tetano
Editor, Senior Moderator
Int J Infect Dis
. 2023 Jun 21;S1201-9712(23)00640-9.
doi: 10.1016/j.ijid.2023.06.016. Online ahead of print. Severe coronavirus disease 2019 in pediatric solid organ transplant recipients: Big data convergence study in Korea (K-COV-N cohort)
Ji-Man Kang[SUP] 1 [/SUP], Minsun Kang[SUP] 2 [/SUP], Young-Eun Kim[SUP] 3 [/SUP], Yoonkyung Choi[SUP] 3 [/SUP], Soo Jeong An[SUP] 4 [/SUP], Jaehyun Seong[SUP] 5 [/SUP], Min Jin Go[SUP] 5 [/SUP], Kyungmin Huh[SUP] 6 [/SUP], Jaehun Jung[SUP] 7 [/SUP]
Affiliations
Objectives: The risk of severe COVID-19 in children with a solid organ transplant (SOT) is not well established. We compare the relative risk of severe COVID-19 infection between pediatric SOT and non-SOT children.
Methods: The newly constructed K-COV-N cohort (Korea Disease Control and Prevention Agency-COVID-19-National Health Insurance Service) was used. Children with COVID-19 (<18 years old) who underwent SOT between January 2008-January 2022 were included. Non-SOT children with COVID-19 were selected in a ratio of 1:4 using propensity score matching. Three definitions of severe COVID-19 were established based on their requirement of respiratory support: Severe I (requiring respiratory support above a high-flow nasal cannula or prolonged hospitalization ≥6 days), Severe II (requiring any oxygen supplement), and Severe III (requiring any oxygen supplement or prolonged hospitalization ≥6 days).
Results: Among 2,957,323 children with COVID-19, 206 pediatric SOTRs were identified and included in the analysis along with 803 matched non-SOT children. Most infections (96.6%) occurred during the Omicron period; no cases of mortality were reported. Pediatric SOTR had a 3.6-fold (95% CI=1.1-11.7, P=0.03) higher risk of Severe I, and a 4.9-fold (95% CI=1.6-15.0, P=0.006) higher risk of Severe III than non-SOT children. No cases of Severe II occurred in the non-SOT children. Although not statistically significant, no severe COVID-19 cases were reported in the vaccinated SOT group (0.0% vs 5.7%, P=0.09 in Severe III).
Conclusions: Pediatric SOTRs have a significantly higher risk of severe COVID-19 than non-SOT children. Our findings support the need for tailored strategies for these high-risk children.
Keywords: Korea; children; relative risk; severe COVID-19; solid organ transplant.
. 2023 Jun 21;S1201-9712(23)00640-9.
doi: 10.1016/j.ijid.2023.06.016. Online ahead of print. Severe coronavirus disease 2019 in pediatric solid organ transplant recipients: Big data convergence study in Korea (K-COV-N cohort)
Ji-Man Kang[SUP] 1 [/SUP], Minsun Kang[SUP] 2 [/SUP], Young-Eun Kim[SUP] 3 [/SUP], Yoonkyung Choi[SUP] 3 [/SUP], Soo Jeong An[SUP] 4 [/SUP], Jaehyun Seong[SUP] 5 [/SUP], Min Jin Go[SUP] 5 [/SUP], Kyungmin Huh[SUP] 6 [/SUP], Jaehun Jung[SUP] 7 [/SUP]
Affiliations
- PMID: 37352913
- DOI: 10.1016/j.ijid.2023.06.016
Objectives: The risk of severe COVID-19 in children with a solid organ transplant (SOT) is not well established. We compare the relative risk of severe COVID-19 infection between pediatric SOT and non-SOT children.
Methods: The newly constructed K-COV-N cohort (Korea Disease Control and Prevention Agency-COVID-19-National Health Insurance Service) was used. Children with COVID-19 (<18 years old) who underwent SOT between January 2008-January 2022 were included. Non-SOT children with COVID-19 were selected in a ratio of 1:4 using propensity score matching. Three definitions of severe COVID-19 were established based on their requirement of respiratory support: Severe I (requiring respiratory support above a high-flow nasal cannula or prolonged hospitalization ≥6 days), Severe II (requiring any oxygen supplement), and Severe III (requiring any oxygen supplement or prolonged hospitalization ≥6 days).
Results: Among 2,957,323 children with COVID-19, 206 pediatric SOTRs were identified and included in the analysis along with 803 matched non-SOT children. Most infections (96.6%) occurred during the Omicron period; no cases of mortality were reported. Pediatric SOTR had a 3.6-fold (95% CI=1.1-11.7, P=0.03) higher risk of Severe I, and a 4.9-fold (95% CI=1.6-15.0, P=0.006) higher risk of Severe III than non-SOT children. No cases of Severe II occurred in the non-SOT children. Although not statistically significant, no severe COVID-19 cases were reported in the vaccinated SOT group (0.0% vs 5.7%, P=0.09 in Severe III).
Conclusions: Pediatric SOTRs have a significantly higher risk of severe COVID-19 than non-SOT children. Our findings support the need for tailored strategies for these high-risk children.
Keywords: Korea; children; relative risk; severe COVID-19; solid organ transplant.