A community-based cross-sectional survey of young children with SARS-CoV-2 infection during the Omicron wave in Beijing, China.

OBJECTIVES

SARS-CoV-2 infections in young children are predominantly transmitted through family clusters and typically present with mild symptoms. Most affected children receive healthcare at home or within community healthcare centres. Previous studies from China on the clinical features of infected children have mostly focused on hospitalised cases. In this study, we aimed to investigate the clinical characteristics of these infected children aged 0-6 years old in the community during the Omicron wave in Beijing.

DESIGN

In this community-based survey, we recruited the families with young children aged 0-6 years. Data from these children were reported by their caregivers. Collected data included demographics, family cluster features, symptom burden, breastfeeding practices, immunisation status and treatments received. We analysed the prevalence of symptoms across different age groups and compared clinical features between vaccinated and unvaccinated children aged over 3 years.

SETTING

The community survey was conducted in the Qingta community of Beijing from 7 January to 22 January 2023.

PARTICIPANTS

Participants were a subsample of the Family Nurturance Practices Cohort Study (Qingta community, Beijing, n=2521). Totally, 1492 children aged 0-6 years were reported by their caregivers, and 1464 of these children were included in this study.

RESULTS

In the study, 145 infants (9.9%), 407 toddlers (27.8%) and 912 preschoolers (62.3%) were included, respectively. Compared with preschoolers, more infants and toddlers presented with high-grade fever, gastrointestinal manifestations (diarrhoea or constipation, loss of appetite and vomiting), rash, fatigue, irritability and sleeping problems (p<0.05). 51% of the breastfeeding mothers (73/143) experienced decreased breast milk secretion. Among them, 75.4% (55/73) reported over 50% decrease in breast milk secretion. More children in the unvaccinated group suffered from high-grade fever, cough, decreased appetite and sleep problems than those in the vaccinated group (p<0.05).

CONCLUSION

During this wave, most young children were affected in family clusters and exhibited mild symptoms. Younger children experienced more symptom burdens and breastfeeding problems in the community. For children over 3 years old, vaccination appeared to reduce symptom severity. These findings suggest the heterogeneity in symptoms across age groups, and the temporary decline in breastfeeding mothers' lactation should be considered in community healthcare for young children with SARS-CoV-2 Omicron infection.