Journal Article

Outcomes of SARS-CoV-2 infection among children and young people with pre-existing rheumatic and musculoskeletal diseases

Eulert, Sascha, Uziel, Yosef, Belot, Alexandre, Kallinich, Tilmann, Clemente, Daniel, Berkun, Yackov, Kearsley-Fleet, Lianne, Fingerhutová, Šárka, Raffeiner, Bernd, Hyrich, Kimme L, Koné-Paut, Isabelle, Švestková, Natálie, Wulffraat, Nico M, Costello, Ruth, Waite, Helen, Chang, Min-Lee, Lawson-Tovey, Saskia, Oliveira Ramos, Filipa, Dackhammar, Christina, Melki, Isabelle, Aeschlimann, Florence A, Natter, Marc, Mateus, Elsa F, Strangfeld, Anja, Machado, Pedro M

2022

Overview

ObjectivesSome adults with rheumatic and musculoskeletal diseases (RMDs) are at increased risk of COVID-19-related death. Excluding post-COVID-19 multisystem inflammatory syndrome of children, children and young people (CYP) are overall less prone to severe COVID-19 and most experience a mild or asymptomatic course. However, it is unknown if CYP with RMDs are more likely to have more severe COVID-19. This analysis aims to describe outcomes among CYP with underlying RMDs with COVID-19.MethodsUsing the European Alliance of Associations for Rheumatology COVID-19 Registry, the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry, and the CARRA-sponsored COVID-19 Global Paediatric Rheumatology Database, we obtained data on CYP with RMDs who reported SARS-CoV-2 infection (presumptive or confirmed). Patient characteristics and illness severity were described, and factors associated with COVID-19 hospitalisation were investigated.Results607 CYP with RMDs <19 years old from 25 different countries with SARS-CoV-2 infection were included, the majority with juvenile idiopathic arthritis (JIA; n=378; 62%). Forty-three (7%) patients were hospitalised; three of these patients died. Compared with JIA, diagnosis of systemic lupus erythematosus, mixed connective tissue disease, vasculitis, or other RMD (OR 4.3; 95% CI 1.7 to 11) or autoinflammatory syndrome (OR 3.0; 95% CI 1.1 to 8.6) was associated with hospitalisation, as was obesity (OR 4.0; 95% CI 1.3 to 12).ConclusionsThis is the most significant investigation to date of COVID-19 in CYP with RMDs. It is important to note that the majority of CYP were not hospitalised, although those with severe systemic RMDs and obesity were more likely to be hospitalised.

• Publisher: BMJ Publishing Group Ltd and European League Against Rheumatism,Elsevier Limited,BMJ Publishing Group
• Subject: Adolescent / Antigens / Arthritis / Arthritis, Juvenile / Arthritis, Juvenile - complications / Arthritis, Juvenile - epidemiology / Body mass index / Child / Children / Collaboration / Comorbidity / Connective tissue diseases / Coronaviruses / COVID-19 / COVID-19 - complications / COVID-19 - epidemiology / Data collection / Data entry / Families & family life / Hospitalization / Humans / Immunology / Infections / Inflammation / Life Sciences / Lupus / Mixed connective tissue disease / Musculoskeletal diseases / Musculoskeletal Diseases - epidemiology / Obesity / Obesity - complications / Paediatric Rheumatology / Patients / Pediatrics / Remission (Medicine) / Rheumatic Diseases - complications / Rheumatic Diseases - epidemiology / Rheumatology / SARS-CoV-2 / Severe acute respiratory syndrome coronavirus 2 / Systemic lupus erythematosus / Tumor necrosis factor-TNF / Vasculitis / Young Adult