To the Editor: Omicron was identified as the fifth variant of concern with mutations in the receptor-binding domain of spike glycoprotein that accounted for the increased transmission and immune escape rate. Even though COVID is milder in children, those with comorbidity remain at a higher risk. The present cross-sectional study was planned to collate the clinical and demographic profiles of children hospitalized with COVID-19 in the third wave at a dedicated tertiary care COVID center between 5 January and 28 February 2022 after IEC permission. A total of 443 children presenting to the pediatrics emergency requiring hospitalization were screened for COVID-19 infection by rapid antigen test (RAT) or RT-PCR for COVID-19 on a nasal swab and/or throat swab sample. Of 84, 59 (18.9%) COVID-19+ve children required hospitalization and were enrolled after parental consent. The severity of illness was graded as mild, moderate or severe COVID-19 and managed as per the standard guidelines of the Government of India [1].

Most children had a mild COVID infection with associated comorbidities necessitating hospitalization and oxygen support. Ten children (16.94%), including 6 infants, required oxygen support at baseline, and another 11 (18.4%) during hospitalization. Three patients developed MIS-C and were treated with both intravenous immunoglobulin and methylprednisolone. All 3 patients had fever, 2 had diarrhea, and 1 had shock at presentation. Ten (16.9%) patients (5 infants) succumbed to the illness. Seven of these required oxygen support at baseline, and the remaining 3 deteriorated during hospitalization. The cause of death was severe COVID and MIS-C in 1 patient each, and attributed to comorbidities in 8. The hospitalization trends and milder course were similar to other studies reported from South Africa and Spain [2, 3]. Children requiring oxygen support were younger, had lower weight-for-height z scores, higher blood urea levels, and higher leucocyte counts than those not requiring oxygen. However, this difference was not statistically significant.