Risk of COVID-19 in children treated for demyelinating disorders in the UK
Developmental Medicine and Child Neurology
; 64(SUPPL 1):22, 2022.
Article
in English
| EMBASE | ID: covidwho-1723132
ABSTRACT
Objective:
Paediatric neurologists are concerned about the risk of COVID-19 in children with demyelinating disorders receiving immunomodulatory treatment. To investigate this, we collected data via the UK Childhood Neuro-Inflammatory Disorders (UK-CNID) network of the British Paediatric Neurology Association (BPNA).Methods:
Survey of paediatric neurologists managing unvaccinated UK children (<18 years) with a demyelinating disorder (multiple sclerosis [MS];neuromyelitis optica spectrum disorder [NMOSD] and myelin oligodendrocyte glycoprotein antibody disease [MOGAD]) on immunomodulatory therapy with SARS-CoV-2 infection confirmed by reverse transcriptase-polymerase chain reaction (RT-PCR) of nasopharyngeal swabs between March and December 2020.Results:
Of 151 UK children (MS 98, MOGAD 37, NMOSD 16) with a median age of 9 years (range 6-18y), with a demyelinating disorder, nine (6.0%) had a positive PCR for SARS-CoV-2. Five had MS and four MOGAD. Four were from south Asian or south-east Asian, four were White and one was mixed White and south Asian. Seven children had COVID-19 symptoms;two were asymptomatic. Two required a brief hospital admission for typical COVID-19 respiratory symptoms and the remaining five had mild symptoms including fever, rash, cough and headache. One with MOGAD, treated with azathioprine, developed transverse myelitis 12 days after COVID-19 onset. She recovered fully with a course of corticosteroids. MS patients were on following disease modifying therapies;dimethylfumarate (n=2), fingolimod (n=1);natalizumab (n=1) and ocrelizumab (n=1). MOGAD cases were on the following immune therapy combination of oral prednisolone and intravenous immunoglobulin (n=2), prednisolone steroids (n=1) and azathioprine (n=1).Conclusions:
In contrast to adult patients, who often have underlying co-morbidities and advanced neurological disabilities, we have identified that children treated for demyelinating disorders appear to have a milder COVID-19 course. Whilst the number of children treated for demyelinating disorders that developed COVID-19 is low, the overall mild course described may provide reassurance to neurologists, patients and family members.
azathioprine; corticosteroid; dimethyl fumarate; endogenous compound; fingolimod; human immunoglobulin; myelin oligodendrocyte glycoprotein; natalizumab; ocrelizumab; prednisolone; adult; child; childhood; comorbidity; conference abstract; controlled study; coronavirus disease 2019; cough headache; demyelinating disease; drug combination; drug therapy; female; fever; hospital admission; human; immunotherapy; major clinical study; multiple sclerosis; myelooptic neuropathy; nasopharyngeal swab; nervous system inflammation; neurodisability; neurologist; neurology; nonhuman; rash; reassurance; reverse transcription polymerase chain reaction; school child; Severe acute respiratory syndrome coronavirus 2; transverse myelitis
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Prognostic study
Language:
English
Journal:
Developmental Medicine and Child Neurology
Year:
2022
Document Type:
Article
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