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- Title
Clinical Experience With Severe Acute Respiratory Syndrome Coronavirus 2–Related Illness in Children: Hospital Experience in Cape Town, South Africa.
- Authors
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; Fourie, Barend; Claassen, Mathilda; Workman, Jessica J; Goussard, Pierre; Zyl, Gert Van; Rabie, Helena
- Abstract
Background Children seem relatively protected from serious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–related disease, but little is known about children living in settings with high tuberculosis and human immunodeficiency virus (HIV) burden. This study reflects clinical data on South African children with SARS-CoV-2. Methods We collected clinical data of children aged <13 years with laboratory-confirmed SARS-CoV-2 presenting to Tygerberg Hospital, Cape Town, between 17 April and 24 July 2020. Results One hundred fifty-nine children (median age, 48.0 months [interquartile range {IQR}, 12.0–106.0 months]) were included. Hospitalized children (n = 62), with a median age of 13.5 months (IQR, 1.8–43.5 months) were younger than children not admitted (n = 97; median age, 81.0 months [IQR, 34.5–120.5 months]; P < .01.). Thirty-three of 159 (20.8%) children had preexisting medical conditions. Fifty-one of 62 (82.3%) hospitalized children were symptomatic; lower respiratory tract infection was diagnosed in 21 of 51 (41.2%) children, and in 11 of 16 (68.8%) children <3 months of age. Respiratory support was required in 25 of 51 (49.0%) children; 13 of these (52.0%) were <3 months of age. One child was HIV infected and 11 of 51 (21.2%) were HIV exposed but uninfected, and 7 of 51 (13.7%) children had a recent or new diagnosis of tuberculosis. Conclusions Children <1 year of age hospitalized with SARS-CoV-2 in Cape Town frequently required respiratory support. Access to oxygen may be limited in some low- and middle-income countries, which could potentially drive morbidity and mortality. HIV infection was uncommon but a relationship between HIV exposure, tuberculosis, and SARS-CoV-2 should be explored.
- Subjects
SUB-Saharan Africa; SOUTH Africa; CLINICAL pathology; HIV-positive persons; COVID-19; RESPIRATORY infections; PUBLIC hospitals; RESPIRATORY therapy; DESCRIPTIVE statistics; TUBERCULOSIS; HOSPITAL care of children; CHILDREN
- Publication
Clinical Infectious Diseases, 2021, Vol 72, Issue 12, pe938
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciaa1666