Prospective characterisation of SARS-CoV-2 infections among children presenting to tertiary paediatric hospitals across Australia in 2020: a national cohort study

被引：12

作者：

Wurzel, Danielle ^{[1
,2
,3
]}

McMinn, Alissa ^{[1
]}

Hoq, Monsurul ^{[4
]}

Blyth, Christopher C. ^{[5
,6
,7
,8
]}

Burgner, David ^{[1
,9
,10
]}

Tosif, Shidan ^{[1
,9
,11
]}

Buttery, Jim ^{[1
,9
]}

Carr, Jeremy ^{[12
,13
]}

Clark, Julia E. ^{[14
]}

Cheng, Allen C. ^{[15
,16
]}

Dinsmore, Nicole ^{[17
]}

Francis, Joshua Reginald ^{[18
,19
]}

Kynaston, Anne ^{[20
]}

Lucas, Ryan ^{[21
]}

Marshall, Helen ^{[22
,23
,24
]}

McMullan, Brendan ^{[25
,26
,27
]}

Singh-Grewal, Davinder ^{[26
,28
,29
]}

Wood, Nicholas ^{[30
,31
]}

Macartney, Kristine ^{[29
,30
,32
]}

Britton, Phil N. ^{[32
,33
]}

Crawford, Nigel W. ^{[1
,9
,11
]}

机构：

[1] Murdoch Childrens Res Inst, Infect & Immun Theme, Parkville, Vic, Australia

[2] Royal Childrens Hosp Melbourne, Resp & Sleep Med, Parkville, Vic, Australia

[3] Univ Melbourne, Melbourne Sch Populat & Global Hlth, Parkville, Vic, Australia

[4] Murdoch Childrens Res Inst, Clin Epidemiol & Biostat Unit, Parkville, Vic, Australia

[5] Univ Western Australia, Wesfarmers Ctr Vaccines & Infect Dis, Perth, WA, Australia

[6] Univ Western Australia, Telethon Kids Inst, Perth, WA, Australia

[7] Perth Childrens Hosp, Dept Infect Dis, Perth, WA, Australia

[8] QEII Med Ctr, Dept Microbiol, PathWest Lab Med, Perth, WA, Australia

[9] Univ Melbourne, Dept Paediat, Melbourne, Vic, Australia

[10] Royal Childrens Hosp, Dept Infect Dis, Parkville, Vic, Australia

[11] Royal Childrens Hosp Melbourne, Gen Med, Parkville, Vic, Australia

[12] Monash Childrens Hosp, Dept Infect & Immun, Clayton, Vic, Australia

[13] Univ Oxford, Dept Paediat, Oxford, England

[14] Childrens Hlth Queensland Hosp & Hlth Serv, Infectious Dis, Herston, Qld, Australia

[15] Monash Univ, Infectious Dis Epidemiol Unit, Sch Publ Hlth & Prevent Med, Clayton, Vic, Australia

[16] Alfred Hlth, Infect Prevent & Healthcare Epidemiol Unit, Dept Infect Dis, Melbourne, Vic, Australia

[17] Natl Ctr Immunisat Res & Surveillance Vaccine Pre, Westmead, NSW, Australia

[18] Charles Darwin Univ, Menzies Sch Hlth Res, Casuarina, NT, Australia

[19] Royal Darwin Hosp, Dept Paediat, Casuarina, NT, Australia

[20] Queensland Childrens Hosp, South Brisbane, Qld, Australia

[21] Childrens Hosp Westmead, Gen Med, Westmead, NSW, Australia

[22] Univ Adelaide, Discipline Paediat, Adelaide Med Sch, Adelaide, SA, Australia

[23] Univ Adelaide, Robinson Res Inst, Adelaide, SA, Australia

[24] Womens & Childrens Hlth Network, Vaccinol & Immunol Res Trials Unit, Adelaide, SA, Australia

[25] Sydney Childrens Hosp, Dept Immunol & Infect Dis, Sydney, NSW, Australia

[26] Univ New South Wales, Sch Womens & Childrens Hlth, Sydney, NSW, Australia

[27] Univ Melbourne, Natl Ctr Infect Canc, Melbourne, Vic, Australia

[28] Sydney Childrens Hosp Network, Dept Rheumatol, Sydney, NSW, Australia

[29] Univ Sydney, Child & Adolescent Hlth, Sydney, NSW, Australia

[30] Childrens Hosp, Natl Ctr Immunisat Res & Surveillance, Westmead, NSW, Australia

[31] Univ Sydney, Childrens Hosp Westmead, Clin Sch, Sydney, NSW, Australia

[32] Childrens Hosp Westmead, Dept Infect Dis & Microbiol, Sydney, NSW, Australia

[33] Univ Sydney, Sydney Med Sch, Sydney, NSW, Australia

来源：

BMJ OPEN | 2021年 / 11卷 / 11期

基金：

澳大利亚国家健康与医学研究理事会; 英国医学研究理事会;

关键词：

COVID-19; paediatrics; virology; epidemiology; public health; paediatric infectious disease & immunisation; COVID-19; DISEASE;

D O I：

10.1136/bmjopen-2021-054510

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective To present Australia-wide data on paediatric COVID-19 and multisystem inflammatory syndromes to inform health service provision and vaccination prioritisation. Design Prospective, multicentre cohort study. Setting Eight tertiary paediatric hospitals across six Australian states and territories in an established research surveillance network-Paediatric Active Enhanced Disease (PAEDS). Participants All children aged <19 years with SARS-CoV-2 infection including COVID-19, Paediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS) and Kawasaki-like disease TS infection (KD-TS) treated at a PAEDS site from 24 March 2020 to 31 December 2020. Intervention Laboratory-confirmed SARS-CoV-2 infection. Main outcome Incidence of severe disease among children with COVID-19, PIMS-TS and KD-TS. We also compared KD epidemiology before and during the COVID-19 pandemic. Results Among 386 children with SARS-CoV-2 infection, 381 (98.7%) had COVID-19 (median 6.3 years (IQR 2.1-12.8),53.3% male) and 5 (1.3%) had multisystem inflammatory syndromes (PIMS-TS, n=4; KD-TS, n=1) (median 7.9 years (IQR 7.8-9.8)). Most children with COVID-19 (n=278; 73%) were Australian-born from jurisdictions with highest community transmission. Comorbidities were present in 72 (18.9%); cardiac and respiratory comorbidities were most common (n=32/72;44%). 37 (9.7%) children with COVID-19 were hospitalised, and two (0.5%) required intensive care. Postinfective inflammatory syndromes (PIMS-TS/KD-TS) were uncommon (n=5; 1.3%), all were hospitalised and three (3/5; 60%) required intensive care management. All children recovered and there were no deaths. KD incidence remained stable during the pandemic compared with prepandemic. Conclusions Most children with COVID-19 had mild disease. Severe disease was less frequent than reported in high prevalence settings. Preventative strategies, such as vaccination, including children and adolescents, could reduce both the acute and postinfective manifestations of the disease.

引用

页数：9

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