학술논문
Severe Pediatric COVID-19 and Multisystem Inflammatory Syndrome in Children From Wild-type to Population Immunity: A Prospective Multicenter Cohort Study With Real-time Reporting.
Document Type
Academic Journal
Author
Tulling AJ; From the Department of Pediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, the Netherlands.; Lugthart G; From the Department of Pediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, the Netherlands.; Mooij MG; Department of Pediatric Nephrology, Sophia Children's Hospital, Erasmus MC, Rotterdam, the Netherlands.; Brackel CLH; Department of Pediatrics, Tergooi MC, Hilversum, the Netherlands.; Terheggen-Lagro SWJ; Department of Pediatric Pulmonology, Emma Children's Hospital, Amsterdam University Medical Center, Amsterdam, the Netherlands.; Oostenbrink R; Department of General Pediatrics, Sophia Children's Hospital, Erasmus MC, Rotterdam, the Netherlands.; Buysse CMP; Department of Pediatric Intensive Care, Sophia Children's Hospital, Erasmus MC, Rotterdam, the Netherlands.; Hashimoto S; Department of Pediatric Pulmonology, Emma Children's Hospital, Amsterdam University Medical Center, Amsterdam, the Netherlands.; Armbrust W; Department of Pediatric Rheumatology, University Medical Center Groningen, Groningen, the Netherlands.; Bannier MAGE; Department of Pediatrics, University Medical Center Maastricht, Maastricht, the Netherlands.; Bekhof J; Department of Pediatrics, Isala Hospital, Zwolle, the Netherlands.; van Gameren-Oosterom HB; Department of Pediatrics, Groene Hart Hospital, Gouda, the Netherlands.; Hendriks H; Department of Pediatrics, Zuyderland Medical Center, Heerlen, the Netherlands.; van Houten MA; Department of Pediatrics, Spaarne Gasthuis, Hoofddorp, the Netherlands.; van der Linden JW; Department of Pediatrics, Bernhoven, Uden, the Netherlands.; Lebon A; Department of Pediatrics, Albert Schweitzer Hospital, Dordrecht, the Netherlands.; van Onzenoort-Bokken L; Department of Pediatrics, Máxima Medical Center, Veldhoven, the Netherlands.; Tramper-Stranders GA; Department of Pediatrics, Franciscus Gasthuis and Vlietland, Rotterdam, the Netherlands.; van Veen M; Department of Pediatrics, Juliana Children's Hospital, Hagaziekenhuis, the Hague, the Netherlands.; von Asmuth EGJ; From the Department of Pediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, the Netherlands.; Buddingh EP; From the Department of Pediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, the Netherlands.
Source
Publisher: Williams & Wilkins Country of Publication: United States NLM ID: 8701858 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-0987 (Electronic) Linking ISSN: 08913668 NLM ISO Abbreviation: Pediatr Infect Dis J Subsets: MEDLINE
Subject
Language
English
Abstract
Background: SARS-CoV-2 variant evolution and increasing immunity altered the impact of pediatric SARS-CoV-2 infection. Public health decision-making relies on accurate and timely reporting of clinical data.
Methods: This international hospital-based multicenter, prospective cohort study with real-time reporting was active from March 2020 to December 2022. We evaluated longitudinal incident rates and risk factors for disease severity.
Results: We included 564 hospitalized children with acute COVID-19 (n = 375) or multisystem inflammatory syndrome in children (n = 189) from the Netherlands, Curaçao and Surinam. In COVID-19, 134/375 patients (36%) needed supplemental oxygen therapy and 35 (9.3%) required intensive care treatment. Age above 12 years and preexisting pulmonary conditions were predictors for severe COVID-19. During omicron, hospitalized children had milder disease. During population immunity, the incidence rate of pediatric COVID-19 infection declined for older children but was stable for children below 1 year. The incidence rate of multisystem inflammatory syndrome in children was highest during the delta wave and has decreased rapidly since omicron emerged. Real-time reporting of our data impacted national pediatric SARS-CoV-2 vaccination- and booster-policies.
Conclusions: Our data supports the notion that similar to adults, prior immunity protects against severe sequelae of SARS-CoV-2 infections in children. Real-time reporting of accurate and high-quality data is feasible and impacts clinical and public health decision-making. The reporting framework of our consortium is readily accessible for future SARS-CoV-2 waves and other emerging infections.
Competing Interests: The authors have no conflicts of interest to disclose.
(Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
Methods: This international hospital-based multicenter, prospective cohort study with real-time reporting was active from March 2020 to December 2022. We evaluated longitudinal incident rates and risk factors for disease severity.
Results: We included 564 hospitalized children with acute COVID-19 (n = 375) or multisystem inflammatory syndrome in children (n = 189) from the Netherlands, Curaçao and Surinam. In COVID-19, 134/375 patients (36%) needed supplemental oxygen therapy and 35 (9.3%) required intensive care treatment. Age above 12 years and preexisting pulmonary conditions were predictors for severe COVID-19. During omicron, hospitalized children had milder disease. During population immunity, the incidence rate of pediatric COVID-19 infection declined for older children but was stable for children below 1 year. The incidence rate of multisystem inflammatory syndrome in children was highest during the delta wave and has decreased rapidly since omicron emerged. Real-time reporting of our data impacted national pediatric SARS-CoV-2 vaccination- and booster-policies.
Conclusions: Our data supports the notion that similar to adults, prior immunity protects against severe sequelae of SARS-CoV-2 infections in children. Real-time reporting of accurate and high-quality data is feasible and impacts clinical and public health decision-making. The reporting framework of our consortium is readily accessible for future SARS-CoV-2 waves and other emerging infections.
Competing Interests: The authors have no conflicts of interest to disclose.
(Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)