the unknown challenges and jointly meet the beautiful future of mankind [11]. Prevention of novel coronavirus variants remains a long and arduous task.
Copyright: © 2022 Fuyong JIAO., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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