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Outcomes of SARS-CoV-2 infection among children and young people with pre-existing rheumatic and musculoskeletal diseases.
Kearsley-Fleet, Lianne; Chang, Min-Lee; Lawson-Tovey, Saskia; Costello, Ruth; Fingerhutová, Sárka; Svestková, Natálie; Belot, Alexandre; Aeschlimann, Florence A; Melki, Isabelle; Koné-Paut, Isabelle; Eulert, Sascha; Kallinich, Tilmann; Berkun, Yackov; Uziel, Yosef; Raffeiner, Bernd; Oliveira Ramos, Filipa; Clemente, Daniel; Dackhammar, Christina; Wulffraat, Nico M; Waite, Helen; Strangfeld, Anja; Mateus, Elsa F; Machado, Pedro M; Natter, Marc; Hyrich, Kimme L.
  • Kearsley-Fleet L; Centre for Epidemiology Versus Arthritis, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.
  • Chang ML; Computational Health Informatics Program, Boston Children's Hospital, Boston, Massachusetts, USA.
  • Lawson-Tovey S; Centre for Genetics and Genomics Versus Arthritis, The University of Manchester, Manchester, UK.
  • Costello R; National Institute of Health Research Manchester Biomedical Research Centre, Centre for Musculoskeletal Research, Manchester University NHS Foundation Trust, Manchester, UK.
  • Fingerhutová S; Centre for Epidemiology Versus Arthritis, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.
  • Svestková N; Department of Pediatrics and Adolescent Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic.
  • Belot A; Department of Pediatrics and Adolescent Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic.
  • Aeschlimann FA; Pediatric Nephrology, Rheumatology & Dermatology Department, HFME, Université Lyon-1, Hospices Civils de Lyon, Lyon, France.
  • Melki I; Pediatric Hematology-Immunology and Rheumatology Department, AP-HP, Hôpital universitaire Necker-Enfants malades, Paris, France.
  • Koné-Paut I; Pediatric Hematology-Immunology and Rheumatology Department, AP-HP, Hôpital universitaire Necker-Enfants malades, Paris, France.
  • Eulert S; General Pediatrics, Infectious Disease and Internal Medicine Department, AP-HP, Hôpital Robert Debré, Reims, France.
  • Kallinich T; Service de Rhumatologie Pédiatrique, Centre de Référence des Maladies Auto-Inflammatoires de l'enfant, Centre Hospitalier Universitaire de Bicêtre, Paris, France.
  • Berkun Y; Epidemiology Unit, German Rheumatism Research Center Berlin, Berlin, Germany.
  • Uziel Y; Department of Pediatrics, Division of Pneumonology and Immunology with intensive Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany.
  • Raffeiner B; Department of Pediatrics, Hadassah-Hebrew University Medical Center, Jerusalem, Mount Scopus, Israel.
  • Oliveira Ramos F; Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
  • Clemente D; Paediatric Rheumatology Unit, Department of Paediatrics, Sackler School of Medicine, Tel-Aviv University, Meir Medical Center, Tel-Aviv, Israel.
  • Dackhammar C; Clinical Affairs Committee, Pediatric Rheumatology European Society (PReS), Geneva, Switzerland.
  • Wulffraat NM; Department of Rheumatology, Central Hospital of Bolzano, Bolzano, Italy.
  • Waite H; Rheumatology Department, Centro Hospitalar Universitário Lisboa Norte EPE, Lisboa, Portugal.
  • Strangfeld A; Paediatric Rheumatology Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.
  • Mateus EF; Department of Rheumatology, Sahlgrenska University Hospital, Goteborg, Sweden.
  • Machado PM; Pediatrics, University Medical Center Utrecht, Utrecht, The Netherlands.
  • Natter M; Epidemiology Unit, German Rheumatism Research Center Berlin, Berlin, Germany.
  • Hyrich KL; Portuguese League Against Rheumatic Diseases (LPCDR), Lisbon, Portugal.
Ann Rheum Dis ; 81(7): 998-1005, 2022 07.
Article in English | MEDLINE | ID: covidwho-1765099
ABSTRACT

OBJECTIVES:

Some 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.

METHODS:

Using 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.

RESULTS:

607 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).

CONCLUSIONS:

This 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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Arthritis, Juvenile / Rheumatic Diseases / Musculoskeletal Diseases / COVID-19 Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Adolescent / Adult / Child / Humans / Young adult Language: English Journal: Ann Rheum Dis Year: 2022 Document Type: Article Affiliation country: Annrheumdis-2022-222241

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Arthritis, Juvenile / Rheumatic Diseases / Musculoskeletal Diseases / COVID-19 Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Adolescent / Adult / Child / Humans / Young adult Language: English Journal: Ann Rheum Dis Year: 2022 Document Type: Article Affiliation country: Annrheumdis-2022-222241