Outcomes of SARS-CoV-2 infection among children and young people with pre-existing rheumatic and musculoskeletal diseases

Lianne Kearsley-Fleet, Min Lee Chang, Saskia Lawson-Tovey, Ruth Costello, Šárka Fingerhutová, Natálie Švestková, Alexandre Belot, Florence A. Aeschlimann, Isabelle Melki, Isabelle Koné-Paut, Sascha Eulert, Tilmann Kallinich, Yackov Berkun, Yosef Uziel, Bernd Raffeiner, Filipa Oliveira Ramos, Daniel Clemente, Christina Dackhammar, Nico M. Wulffraat, Helen WaiteAnja Strangfeld, Elsa F. Mateus, Pedro M. Machado, Marc Natter, Kimme L. Hyrich*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)998-1005
Number of pages8
JournalAnnals of the Rheumatic Diseases
Volume81
Issue number7
DOIs
StatePublished - 1 Jul 2022

Funding

FundersFunder number
European Alliance of Associations for Rheumatology
NPRD
National Institutes of Health
GlaxoSmithKline
Novartis
National Center for Advancing Translational SciencesUL1TR002535
NIHR Biomedical Research Centre, Royal Marsden NHS Foundation Trust/Institute of Cancer Research
Manchester Biomedical Research Centre
Childhood Arthritis and Rheumatology Research Alliance
National Institute for Health and Care Research
Deutsche ForschungsgemeinschaftMI 2760/1-1
UCLH Biomedical Research Centre

    Keywords

    • Arthritis
    • Covid-19
    • Infections
    • Juvenile

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