Coronavirus (COVID-19) infection in children at a specialist centre: outcome and implications of underlying ‘high-risk’ comorbidities in a paediatric population
Coronavirus (COVID-19) infection in children at a specialist centre: outcome and implications of underlying ‘high-risk’ comorbidities in a paediatric population
Abstract BackgroundThere is evolving evidence of significant differences in severity and outcomes of coronavirus disease 2019 (COVID-19) in children compared to adults. Underlying medical conditions associated with increased risk of severe disease are based on adult data, but have been applied across all ages resulting in large numbers of families undertaking social ‘shielding’ (vulnerable group). We conducted a retrospective analysis of children with suspected COVID-19 at a Specialist Children’s Hospital to determine outcomes based on COVID-19 testing status and underlying health vulnerabilities. MethodsRoutine clinical data were extracted retrospectively from the Institution’s Electronic Health Record system and Digital Research Environment for patients with suspected and confirmed COVID-19 diagnoses. Data were compared between Sars-CoV-2 positive and negative patients (CoVPos / CoVNeg respectively), and in relation to presence of underlying health vulnerabilities based on Public Health England guidance. FindingsBetween 1st March and 15th May 2020, 166 children (<18 years of age) presented to a specialist children’s hospital with clinical features of possible COVID-19 infection. 65 patients (39.2%) tested positive for SARS-CoV-2 virus. CoVPos patients were older (median 9 [0.9 - 14] years vs median 1 [0.1 - 5.7.5] years respectively, p<0.001). There was a significantly reduced proportion of vulnerable cases (47.7% vs 72.3%, p=0.002), but no difference in proportion of vulnerable patients requiring ventilation (61% vs 64.3%, p = 0.84) between CoVPos and CoVNeg groups. However, a significantly lower proportion of CoVPos patients required mechanical ventilation support compared to CoVNeg patients (27.7 vs 57.4%, p<0.001). Mortality was not significantly different between CoVPos and CoVNeg groups (1.5 vs 4% respectively, p=0.67) although there were no direct COVID-19 related deaths in this highly preselected paediatric population. InterpretationCOVID-19 infection may be associated with severe disease in childhood presenting to a specialist hospital, but does not appear significantly different in severity to other causes of similar clinical presentations. In children presenting with pre-existing ‘COVID-19 vulnerable’ medical conditions at a specialist centre, there does not appear to be significantly increased risk of either contracting COVID-19 or severe complications, apart from those undergoing chemotherapy, who are over-represented.
Bryant WA、du Pr¨| P、Cortina-Borja M、Moshal K、Dunn H、Hartley J、Booth J、Spiridou A、Issitt RW、Taylor AM、Ramnarayan P、Hemingway H、Sebire NJ
Great Ormond Street Hospital and Great Ormond Street Institute of Child Health and NIHR GOSH Biomedical Research CentreGreat Ormond Street Hospital and Great Ormond Street Institute of Child Health and NIHR GOSH Biomedical Research CentreFaculty of Population Health Sciences, University College LondonGreat Ormond Street Hospital and Great Ormond Street Institute of Child Health and NIHR GOSH Biomedical Research CentreGreat Ormond Street Hospital and Great Ormond Street Institute of Child Health and NIHR GOSH Biomedical Research CentreGreat Ormond Street Hospital and Great Ormond Street Institute of Child Health and NIHR GOSH Biomedical Research CentreGreat Ormond Street Hospital and Great Ormond Street Institute of Child Health and NIHR GOSH Biomedical Research CentreGreat Ormond Street Hospital and Great Ormond Street Institute of Child Health and NIHR GOSH Biomedical Research CentreGreat Ormond Street Hospital and Great Ormond Street Institute of Child Health and NIHR GOSH Biomedical Research Centre||Institute of Cardiovascular Science, University College London United KingdomInstitute of Cardiovascular Science, University College London United KingdomGreat Ormond Street Hospital and Great Ormond Street Institute of Child Health and NIHR GOSH Biomedical Research CentreInstitute of Health Informatics UCL and NIHR UCLH Biomedical Research CentreGreat Ormond Street Hospital and Great Ormond Street Institute of Child Health and NIHR GOSH Biomedical Research Centre
儿科学医学研究方法医药卫生理论
COVID-19coronaviruspaediatricchildhoodinfection
Bryant WA,du Pr¨| P,Cortina-Borja M,Moshal K,Dunn H,Hartley J,Booth J,Spiridou A,Issitt RW,Taylor AM,Ramnarayan P,Hemingway H,Sebire NJ.Coronavirus (COVID-19) infection in children at a specialist centre: outcome and implications of underlying ‘high-risk’ comorbidities in a paediatric population[EB/OL].(2025-03-28)[2025-04-28].https://www.medrxiv.org/content/10.1101/2020.05.20.20107904.点此复制
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