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 HIV burden. This study reflects clinical data on South African children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
We collected clinical data of children aged younger than 13 years with laboratory confirmed SARS-CoV-2 presenting to Tygerberg Hospital, Cape Town between 17th of April and 24th of July 2020.
Hundred and fifty-nine children (median age 48·0 months (interquartile range, IQR 12·0-106·0)) were included. Hospitalized children (n=62), median age of 13·5 months (IQR 1·8-43·5) were younger than children not admitted (n=97), median age 81·0 months (IQR 34·5-120·5, p< 0·01). Thirty-three of 159 (20·8%) children had pre-existing medical conditions. Fifty-one of 62 (82·3%) hospitalized children were symptomatic; lower respiratory tract infection was diagnosed in 21/51 (41·2%) and 11/16 (68·8%) children younger than 3 months of age. Respiratory support was required in 25/51 (49·0%) children; 13/25 (52·0%) children were younger than 3 months. One child was HIV infected and 11/51 (21·2%) were HIV exposed uninfected and 7/51 (13·7%) children had a recent or new diagnosis of tuberculosis.
Children less than 1 year of age hospitalized with SARS-CoV-2 in Cape Town frequently required respiratory support, the access to oxygen may be limited in some LMICs 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.
© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
About The Expert
Marieke M van der Zalm
Juanita Lishman
Lilly M Verhagen
Andrew Redfern
Liezl Smit
Mikhail Barday
Dries Ruttens
A’ishah da Costa
Sandra van Jaarsveld
Justina Itana
Neshaad Schrueder
Marije Van Schalkwyk
Noor Parker
Ilse Appel
Barend Fourie
Mathilda Claassen
Jessica J Workman
Pierre Goussard
Gert Van Zyl
Helena Rabie
References
PubMed