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Outcomes of COVID-19 in a cohort of pediatric patients with rheumatic diseases

BACKGROUND: There are few reports of COVID-19 in pediatric patients with rheumatic diseases. This study describes the clinical presentation and outcomes of COVID-19 in this population. METHODS: We analyzed a single-center case series of pediatric patients with rheumatic diseases and laboratory-confi...

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Autores principales: Villacis-Nunez, D. Sofia, Rostad, Christina A., Rouster-Stevens, Kelly, Khosroshahi, Arezou, Chandrakasan, Shanmuganathan, Prahalad, Sampath
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8215630/
https://www.ncbi.nlm.nih.gov/pubmed/34154620
http://dx.doi.org/10.1186/s12969-021-00568-4
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author Villacis-Nunez, D. Sofia
Rostad, Christina A.
Rouster-Stevens, Kelly
Khosroshahi, Arezou
Chandrakasan, Shanmuganathan
Prahalad, Sampath
author_facet Villacis-Nunez, D. Sofia
Rostad, Christina A.
Rouster-Stevens, Kelly
Khosroshahi, Arezou
Chandrakasan, Shanmuganathan
Prahalad, Sampath
author_sort Villacis-Nunez, D. Sofia
collection PubMed
description BACKGROUND: There are few reports of COVID-19 in pediatric patients with rheumatic diseases. This study describes the clinical presentation and outcomes of COVID-19 in this population. METHODS: We analyzed a single-center case series of pediatric patients with rheumatic diseases and laboratory-confirmed COVID-19. Demographic, baseline and COVID-19 associated clinical features were compared between ambulatory and hospitalized patients using univariate analysis. RESULTS: Fifty-five cases were identified: 45 (81.8%) in the ambulatory group and 10 (18.2%) hospitalized. African American race (OR 7.78; 95% CI [1.46–55.38]; p = 0.006) and cardiovascular disease (OR 19.40; 95% CI 2.45–254.14; p = 0.001) predominated in hospitalized patients. Active rheumatic disease (OR 11.83; 95% CI 1.43–558.37; p = 0.01), medium/high-dose corticosteroid use (OR 14.12; 95% CI [2.31–106.04]; p = 0.001), mycophenolate use (OR 8.84; 95% CI [1.64–63.88]; p = 0.004), rituximab use (OR 19.40; 95% CI [2.45–254.14]; p = 0.001) and severe immunosuppression (OR 34.80; 95% CI [3.94–1704.26]; p = < 0.001) were associated with increased odds of hospitalization. Fever (OR 7.78; 95% CI [1.46–55.38]; p = 0.006), dyspnea (OR 26.28; 95% CI [2.17–1459.25]; p = 0.003), chest pain (OR 13.20; 95% CI [1.53–175.79]; p = 0.007), and rash (OR 26.28; 95% CI [2.17–1459.25]; p = 0.003) were more commonly observed in hospitalized patients. Rheumatic disease flares were almost exclusive to hospitalized patients (OR 55.95; 95% CI [5.16–3023.74]; p < 0.001).. One patient did not survive. CONCLUSIONS: Medium/high-dose corticosteroid, mycophenolate and rituximab use, and severe immunosuppression were risk factors for hospitalization. Fever, dyspnea, chest pain, and rash were high-risk symptoms for hospitalization. Rheumatic disease activity and flare could contribute to the need for hospitalization.
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spelling pubmed-82156302021-06-21 Outcomes of COVID-19 in a cohort of pediatric patients with rheumatic diseases Villacis-Nunez, D. Sofia Rostad, Christina A. Rouster-Stevens, Kelly Khosroshahi, Arezou Chandrakasan, Shanmuganathan Prahalad, Sampath Pediatr Rheumatol Online J Research Article BACKGROUND: There are few reports of COVID-19 in pediatric patients with rheumatic diseases. This study describes the clinical presentation and outcomes of COVID-19 in this population. METHODS: We analyzed a single-center case series of pediatric patients with rheumatic diseases and laboratory-confirmed COVID-19. Demographic, baseline and COVID-19 associated clinical features were compared between ambulatory and hospitalized patients using univariate analysis. RESULTS: Fifty-five cases were identified: 45 (81.8%) in the ambulatory group and 10 (18.2%) hospitalized. African American race (OR 7.78; 95% CI [1.46–55.38]; p = 0.006) and cardiovascular disease (OR 19.40; 95% CI 2.45–254.14; p = 0.001) predominated in hospitalized patients. Active rheumatic disease (OR 11.83; 95% CI 1.43–558.37; p = 0.01), medium/high-dose corticosteroid use (OR 14.12; 95% CI [2.31–106.04]; p = 0.001), mycophenolate use (OR 8.84; 95% CI [1.64–63.88]; p = 0.004), rituximab use (OR 19.40; 95% CI [2.45–254.14]; p = 0.001) and severe immunosuppression (OR 34.80; 95% CI [3.94–1704.26]; p = < 0.001) were associated with increased odds of hospitalization. Fever (OR 7.78; 95% CI [1.46–55.38]; p = 0.006), dyspnea (OR 26.28; 95% CI [2.17–1459.25]; p = 0.003), chest pain (OR 13.20; 95% CI [1.53–175.79]; p = 0.007), and rash (OR 26.28; 95% CI [2.17–1459.25]; p = 0.003) were more commonly observed in hospitalized patients. Rheumatic disease flares were almost exclusive to hospitalized patients (OR 55.95; 95% CI [5.16–3023.74]; p < 0.001).. One patient did not survive. CONCLUSIONS: Medium/high-dose corticosteroid, mycophenolate and rituximab use, and severe immunosuppression were risk factors for hospitalization. Fever, dyspnea, chest pain, and rash were high-risk symptoms for hospitalization. Rheumatic disease activity and flare could contribute to the need for hospitalization. BioMed Central 2021-06-21 /pmc/articles/PMC8215630/ /pubmed/34154620 http://dx.doi.org/10.1186/s12969-021-00568-4 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Villacis-Nunez, D. Sofia
Rostad, Christina A.
Rouster-Stevens, Kelly
Khosroshahi, Arezou
Chandrakasan, Shanmuganathan
Prahalad, Sampath
Outcomes of COVID-19 in a cohort of pediatric patients with rheumatic diseases
title Outcomes of COVID-19 in a cohort of pediatric patients with rheumatic diseases
title_full Outcomes of COVID-19 in a cohort of pediatric patients with rheumatic diseases
title_fullStr Outcomes of COVID-19 in a cohort of pediatric patients with rheumatic diseases
title_full_unstemmed Outcomes of COVID-19 in a cohort of pediatric patients with rheumatic diseases
title_short Outcomes of COVID-19 in a cohort of pediatric patients with rheumatic diseases
title_sort outcomes of covid-19 in a cohort of pediatric patients with rheumatic diseases
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8215630/
https://www.ncbi.nlm.nih.gov/pubmed/34154620
http://dx.doi.org/10.1186/s12969-021-00568-4
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