ABSTRACT
Coronavirus disease 2019 (COVID-19) is usually less severe in children compared to adults. This study describes detailed clinical characteristics, treatment and outcomes of children with laboratory-confirmed COVID-19 in a non-hospitalised and hospitalised setting and quantifies factors associated with admission to hospital and intensive care unit in children with SARS-CoV-2 infection on a nationwide level. Data were collected through the Swiss Paediatric Surveillance Unit from children < 18 years with laboratory-confirmed SARS-CoV-2 infection. All 33 paediatric hospitals in Switzerland reported non-hospitalised and hospitalised cases from March 1 to October 31, 2020 during both pandemic peaks. In total, 678 children were included. The median age was 12.2 (IQR 5.0 – 14.6) years, 316 (47%) were female and 106 (16%) had comorbidities. Overall, 126 (18.6%) children were hospitalised of whom 16 (12.7%) required ICU admission. Comorbidities were the only factor associated with hospital admission in a multivariable regression analysis (odds ratio 3.23, 95%CI 1.89 to 5.50; p-value <0.01). Hospitalised children more often presented with fever (96 [76.2%] vs 209 [38.1%], p-value<0.01) and rash (16 [12.8%] vs 6 [1.1%], p-value<0.01). Anosmia/dysgeusia was more prevalent in non-hospitalised children (73 [13.3%] vs 3 [2.4%], p-value<0.01). In the hospitalised children, oxygen treatment was required in 34 (27.0%), inotropes in nine (7.3%) and mechanical ventilation in eight (6.3%). Complications were reported in 28 (4.1%) children with cardiovascular complications being most frequent (11 [1.6%]). Three deaths were recorded. Conclusion: This study confirms that COVID-19 is mostly a mild disease in children. Fever, rash, and comorbidities are associated with higher admission rates. Continuous observation is necessary to further understand paediatric COVID-19, guide therapy and evaluate the necessity for vaccination in children.
Subject(s)
COVID-19ABSTRACT
Background: Coronavirus disease 2019 (COVID-19) is usually less severe in children compared to adults. This study describes detailed clinical characteristics, treatment and outcomes of children with laboratory-confirmed COVID-19 in a non-hospitalised and hospitalised setting and quantifies factors associated with admission to hospital and intensive care unit in children with SARS-CoV-2 infection on a nationwide level.Methods: Data were collected through the Swiss Paediatric Surveillance Unit from children < 18 years with laboratory-confirmed SARS-CoV-2 infection. All 33 paediatric hospitals in Switzerland reported non-hospitalised and hospitalised cases from March 1 to October 31, 2020 during both pandemic peaks.Findings: In total, 678 children were included. The median age was 12.2 (IQR 5.0 – 14.6) years, 316 (47%) were female and 106 (16%) had comorbidities. Overall, 126 (18.6%) children were hospitalised of whom 16 (12.7%) required ICU admission. Comorbidities were the only factor associated with hospital admission in a multivariable regression analysis (odds ratio 3.23, 95%CI 1.89 to 5.50; p-value <0.01). Hospitalised children more often presented with fever (96 [76.2%] vs 209 [38.1%], p-value<0.01) and rash (16 [12.8%] vs 6 [1.1%], p-value<0.01). Anosmia/dysgeusia was more prevalent in non-hospitalised children (73 [13.3%] vs 3 [2.4%], p-value<0.01). In the hospitalised children, oxygen treatment was required in 34 (27.0%), inotropes in nine (7.3%) and mechanical ventilation in eight (6.3%). Complications were reported in 28 (4.1%) children with cardiovascular complications being most frequent (11 [1.6%]). Three deaths were recorded.Interpretation: This study confirms that COVID-19 is mostly a mild disease in children. Fever, rash, and comorbidities are associated with higher admission rates. Continuous observation is necessary to further understand paediatric COVID-19, guide therapy and evaluate the necessity for vaccination in children.Funding: The study is supported by the Swiss Federal Office of Public Health and has received grants from the Swiss Society of Paediatrics and the Paediatric Infectious Disease Group of Switzerland.Declaration of Interest: None to declare.Ethical Approval: The study has received ethical approval by the Ethikkommission Nordwest- undZentralschweiz (EKNZ 2020-01130).
Subject(s)
COVID-19 , Fever , Dysgeusia , Communicable DiseasesABSTRACT
Transmission chains within cities provide an important contribution to case burden and economic impact during the ongoing COVID-19 pandemic, and should be a major focus for preventive measures to achieve containment. Here, at very high spatio-temporal resolution, we analysed determinants of SARS-CoV-2 transmission in a medium-sized European city. We combined detailed epidemiological, mobility, and socioeconomic data-sets with whole genome sequencing during the first SARS-CoV-2 wave. Both phylogenetic clustering and compartmental modelling analysis were performed based on the dominating viral variant (B.1-C15324T; 60% of all cases). Here we show that transmissions on the city population level are driven by the socioeconomically weaker and highly mobile groups. Simulated vaccination scenarios showed that vaccination of a third of the population at 90% efficacy prioritising the latter groups would induce a stronger preventive effect compared to vaccinating exclusively senior population groups first. Our analysis accounts for both social interaction and mobility on the basis of molecularly related cases, thereby providing high confidence estimates of the underlying epidemic dynamics that may readily be translatable to other municipal areas.
Subject(s)
COVID-19ABSTRACT
Infecting large portions of the global population, seasonal influenza is a major burden on societies around the globe. While the global source sink dynamics of the different seasonal influenza viruses have been studied intensively, it’s local spread remains less clear. In order to improve our understanding of how influenza is transmitted on a city scale, we collected an extremely densely sampled set of influenza sequences alongside patient metadata. To do so, we sequenced influenza viruses isolated from patients of two different hospitals, as well as private practitioners in Basel, Switzerland during the 2016/2017 influenza season. The genetic sequences reveal that repeated introductions into the city drove the influenza season. We then reconstruct how the effective reproduction number changed over the course of the season. We find trends in transmission dynamics correlated positively with trends in temperature, but not relative humidity nor school holidays. Alongside the genetic sequence data that allows us to see how individual cases are connected, we gathered patient information, such as the age or household status. Zooming into the local transmission outbreaks suggests that the elderly were to a large extent infected within their own transmission network, while school children likely drove the spread within the remaining transmission network. These patterns will be valuable to plan interventions combating the spread of respiratory diseases within cities given that similar patterns are observed for other influenza seasons and cities. Author summary As shown with the current SARS-CoV-2 pandemic, respiratory diseases can quickly spread around the globe. While it can be hugely important to understand how diseases spread around the globe, local spread is most often the main driver of novel infections of respiratory diseases such as SARS-CoV-2 or influenza. We here use genetic sequence data alongside patient information to better understand what the drives the local spread of influenza by looking at the 2016/2017 influenza season in Basel, Switzerland as an example. The genetic sequence data allows us to reconstruct the how the transmission dynamics changed over the course of the season, which we correlate to changes, but not humidity or school holidays. Additionally, the genetic sequence data allows us to see how individual cases are connected. Using patient information, such as age and household status our analyses suggest that the elderly mainly transmit within their own transmission network. Additionally, they suggest that school aged children, but not pre-school aged children are important drivers of the local spread of influenza.