tetano
Editor, Senior Moderator
Clin Infect Dis
. 2020 Nov 10;ciaa1666.
doi: 10.1093/cid/ciaa1666. Online ahead of print.
Clinical experience with SARS CoV-2 related illness in children - hospital experience in Cape Town, South Africa
Marieke M van der Zalm[SUP] 1 [/SUP], Juanita Lishman[SUP] 2 [/SUP], Lilly M Verhagen[SUP] 2 3 [/SUP], Andrew Redfern[SUP] 2 [/SUP], Liezl Smit[SUP] 2 [/SUP], Mikhail Barday[SUP] 2 [/SUP], Dries Ruttens[SUP] 2 4 [/SUP], A'ishah da Costa[SUP] 2 [/SUP], Sandra van Jaarsveld[SUP] 2 [/SUP], Justina Itana[SUP] 2 [/SUP], Neshaad Schrueder[SUP] 5 [/SUP], Marije Van Schalkwyk[SUP] 6 [/SUP], Noor Parker[SUP] 2 [/SUP], Ilse Appel[SUP] 2 [/SUP], Barend Fourie[SUP] 2 [/SUP], Mathilda Claassen[SUP] 7 [/SUP], Jessica J Workman[SUP] 1 [/SUP], Pierre Goussard[SUP] 2 [/SUP], Gert Van Zyl[SUP] 7 [/SUP], Helena Rabie[SUP] 2 [/SUP]
Affiliations
Abstract
Background: Children seem relatively protected from serious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) related disease, but little is known about children living in settings with high tuberculosis and HIV burden. This study reflects clinical data on South African children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Methods: We collected clinical data of children aged younger than 13 years with laboratory confirmed SARS-CoV-2 presenting to Tygerberg Hospital, Cape Town between 17th of April and 24th of July 2020.
Results: Hundred and fifty-nine children (median age 48?0 months (interquartile range, IQR 12?0-106?0)) were included. Hospitalized children (n=62), median age of 13?5 months (IQR 1?8-43?5) were younger than children not admitted (n=97), median age 81?0 months (IQR 34?5-120?5, p< 0?01). Thirty-three of 159 (20?8%) children had pre-existing medical conditions. Fifty-one of 62 (82?3%) hospitalized children were symptomatic; lower respiratory tract infection was diagnosed in 21/51 (41?2%) and 11/16 (68?8%) children younger than 3 months of age. Respiratory support was required in 25/51 (49?0%) children; 13/25 (52?0%) children were younger than 3 months. One child was HIV infected and 11/51 (21?2%) were HIV exposed uninfected and 7/51 (13?7%) children had a recent or new diagnosis of tuberculosis.
Conclusion: Children less than 1 year of age hospitalized with SARS-CoV-2 in Cape Town frequently required respiratory support, the access to oxygen may be limited in some LMICs which could potentially drive morbidity and mortality. HIV infection was uncommon but a relationship between HIV exposure, tuberculosis and SARS-CoV-2 should be explored.
Keywords: COVID-19; Children; MIS-C; Sub-Saharan Africa; respiratory virus infections.
. 2020 Nov 10;ciaa1666.
doi: 10.1093/cid/ciaa1666. Online ahead of print.
Clinical experience with SARS CoV-2 related illness in children - hospital experience in Cape Town, South Africa
Marieke M van der Zalm[SUP] 1 [/SUP], Juanita Lishman[SUP] 2 [/SUP], Lilly M Verhagen[SUP] 2 3 [/SUP], Andrew Redfern[SUP] 2 [/SUP], Liezl Smit[SUP] 2 [/SUP], Mikhail Barday[SUP] 2 [/SUP], Dries Ruttens[SUP] 2 4 [/SUP], A'ishah da Costa[SUP] 2 [/SUP], Sandra van Jaarsveld[SUP] 2 [/SUP], Justina Itana[SUP] 2 [/SUP], Neshaad Schrueder[SUP] 5 [/SUP], Marije Van Schalkwyk[SUP] 6 [/SUP], Noor Parker[SUP] 2 [/SUP], Ilse Appel[SUP] 2 [/SUP], Barend Fourie[SUP] 2 [/SUP], Mathilda Claassen[SUP] 7 [/SUP], Jessica J Workman[SUP] 1 [/SUP], Pierre Goussard[SUP] 2 [/SUP], Gert Van Zyl[SUP] 7 [/SUP], Helena Rabie[SUP] 2 [/SUP]
Affiliations
- PMID: 33170927
- DOI: 10.1093/cid/ciaa1666
Abstract
Background: Children seem relatively protected from serious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) related disease, but little is known about children living in settings with high tuberculosis and HIV burden. This study reflects clinical data on South African children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Methods: We collected clinical data of children aged younger than 13 years with laboratory confirmed SARS-CoV-2 presenting to Tygerberg Hospital, Cape Town between 17th of April and 24th of July 2020.
Results: Hundred and fifty-nine children (median age 48?0 months (interquartile range, IQR 12?0-106?0)) were included. Hospitalized children (n=62), median age of 13?5 months (IQR 1?8-43?5) were younger than children not admitted (n=97), median age 81?0 months (IQR 34?5-120?5, p< 0?01). Thirty-three of 159 (20?8%) children had pre-existing medical conditions. Fifty-one of 62 (82?3%) hospitalized children were symptomatic; lower respiratory tract infection was diagnosed in 21/51 (41?2%) and 11/16 (68?8%) children younger than 3 months of age. Respiratory support was required in 25/51 (49?0%) children; 13/25 (52?0%) children were younger than 3 months. One child was HIV infected and 11/51 (21?2%) were HIV exposed uninfected and 7/51 (13?7%) children had a recent or new diagnosis of tuberculosis.
Conclusion: Children less than 1 year of age hospitalized with SARS-CoV-2 in Cape Town frequently required respiratory support, the access to oxygen may be limited in some LMICs which could potentially drive morbidity and mortality. HIV infection was uncommon but a relationship between HIV exposure, tuberculosis and SARS-CoV-2 should be explored.
Keywords: COVID-19; Children; MIS-C; Sub-Saharan Africa; respiratory virus infections.