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COVID-19 symptom surveillance in immunocompromised children and young people in the UK: a prospective observational cohort study.
Shaunak, Meera; Patel, Ravin; Driessens, Corine; Mills, Lynne; Leahy, Alice; Gbesemete, Diane; Owens, Daniel R; Lucas, Jane S; Faust, Saul N; de Graaf, Hans.
  • Shaunak M; NIHR Southampton Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
  • Patel R; Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK.
  • Driessens C; Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK.
  • Mills L; PCD Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
  • Leahy A; NIHR Southampton Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
  • Gbesemete D; Paediatric Rheumatology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
  • Owens DR; NIHR Southampton Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
  • Lucas JS; Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK.
  • Faust SN; NIHR Southampton Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
  • de Graaf H; Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK.
BMJ Open ; 11(3): e044899, 2021 03 17.
Article in English | MEDLINE | ID: covidwho-1140337
ABSTRACT

OBJECTIVES:

To describe the frequency of symptoms compatible with SARS-CoV-2 infection in immunocompromised children and young people in the UK during the SARS-CoV-2 pandemic. To describe patient/parent anxiety regarding SARS-CoV-2 infection in this cohort.

DESIGN:

A prospective observational cohort study.

SETTING:

46 centres across the UK between 16 March and 4 July 2020. A weekly online questionnaire based on the International Severe Acute Respiratory and emerging Infections Consortium-WHO Case Report Form was used to collect participant reported data on symptoms, test results, National Health Service attendance, hospital admission and impact on daily life.

PARTICIPANTS:

1490 immunocompromised children, defined as those requiring an annual influenza vaccination due to their underlying condition or medication. MAIN OUTCOME

MEASURES:

Incidence of SARS-CoV-2-like symptoms and patient/parent anxiety score.

RESULTS:

Over 16 weeks during the first wave of the pandemic, no SARS-CoV-2 infection was diagnosed in this large immunocompromised paediatric cohort (median age 11 years, 54.4% female). 110 symptomatic participants underwent a test for SARS-CoV-2; all were negative. 922 (67.4%) participants reported at least one symptom consistent with suspected SARS-CoV-2 infection over the study period. 476 (34.8%) reported three or more symptoms. The most frequently reported symptoms included joint pain, fatigue, headache, nausea and muscle pain. SARS-CoV-2 testing during this period was performed on admitted patients only. 137 participants had their medication suspended or changed during the study period due to assumed COVID-19 disease risk. 62% reported high levels of anxiety (scores of 7-10 out of 10) at the start of the study, with anxiety levels remaining high throughout the study period.

CONCLUSIONS:

Although symptoms related to SARS-CoV-2 infection in children were common, there were no positive tests in this large immunocompromised cohort. Symptom-based screening to facilitate early detection of SARS-CoV-2 infection may not be helpful in these individuals. Patient/parent anxiety about SARS-CoV-2 infection was high. TRIAL REGISTRATION NUMBER NCT04382508.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study / Randomized controlled trials Topics: Vaccines Limits: Adolescent / Child / Female / Humans / Male Country/Region as subject: Europa Language: English Journal: BMJ Open Year: 2021 Document Type: Article Affiliation country: Bmjopen-2020-044899

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study / Randomized controlled trials Topics: Vaccines Limits: Adolescent / Child / Female / Humans / Male Country/Region as subject: Europa Language: English Journal: BMJ Open Year: 2021 Document Type: Article Affiliation country: Bmjopen-2020-044899