Clinical Experience With Severe Acute Respiratory Syndrome Coronavirus 2–Related Illness in Children: Hospital Experience in Cape Town, South Africa

Zalm, Marieke M. van der; Lishman, Juanita; Verhagen, Lilly M.; Redfern, Andrew; Smit, Liezl; Barday, Mikhail; Ruttens, Dries; Costa, A'ishah da; Jaarsveld, Sandra van; Itana, Justina; Schrueder, Neshaad; Schalkwyk, Marije Van; Parker, Noor; Appel, Ilse Nadine; Fourie, Barend; Claassen, Mathilda; Workman, Jessica J; Goussard, Pierre; Zyl, Gert van; Rabie, Helena

doi:10.1093/cid/ciaa1666

Cited by 48 publications

(47 citation statements)

References 22 publications

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“…A study conducted in South Africa among children younger than 13 years showed that among hospitalized children, majority were symptomatic, one-fifth had pre-existing medical condition and respiratory support was required in half of the children [17].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 in Hospitalized Ethiopian Children: Characteristics and Outcome Profile

Leulseged

et al. 2020

Preprint

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Background: Considering the number of people affected and the burden to the health care system due to the Coronavirus pandemic, there is still a gap in understanding the disease better leaving a space for new evidence to be filled by researchers. This scarcity of evidence is observed especially among children with the virus. Understanding the disease pattern and its effect among children is vital in providing timely and targeted intervention. Aim: To assess the characteristics and outcome profile of 115 RT-PCR confirmed children with COVID-19, and to determine the presence of significant difference in disease severity and survival distribution between groups among children admitted to Millennium COVID-19 Care Center in Ethiopia. Methods: A prospective cohort study was conducted among 90 consecutively admitted eligible RT-PCR confirmed COVID-19 children from end of June to mid September, 2020. Frequency tables, KM plots, median survival times and Log-rank test were used to describe the data and compare survival distribution between groups. A chi-square test/ Fischer exact test were used to determine the presence of a significant difference between the independent variables and disease severity. A statistically significant difference was detected for variables with a P-value of ≤ 0.05. Survival experience of different groups was compared using KM survival curves. Log-rank test was used to assess the presence of significant difference among survival distributions of groups for equality where a statistically significant difference in survival distribution between groups was detected for variables with a P-value of ≤ 0.05. Results: From the 90 children, 67 (74.4%) achieved clinical improvement and 23 (25.6%) were censored. There was no death. The median time to clinical improvement was 14 days. The median age of the participants was 15 years and 63.3% of the participants were females. The commonest reported route of disease transmission was through close contact with a diagnosed person (45.6%). Only three (3.3%) had a history of pre-existing comorbid illness. More than a quarter (26.7%) had one or more symptoms at admission, the commonest being cough (22.2%). Seventy three (81.1%) of the patients had mild COVID-19 at admission and the rest (18.9%) had moderate disease. On the chi-square and Fischers exact test, children with one or more symptom at presentation (73.3% Vs 36.7%, p-value= 0.0001), fever (40.0 % Vs 60.0%, p-value=0.045), cough (20.0 % Vs 80.0%, p-value=0.0001), sore throat (44.4 % Vs 55.6%, p-value=0.011), and headache (44.4 % Vs 55.6%, p-value=0.011) were more likely to develop moderate COVID-19. On the log rank test, a significant difference in survival between groups was observed only for sex. A significantly longer time was needed for female patients to achieve clinical improvement compared to male patients (15 days Vs 14 days, p-value= 0.042). Conclusions: The average duration of time to clinical improvement was 14 days and 74.4% achieved clinical improvement. There was no death during the observation period. The pediatric patients seemed to have a milder disease presentation and a favorable outcome compared to other countries report and also the adult pattern observed in our country. Having particular symptom groups is associated with the development of moderate COVID-19. Being female seemed to delay the time to clinical improvement. Further multicenter study with a large sample size is recommended to reach at a better conclusion.

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Section: Introductionmentioning

confidence: 99%

COVID-19 in Hospitalized Ethiopian Children: Characteristics and Outcome Profile

Leulseged

et al. 2020

Preprint

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“…One (2.3%) study did not specify the inclusion criteria [ 46 ]. Only two (4.7%) studies specifically evaluated children [ 63 , 71 ]; others included only adults or described a mixed population. Patient information was retrieved mainly from medical records at participating healthcare facilities, or from surveillance registries or insurance databases ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

Active pulmonary tuberculosis and coronavirus disease 2019: A systematic review and meta-analysis

et al. 2021

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Objective The proportion of COVID-19 patients having active pulmonary tuberculosis, and its impact on COVID-19 related patient outcomes, is not clear. We conducted this systematic review to evaluate the proportion of patients with active pulmonary tuberculosis among COVID-19 patients, and to assess if comorbid pulmonary tuberculosis worsens clinical outcomes in these patients. Methods We queried the PubMed and Embase databases for studies providing data on (a) proportion of COVID-19 patients with active pulmonary tuberculosis or (b) severe disease, hospitalization, or mortality among COVID-19 patients with and without active pulmonary tuberculosis. We calculated the proportion of tuberculosis patients, and the relative risk (RR) for each reported outcome of interest. We used random-effects models to summarize our data. Results We retrieved 3,375 citations, and included 43 studies, in our review. The pooled estimate for proportion of active pulmonary tuberculosis was 1.07% (95% CI 0.81%-1.36%). COVID-19 patients with tuberculosis had a higher risk of mortality (summary RR 1.93, 95% CI 1.56–2.39, from 17 studies) and for severe COVID-19 disease (summary RR 1.46, 95% CI 1.05–2.02, from 20 studies), but not for hospitalization (summary RR 1.86, 95% CI 0.91–3.81, from four studies), as compared to COVID-19 patients without tuberculosis. Conclusion Active pulmonary tuberculosis is relatively common among COVID-19 patients and increases the risk of severe COVID-19 and COVID-19-related mortality.

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“…Many authors appealed to elucidate the tangible influence of HIV and TB over COVID-19 severity, since resources were often scarce, with intensive care facilities completely full so the admission of patients had to be rationed [ 53 ]. This need of a thorough research was especially claimed for children, who represented a significant percentage of hospitalization in low- and middle-income countries, in particular sub-Saharan African countries [ 54 ]. Some COVID-19 surveillance studies and systems designed with the aim of determining the impact of HIV and TB on SARS-CoV-2 infection susceptibility, were ongoing or not finished yet [ 55 ].…”

Section: Resultsmentioning

confidence: 99%

A Pandemic within Other Pandemics. When a Multiple Infection of a Host Occurs: SARS-CoV-2, HIV and Mycobacterium tuberculosis

González-Domenech

Pérez-Hernández²,

Gómez-Ayerbe

et al. 2021

Viruses

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By the middle of 2021, we are still immersed in the coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The concurrence of this new pandemic in regions where human immunodeficiency virus (HIV) and tuberculosis (TB) infections possess the same epidemiological consideration, has arisen concerns about the prognosis, clinical management, symptomatology, and treatment of patients with triple infection. At the same time, healthcare services previously devoted to diagnosis and treatment of TB and HIV are being jeopardized by the urgent need of resources and attention for COVID-19 patients. The aim of this review was to collect any article considering the three conditions (HIV, TB, and SARS-CoV-2), included in PubMed/Medline and published in the English language since the beginning of the COVID-19 pandemic. We focused on detailed descriptions of the unusual cases describing the three co-infections. Eighty-four out of 184 publications retrieved met our inclusion criteria, but only three of them reported cases (five in total) with the three concomitant infections. The clinical evolution, management, and therapy of all of them were not different from mild/severe cases with exclusive COVID-19; the outcome was not worse either, with recovery for the five patients. Cases of patients with COVID-19 besides HIV and TB infections are scarce in literature, but studies deliberately embracing the triple infection as a priori inclusion criterion should be carried out in order to provide a complete understanding of joint influence.

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Clinical Experience With Severe Acute Respiratory Syndrome Coronavirus 2–Related Illness in Children: Hospital Experience in Cape Town, South Africa

Cited by 48 publications

References 22 publications

COVID-19 in Hospitalized Ethiopian Children: Characteristics and Outcome Profile

COVID-19 in Hospitalized Ethiopian Children: Characteristics and Outcome Profile

Active pulmonary tuberculosis and coronavirus disease 2019: A systematic review and meta-analysis

A Pandemic within Other Pandemics. When a Multiple Infection of a Host Occurs: SARS-CoV-2, HIV and Mycobacterium tuberculosis

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