tetano
Editor, Senior Moderator
Am J Trop Med Hyg
. 2021 Jun 15;tpmd210299.
doi: 10.4269/ajtmh.21-0299. Online ahead of print.
Comparative Analysis of Pediatric COVID-19 Infection in Southeast Asia, South Asia, Japan, and China
Judith Ju Ming Wong[SUP] 1 2 3 [/SUP], Qalab Abbas[SUP] 4 [/SUP], Soo Lin Chuah[SUP] 5 [/SUP], Ririe Fachrina Malisie[SUP] 6 [/SUP], Kah Min Pon[SUP] 7 [/SUP], Tomohiro Katsuta[SUP] 8 [/SUP], Hongxing Dang[SUP] 9 [/SUP], Pei Chuen Lee[SUP] 10 [/SUP], Muralidharan Jayashree[SUP] 11 [/SUP], Rehena Sultana[SUP] 12 [/SUP], Quratulain Maha[SUP] 13 [/SUP], Chin Seng Gan[SUP] 5 [/SUP], Naoki Shimizu[SUP] 14 [/SUP], Feng Xu[SUP] 9 [/SUP], Swee Fong Tang[SUP] 10 [/SUP], Luming Shi[SUP] 2 15 [/SUP], Jan Hau Lee[SUP] 1 2 3 [/SUP], Koh Cheng Thoon[SUP] 2 16 [/SUP], Chee Fu Yung[SUP] 2 16 17 [/SUP], PACCOVRA Investigators of the PACCMAN Research Group
Affiliations
Abstract
There is a scarcity of data regarding coronavirus disease 2019 (COVID-19) infection in children from southeast and south Asia. This study aims to identify risk factors for severe COVID-19 disease among children in the region. This is an observational study of children with COVID-19 infection in hospitals contributing data to the Pediatric Acute and Critical Care COVID-19 Registry of Asia. Laboratory-confirmed COVID-19 cases were included in this registry. The primary outcome was severity of COVID-19 infection as defined by the World Health Organization (WHO) (mild, moderate, severe, or critical). Epidemiology, clinical and laboratory features, and outcomes of children with COVID-19 are described. Univariate and multivariable logistic regression models were used to identify risk factors for severe/critical disease. A total of 260 COVID-19 cases from eight hospitals across seven countries (China, Japan, Singapore, Malaysia, Indonesia, India, and Pakistan) were included. The common clinical manifestations were similar across countries: fever (64%), cough (39%), and coryza (23%). Approximately 40% of children were asymptomatic, and overall mortality was 2.3%, with all deaths reported from India and Pakistan. Using the multivariable model, the infant age group, presence of comorbidities, and cough on presentation were associated with severe/critical COVID-19. This epidemiological study of pediatric COVID-19 infection demonstrated similar clinical presentations of COVID-19 in children across Asia. Risk factors for severe disease in children were age younger than 12 months, presence of comorbidities, and cough at presentation. Further studies are needed to determine whether differences in mortality are the result of genetic factors, cultural practices, or environmental exposures.
. 2021 Jun 15;tpmd210299.
doi: 10.4269/ajtmh.21-0299. Online ahead of print.
Comparative Analysis of Pediatric COVID-19 Infection in Southeast Asia, South Asia, Japan, and China
Judith Ju Ming Wong[SUP] 1 2 3 [/SUP], Qalab Abbas[SUP] 4 [/SUP], Soo Lin Chuah[SUP] 5 [/SUP], Ririe Fachrina Malisie[SUP] 6 [/SUP], Kah Min Pon[SUP] 7 [/SUP], Tomohiro Katsuta[SUP] 8 [/SUP], Hongxing Dang[SUP] 9 [/SUP], Pei Chuen Lee[SUP] 10 [/SUP], Muralidharan Jayashree[SUP] 11 [/SUP], Rehena Sultana[SUP] 12 [/SUP], Quratulain Maha[SUP] 13 [/SUP], Chin Seng Gan[SUP] 5 [/SUP], Naoki Shimizu[SUP] 14 [/SUP], Feng Xu[SUP] 9 [/SUP], Swee Fong Tang[SUP] 10 [/SUP], Luming Shi[SUP] 2 15 [/SUP], Jan Hau Lee[SUP] 1 2 3 [/SUP], Koh Cheng Thoon[SUP] 2 16 [/SUP], Chee Fu Yung[SUP] 2 16 17 [/SUP], PACCOVRA Investigators of the PACCMAN Research Group
Affiliations
- PMID: 34129517
- DOI: 10.4269/ajtmh.21-0299
Abstract
There is a scarcity of data regarding coronavirus disease 2019 (COVID-19) infection in children from southeast and south Asia. This study aims to identify risk factors for severe COVID-19 disease among children in the region. This is an observational study of children with COVID-19 infection in hospitals contributing data to the Pediatric Acute and Critical Care COVID-19 Registry of Asia. Laboratory-confirmed COVID-19 cases were included in this registry. The primary outcome was severity of COVID-19 infection as defined by the World Health Organization (WHO) (mild, moderate, severe, or critical). Epidemiology, clinical and laboratory features, and outcomes of children with COVID-19 are described. Univariate and multivariable logistic regression models were used to identify risk factors for severe/critical disease. A total of 260 COVID-19 cases from eight hospitals across seven countries (China, Japan, Singapore, Malaysia, Indonesia, India, and Pakistan) were included. The common clinical manifestations were similar across countries: fever (64%), cough (39%), and coryza (23%). Approximately 40% of children were asymptomatic, and overall mortality was 2.3%, with all deaths reported from India and Pakistan. Using the multivariable model, the infant age group, presence of comorbidities, and cough on presentation were associated with severe/critical COVID-19. This epidemiological study of pediatric COVID-19 infection demonstrated similar clinical presentations of COVID-19 in children across Asia. Risk factors for severe disease in children were age younger than 12 months, presence of comorbidities, and cough at presentation. Further studies are needed to determine whether differences in mortality are the result of genetic factors, cultural practices, or environmental exposures.