Clinical epidemiology of paediatric COVID-19 Delta variant cases from North Sumatra, Indonesia

EOCRU Principal Investigator: Dr Anuraj Shankar
Partner PIs: Dr. Tryna Tania (Murni Teguh Memorial Hospital, Medan, North Sumatra, Indonesia); Dr. Ariel Pradipta (GSI Laboratory, Jakarta, Indonesia)
Collaborators: R Lia Kusumawati (University of North Sumatera, Medan, North Sumatra, Indonesia), Inke Nadia Diniyanti Lubis (Murni Teguh Memorial Hospital, Medan, North Sumatra, Indonesia); Meutia A Kumaheri (GSI Laboratory, Jakarta, Indonesia)
Location of activity: Medan

Background
The impact of SARS-CoV-2 and it variants remains poorly understood. Moreover, few studies had reported on the presence, or the clinical relevance, of the Delta variant in children from a low- and middle-income country (LMIC).

Objective
To examine the emergence and clinical impact and epidemiology of the Delta variant in paediatric COVID-19 patients from North Sumatra, Indonesia.

Importance
We tracked the Delta variant among paediatric cases in North Sumatra, Indonesia, from June-July 2021. Whole-genome sequences (WGS) from 18 new COVID-19 paediatric patients showed that 6 were B.1.459 and 6 were B.1.466.2, known variants in Indonesia in Clade 20A. Six were the Delta variant B.1.617.2 of Clade 21A, with 5 on one branch, and one on a distant branch consistent with that patient’s geographic separation, suggesting at least two introductions to the region. Variants tended to be spatially clustered, and four children with Delta variant had an adult infected household member, all of whom had lower real-time polymerase chain reaction (RT-PCR) cycle threshold (Ct) values compared to the child. No temporal trends were observed for Ct. These data support a paradigm shift with children being highly susceptible to the Delta variant and a priority for vaccination.

Outputs to date:
Kusumawati, R. Lia and Lubis, Inke Nadia Diniyanti and Kumaheri, Meutia Ayuputeri and Pradipta, Ariel and Faksri, Kiatichai and Mutiara, Mutiara and Shankar, Anuraj H. and Tania, Tryna, Clinical Epidemiology of Paediatric COVID-19 Delta Variant Cases from North Sumatra, Indonesia. Available at SSRN: https://ssrn.com/abstract=3935668 or http://dx.doi.org/10.2139/ssrn.3935668