Severe COVID-19 Outcomes Rare Among Children and Young People With Rheumatic Diseases

Severe COVID-19 outcomes, including hospitalizations, are rare among children with rheumatic and musculoskeletal diseases (RMDs), according to a press release issued by the Childhood Arthritis and Rheumatology Research Alliance (CARRA) and study results published in Annals of the Rheumatic Disease.^1,2

Researchers used the European Alliance of Associations for Rheumatology (EULAR) COVID-19 Registry, the CARRA Registry, and the COVID-19 Global Pediatric Rheumatology Database to identify data from children with RMDs and suspected or confirmed COVID-19. Data included demographic information, RMD diagnosis and severity, RMD treatment, COVID-19 case information, and medical comorbidities.

Researchers used logistic regression models to identify factors associated with COVID-19-related hospitalization.

The study cohort included 607 children aged 19 years and younger from 25 countries, among whom 399 (66%) were girls. The majority of patients had juvenile idiopathic arthritis (JIA; 62%); 14% had systemic lupus erythematosus (SLE)/mixed connective tissue disease (MCTD), vasculitis, or another RMD; and 13% had autoinflammatory syndromes.

COVID-19 was mild among the majority of patients and asymptomatic in 140 (23%). Overall, the most common symptoms were fever (39%) and cough (30%). A total of 43 patients (7%) were hospitalized with COVID-19 and 3 (0.5%) died.

A diagnosis of SLE/MCTD, vasculitis, or another RMD vs a diagnosis of JIA was significantly associated with hospitalization (odds ratio [OR], 4.3; 95% CI, 1.7-11.0). Diagnosis of an autoinflammatory syndrome also presented an increased risk for hospitalization compared with that of JIA (OR, 3.0; 95% CI, 1.1-8.6).

Children with obesity were more likely to be hospitalized (OR, 4.0; 95% CI, 1.3-12.0), with the use of biologics not increasing risk for hospitalization or death.

One of the main study limitations was the potential misclassification bias with regard to SARS-CoV-2 infection that was based on suspected and confirmed cases.

The researchers concluded, “While protective measures, as indicated by local policy, are important to follow with respect to [minimizing] risk of acquiring SARS-CoV-2 infection, parents and families can be reassured that these data do not support a high probability of severe COVID-19 in the majority of children and young people with underlying RMDs.”

Further research is necessary to better understand the pathogenesis of COVID-19 in children with RMDs, particularly following the widespread use of vaccines. Vaccination status was not available at the time of data collection.

Disclosure: Several study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. 

References

1. Researchers find lower risk of severe COVID-19 infection in most children with juvenile idiopathic arthritis. News release. Childhood Arthritis and Rheumatology Research Alliance (CARRA). Updated March 31, 2022. Accessed April 12, 2022. https://www.prnewswire.com/news-releases/researchers-find-lower-risk-of-severe-covid-19-infection-in-most-children-with-juvenile-idiopathic-arthritis-301514192.html

2. Kearsley-Fleet L, Chang ML, Lawson-Tovey S, et al. Outcomes of SARS-CoV-2 infection among children and young people with pre-existing rheumatic and musculoskeletal diseases. Ann Rheum Dis. Published online March 25, 2022. doi:10.1136/annrheumdis-2022-222241

This article originally appeared on Rheumatology Advisor