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Prospective characterisation of SARS-CoV-2 infections among children presenting to tertiary paediatric hospitals across Australia in 2020: a national cohort study.
Wurzel, Danielle; McMinn, Alissa; Hoq, Monsurul; Blyth, Christopher C; Burgner, David; Tosif, Shidan; Buttery, Jim; Carr, Jeremy; Clark, Julia E; Cheng, Allen C; Dinsmore, Nicole; Francis, Joshua Reginald; Kynaston, Anne; Lucas, Ryan; Marshall, Helen; McMullan, Brendan; Singh-Grewal, Davinder; Wood, Nicholas; Macartney, Kristine; Britton, Phil N; Crawford, Nigel W.
  • Wurzel D; Infection and Immunity Theme, Murdoch Childrens Research Institute, Parkville, Victoria, Australia danielle.wurzel@unimelb.edu.au.
  • McMinn A; Respiratory and Sleep Medicine, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.
  • Hoq M; Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia.
  • Blyth CC; Infection and Immunity Theme, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.
  • Burgner D; Clinical Epidemiology and Biostatistics Unit, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.
  • Tosif S; Wesfarmers Centre of Vaccines and Infectious Disease, Telethon Kids Institute and School of Medicine, University of Western Australia, Perth, Western Australia, Australia.
  • Buttery J; Department of Infectious Diseases, Perth Children's Hospital, Perth, Western Australia, Australia.
  • Carr J; Department of Microbiology, PathWest Laboratory Medicine, QEII Medical Centre, Perth, Western Australia, Australia.
  • Clark JE; Infection and Immunity Theme, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.
  • Cheng AC; Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.
  • Dinsmore N; Department of Infectious Diseases, The Royal Children's Hospital, Parkville, Victoria, Australia.
  • Francis JR; Infection and Immunity Theme, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.
  • Kynaston A; Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.
  • Lucas R; General Medicine, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.
  • Marshall H; Infection and Immunity Theme, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.
  • McMullan B; Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.
  • Singh-Grewal D; Department of Infection and Immunity, Monash Children's Hospital, Clayton, Victoria, Australia.
  • Wood N; Department of Paediatrics, University of Oxford, Oxford, UK.
  • Macartney K; Infectious Diseases, Children's Health Queensland Hospital and Health Service, Herston, Queensland, Australia.
  • Britton PN; Infectious Disease Epidemiology Unit - School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.
  • Crawford NW; Infection Prevention and Healthcare Epidemiology Unit, Department of Infectious Diseases, Alfred Health, Melbourne, Victoria, Australia.
BMJ Open ; 11(11): e054510, 2021 11 08.
Article in English | MEDLINE | ID: covidwho-1507057
ABSTRACT

OBJECTIVE:

To present Australia-wide data on paediatric COVID-19 and multisystem inflammatory syndromes to inform health service provision and vaccination prioritisation.

DESIGN:

Prospective, multicentre cohort study.

SETTING:

Eight tertiary paediatric hospitals across six Australian states and territories in an established research surveillance network-Paediatric Active Enhanced Disease (PAEDS).

PARTICIPANTS:

All children aged <19 years with SARS-CoV-2 infection including COVID-19, Paediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS) and Kawasaki-like disease TS infection (KD-TS) treated at a PAEDS site from 24 March 2020 to 31 December 2020. INTERVENTION Laboratory-confirmed SARS-CoV-2 infection. MAIN

OUTCOME:

Incidence of severe disease among children with COVID-19, PIMS-TS and KD-TS. We also compared KD epidemiology before and during the COVID-19 pandemic.

RESULTS:

Among 386 children with SARS-CoV-2 infection, 381 (98.7%) had COVID-19 (median 6.3 years (IQR 2.1-12.8),53.3% male) and 5 (1.3%) had multisystem inflammatory syndromes (PIMS-TS, n=4; KD-TS, n=1) (median 7.9 years (IQR 7.8-9.8)). Most children with COVID-19 (n=278; 73%) were Australian-born from jurisdictions with highest community transmission. Comorbidities were present in 72 (18.9%); cardiac and respiratory comorbidities were most common (n=32/72;44%). 37 (9.7%) children with COVID-19 were hospitalised, and two (0.5%) required intensive care. Postinfective inflammatory syndromes (PIMS-TS/KD-TS) were uncommon (n=5; 1.3%), all were hospitalised and three (3/5; 60%) required intensive care management. All children recovered and there were no deaths. KD incidence remained stable during the pandemic compared with prepandemic.

CONCLUSIONS:

Most children with COVID-19 had mild disease. Severe disease was less frequent than reported in high prevalence settings. Preventative strategies, such as vaccination, including children and adolescents, could reduce both the acute and postinfective manifestations of the disease.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid / Vaccines Limits: Adolescent / Child / Female / Humans / Male Country/Region as subject: Oceania Language: English Journal: BMJ Open Year: 2021 Document Type: Article Affiliation country: Bmjopen-2021-054510

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid / Vaccines Limits: Adolescent / Child / Female / Humans / Male Country/Region as subject: Oceania Language: English Journal: BMJ Open Year: 2021 Document Type: Article Affiliation country: Bmjopen-2021-054510