SARS-CoV-2 Variants of Concern and Clinical Severity in the Mexican Pediatric Population

Anahí Maldonado-Cabrera, Jesus Alejandro Colin-Vilchis, Ubydul Haque, Carlos Velazquez, Andrea Socorro Alvarez Villaseñor, Luis Eduardo Magdaleno-Márquez, Carlos Iván Calleros-Muñoz, Karen Fernanda Figueroa-Enríquez, Aracely Angulo-Molina*, Ana Lucía Gallego-Hernández*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


The emergence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) variants of concern (VOCs) presents global heterogeneity, and their relative effect on pediatric severity is still limited. In this study, we associate VOCs with pediatric clinical severity outcomes in Mexico. Bioinformatics methods were used to characterize VOCs and single amino acid (aa) mutations in 75,348 SARS-CoV-2 genetic sequences from February 2020 to October 2022. High-predominance VOCs groups were calculated and subsequently associated with 372,989 COVID-19 clinical pediatric outcomes. We identified 21 high-frequency mutations related to Omicron lineages with an increased prevalence in pediatric sequences compared to adults. Alpha and the other lineages had a significant increase in case fatality rate (CFR), intensive critical unit (ICU) admission, and automated mechanical ventilation (AMV). Furthermore, a logistic model with age-adjusted variables estimated an increased risk of hospitalization, ICU/AMV, and death in Gamma and Alpha, in contrast to the other lineages. We found that, regardless of the VOCs lineage, infant patients presented the worst severity prognoses. Our findings improve the understanding of the impact of VOCs on pediatric patients across time, regions, and clinical outcomes. Enhanced understanding of the pediatric severity for VOCs would enable the development and improvement of public health strategies worldwide.

Original languageEnglish
Pages (from-to)535-548
Number of pages14
JournalInfectious Disease Reports
Issue number5
StatePublished - Oct 2023

Bibliographical note

Publisher Copyright:
© 2023 by the authors.


  • COVID-19
  • children
  • hospitalization
  • mortality
  • pediatrics
  • severity


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