EFFECT of COVID-19 on CHILDREN with RHEUMATIC DISEASE

ABSTRACT

Background: Pediatric patients with a diagnosis of rheumatic disease are at increased risk for infectious diseases due to immune dysregulation arising fromthe disease itself, as well as immunoregulatory or immunosuppressive drugs they use. However, there are studies reporting that COVID-19 disease has a moderate course in children with rheumatic disease. Objectives: This study aims to determine the seroprevalence of SARS-CoV-2 in children with rheumatic disease during the COVID-19 pandemic, to evaluate the effects of immunosuppressive drugs and biological agents on seroprevalence of COVID. Methods: Between September 2020 and September 2021, patients aged 2-18 years with a diagnosis of and with a follow-up period of more than 6 months were included in the study. Patients were selected by 'simple random sampling' method. Anti-SARS-CoV-2 antibodies (IgG and IgA) against the S1 domain of the SARS-CoV-2 spike protein were investigated with a micro ELISA kit. Results: 170 patients, 92 (54.1%) girls, with a mean age of 12.16±4.18 years, were included. The median age at diagnosis was 7.59 (IQR 4.33-11.30) years, and the median follow-up time after diagnosis was 3.24 (IQR 1.87-5.99) years. Primary disease distribution was presented on Figure 1. The co-morbid diseases as obesity, hypertension and chronic kidney disease was present in 4.7%, 9.4% and 5.3% of patients, respectively. The distribution of medications was as follows;colchicine 101 patients (59.4%), Disease Modifying Anti-Rheumatism Drugs 49 (28.8%), steroid 25 (14.7%), and biological agents 28 (16.5%). Anti-SARS-CoV-2 Ig G antibody was positive in 40 (23.5%) of the patients. Demographic characteristics and treatment-related variables were similar between SARS-CoV-2 IgG seropositive and seronegative patients (Table 1). Thirty-eight (22.4%) of the patients had close contact with an individual diagnosed with COVID-19. Thirty two (18.9%) patients underwent PCR testing for SARS-CoV-2;only 4 (2.4%) had positive. Of these 32 patients, 28.1% were positive for IgG. IgG seropositivity was observed in 3 (75.0%) of 4 patients with PCR positivity. Conclusion: We found the SARS-CoV-2 seroprevalence of 23.5% in children with a diagnosis of rheumatic disease. It seems that primary rheumatological diagnosis does not affect COVID seropositivity in children.