tetano
Editor, Senior Moderator
Rheumatology (Oxford)
. 2021 Oct 2;keab730.
doi: 10.1093/rheumatology/keab730. Online ahead of print.
Seroprevalence and Clinical Outcomes of SARS-CoV-2 in Paediatric Patients with Rheumatic Disease
Heather M Walters[SUP] 1 2 [/SUP], Zanab Mian[SUP] 1 2 [/SUP], Lydia Thomas[SUP] 1 2 [/SUP], Jane Cerise[SUP] 2 3 [/SUP], B Anne Eberhard[SUP] 1 2 [/SUP], Eileen Pagano[SUP] 1 2 [/SUP], Beth S Gottlieb[SUP] 1 2 [/SUP], Katherine Steigerwald[SUP] 1 2 [/SUP], Joyce S Hui-Yuen[SUP] 1 2 4 [/SUP]
Affiliations
Abstract
Objectives: Immunosuppressed paediatric patients with rheumatic disease (RD) may be at risk for severe or critical disease related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Data remain scarce on COVID-19 outcomes in paediatric RD patients. The aim of this study is to determine the seroprevalence of SARS-CoV-2 IgG and to describe COVID-19 outcomes in immunosuppressed paediatric RD patients.
Methods: Patients diagnosed with RD before age 18 and treated with at least one immunosuppressive medication for at least three months were enrolled from a tertiary paediatric rheumatology practice in New York, and also underwent routine SARS-CoV-2 IgG testing from May to November 2020. Five hundred and seventy-one patients were screened and 262 were enrolled. SARS-CoV-2 IgG+ subjects were assessed for symptoms of COVID-19 infection. SARS-CoV-2 PCR results were recorded where available. Demographic, diagnostic, medication, and outcome data were collected.
Results: Of 262 subjects (186 female), 35 (13%) were SARS-CoV-2 IgG+; 17 (49%) had symptoms suggestive of COVID-19. Of 17 patients who had SARS-CoV-2 PCR testing, 11 (65%) were PCR+; seven of whom were IgG+. Most SARS-CoV-2 IgG+ subjects were not PCR tested. The most common symptoms in IgG+ and/or PCR+ subjects were fever, fatigue, and cough. No SARS-CoV-2 IgG+ or PCR+ subject developed severe or critical COVID-19 or required hospitalisation.
Conclusions: This is the first report of clinical outcomes of SARS-CoV-2 infection and seroprevalence of SARS-CoV-2 IgG in a large cohort of paediatric RD patients. Most SARS-CoV-2 IgG+ subjects had no symptoms of COVID-19 infection. Symptomatic subjects all had mild COVID-19 symptoms, suggesting that risk of severe or critical COVID-19 in immunosuppressed paediatric RD patients is minimal.
Keywords: COVID-19; Paediatric rheumatology; biologics; juvenile idiopathic arthritis; systemic lupus erythematosus.
. 2021 Oct 2;keab730.
doi: 10.1093/rheumatology/keab730. Online ahead of print.
Seroprevalence and Clinical Outcomes of SARS-CoV-2 in Paediatric Patients with Rheumatic Disease
Heather M Walters[SUP] 1 2 [/SUP], Zanab Mian[SUP] 1 2 [/SUP], Lydia Thomas[SUP] 1 2 [/SUP], Jane Cerise[SUP] 2 3 [/SUP], B Anne Eberhard[SUP] 1 2 [/SUP], Eileen Pagano[SUP] 1 2 [/SUP], Beth S Gottlieb[SUP] 1 2 [/SUP], Katherine Steigerwald[SUP] 1 2 [/SUP], Joyce S Hui-Yuen[SUP] 1 2 4 [/SUP]
Affiliations
- PMID: 34599820
- DOI: 10.1093/rheumatology/keab730
Abstract
Objectives: Immunosuppressed paediatric patients with rheumatic disease (RD) may be at risk for severe or critical disease related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Data remain scarce on COVID-19 outcomes in paediatric RD patients. The aim of this study is to determine the seroprevalence of SARS-CoV-2 IgG and to describe COVID-19 outcomes in immunosuppressed paediatric RD patients.
Methods: Patients diagnosed with RD before age 18 and treated with at least one immunosuppressive medication for at least three months were enrolled from a tertiary paediatric rheumatology practice in New York, and also underwent routine SARS-CoV-2 IgG testing from May to November 2020. Five hundred and seventy-one patients were screened and 262 were enrolled. SARS-CoV-2 IgG+ subjects were assessed for symptoms of COVID-19 infection. SARS-CoV-2 PCR results were recorded where available. Demographic, diagnostic, medication, and outcome data were collected.
Results: Of 262 subjects (186 female), 35 (13%) were SARS-CoV-2 IgG+; 17 (49%) had symptoms suggestive of COVID-19. Of 17 patients who had SARS-CoV-2 PCR testing, 11 (65%) were PCR+; seven of whom were IgG+. Most SARS-CoV-2 IgG+ subjects were not PCR tested. The most common symptoms in IgG+ and/or PCR+ subjects were fever, fatigue, and cough. No SARS-CoV-2 IgG+ or PCR+ subject developed severe or critical COVID-19 or required hospitalisation.
Conclusions: This is the first report of clinical outcomes of SARS-CoV-2 infection and seroprevalence of SARS-CoV-2 IgG in a large cohort of paediatric RD patients. Most SARS-CoV-2 IgG+ subjects had no symptoms of COVID-19 infection. Symptomatic subjects all had mild COVID-19 symptoms, suggesting that risk of severe or critical COVID-19 in immunosuppressed paediatric RD patients is minimal.
Keywords: COVID-19; Paediatric rheumatology; biologics; juvenile idiopathic arthritis; systemic lupus erythematosus.