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Article ; Online: Outcomes of COVID-19 in a cohort of pediatric patients with rheumatic diseases.

Villacis-Nunez, D Sofia / Rostad, Christina A / Rouster-Stevens, Kelly / Khosroshahi, Arezou / Chandrakasan, Shanmuganathan / Prahalad, Sampath

Pediatric rheumatology online journal

2021 Volume 19, Issue 1, Page(s) 94

Abstract: Background: There are few reports of COVID-19 in pediatric patients with rheumatic diseases ... We analyzed a single-center case series of pediatric patients with rheumatic diseases and laboratory-confirmed ... This study describes the clinical presentation and outcomes of COVID-19 in this population.: Methods ...

Abstract	Background: There are few reports of COVID-19 in pediatric patients with rheumatic diseases. This study describes the clinical presentation and outcomes of COVID-19 in this population. Methods: We analyzed a single-center case series of pediatric patients with rheumatic diseases and laboratory-confirmed COVID-19. Demographic, baseline and COVID-19 associated clinical features were compared between ambulatory and hospitalized patients using univariate analysis. Results: Fifty-five cases were identified: 45 (81.8%) in the ambulatory group and 10 (18.2%) hospitalized. African American race (OR 7.78; 95% CI [1.46-55.38]; p = 0.006) and cardiovascular disease (OR 19.40; 95% CI 2.45-254.14; p = 0.001) predominated in hospitalized patients. Active rheumatic disease (OR 11.83; 95% CI 1.43-558.37; p = 0.01), medium/high-dose corticosteroid use (OR 14.12; 95% CI [2.31-106.04]; p = 0.001), mycophenolate use (OR 8.84; 95% CI [1.64-63.88]; p = 0.004), rituximab use (OR 19.40; 95% CI [2.45-254.14]; p = 0.001) and severe immunosuppression (OR 34.80; 95% CI [3.94-1704.26]; p = < 0.001) were associated with increased odds of hospitalization. Fever (OR 7.78; 95% CI [1.46-55.38]; p = 0.006), dyspnea (OR 26.28; 95% CI [2.17-1459.25]; p = 0.003), chest pain (OR 13.20; 95% CI [1.53-175.79]; p = 0.007), and rash (OR 26.28; 95% CI [2.17-1459.25]; p = 0.003) were more commonly observed in hospitalized patients. Rheumatic disease flares were almost exclusive to hospitalized patients (OR 55.95; 95% CI [5.16-3023.74]; p < 0.001).. One patient did not survive. Conclusions: Medium/high-dose corticosteroid, mycophenolate and rituximab use, and severe immunosuppression were risk factors for hospitalization. Fever, dyspnea, chest pain, and rash were high-risk symptoms for hospitalization. Rheumatic disease activity and flare could contribute to the need for hospitalization.
MeSH term(s)	Adolescent ; COVID-19/complications ; COVID-19/diagnosis ; COVID-19/pathology ; COVID-19/therapy ; Child ; Child, Preschool ; Female ; Hospitalization ; Humans ; Infant ; Infant, Newborn ; Male ; Rheumatic Diseases/complications ; Rheumatic Diseases/pathology ; Rheumatic Diseases/therapy ; Rheumatic Diseases/virology ; Treatment Outcome ; Young Adult
Language	English
Publishing date	2021-06-21
Publishing country	England
Document type	Journal Article
ZDB-ID	2279468-2
ISSN	1546-0096 ; 1546-0096
ISSN (online)	1546-0096
ISSN	1546-0096
DOI	10.1186/s12969-021-00568-4
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Clinical characteristics and COVID-19 outcomes in a regional cohort of pediatric patients with rheumatic diseases.

Clemente, Daniel / Udaondo, Clara / de Inocencio, Jaime / Nieto, Juan Carlos / Del Río, Pilar Galán / Fernández, Antía García / Palomo, Jaime Arroyo / Bachiller-Corral, Javier / Lopez Robledillo, Juan Carlos / Millán Longo, Claudia / Leon, Leticia / Abasolo, Lydia / Boteanu, Alina

Pediatric rheumatology online journal

2021 Volume 19, Issue 1, Page(s) 162

Abstract: ... of coronavirus disease 2019 (COVID-19) in pediatric patients with rheumatic and musculoskeletal diseases (RMD ... 25%) had a mild-moderate COVID-19 and 6 patients (7.79%) required hospital admission. The median ... and COVID-19 were included. Main outcomes were symptomatic disease and hospital admission ...

Abstract	Background: This study aimed to assess the baseline characteristics and clinical outcomes of coronavirus disease 2019 (COVID-19) in pediatric patients with rheumatic and musculoskeletal diseases (RMD) and identify the risk factors associated with symptomatic or severe disease defined as hospital admission, intensive care admission or death. Methods: An observational longitudinal study was conducted during the first year of the SARS-CoV-2 pandemic (March 2020-March 2021). All pediatric patients attended at the rheumatology outpatient clinics of six tertiary referral hospitals in Madrid, Spain, with a diagnosis of RMD and COVID-19 were included. Main outcomes were symptomatic disease and hospital admission. The covariates were sociodemographic and clinical characteristics and treatment regimens. We ran a multivariable logistic regression model to assess associated factors for outcomes. Results: The study population included 77 pediatric patients. Mean age was 11.88 (4.04) years Of these, 30 patients (38.96%) were asymptomatic, 41 (53.25%) had a mild-moderate COVID-19 and 6 patients (7.79%) required hospital admission. The median length of hospital admission was 5 (2-20) days, one patient required intensive care and there were no deaths. Previous comorbidities increased the risk for symptomatic disease and hospital admission. Compared with outpatients, the factor independently associated with hospital admission was previous use of glucocorticoids (OR 3.51; p = 0.00). No statistically significant risk factors for symptomatic COVID-19 were found in the final model. Conclusion: No differences in COVID-19 outcomes according to childhood-onset rheumatic disease types were found. Results suggest that associated comorbidities and treatment with glucocorticoids increase the risk of hospital admission.
MeSH term(s)	Adolescent ; Antirheumatic Agents/therapeutic use ; Arthritis, Juvenile/drug therapy ; Arthritis, Juvenile/epidemiology ; Asthma/epidemiology ; COVID-19/epidemiology ; COVID-19/physiopathology ; Carrier State/epidemiology ; Child ; Cohort Studies ; Comorbidity ; Female ; Glucocorticoids/therapeutic use ; Heart Diseases/epidemiology ; Hereditary Autoinflammatory Diseases/drug therapy ; Hereditary Autoinflammatory Diseases/epidemiology ; Hospitalization/statistics & numerical data ; Humans ; Intensive Care Units, Pediatric ; Length of Stay ; Logistic Models ; Longitudinal Studies ; Lupus Erythematosus, Systemic/drug therapy ; Lupus Erythematosus, Systemic/epidemiology ; Male ; Multivariate Analysis ; Obesity/epidemiology ; Renal Insufficiency, Chronic/epidemiology ; Rheumatic Diseases/drug therapy ; Rheumatic Diseases/epidemiology ; Risk Factors ; SARS-CoV-2 ; Severity of Illness Index ; Spain/epidemiology
Chemical Substances	Antirheumatic Agents ; Glucocorticoids
Language	English
Publishing date	2021-11-27
Publishing country	England
Document type	Journal Article ; Observational Study
ZDB-ID	2279468-2
ISSN	1546-0096 ; 1546-0096
ISSN (online)	1546-0096
ISSN	1546-0096
DOI	10.1186/s12969-021-00648-5
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Article ; Online: Clinical characteristics and COVID-19 outcomes in a regional cohort of pediatric patients with rheumatic diseases

Clemente, Daniel / Udaondo, Clara / de Inocencio, Jaime / Nieto, Juan Carlos / Galan del Rio, Pilar / Garcia Fernandez, Antia / Arroyo Palomo, Jaime / Bachiller-Corral, Javier / Lopez Robledillo, Juan Carlos / Leon, Leticia / Abasolo, Lydia / Boteanu, Alina

medRxiv

Abstract: ... of coronavirus disease 2019 (COVID-19) in pediatric patients with rheumatic and musculoskeletal diseases (RMD ... other 6 patients (7.79%) required hospital admission related to COVID-19. The median length of stay was 5 ... diagnosis of RMD and COVID-19 were included. Main outcomes were symptomatic disease and hospital admission ...

Abstract	Background: This study aimed to assess the baseline characteristics and clinical outcomes of coronavirus disease 2019 (COVID-19) in pediatric patients with rheumatic and musculoskeletal diseases (RMD) and identify the risk factors associated with symptomatic or severe disease defined as hospital admission, intensive care admission or death. Methods: An observational longitudinal study was conducted during the first year of pandemic SARS-CoV-2 (1st March 2020 to 1st March 2021). All pediatric patients attended at the rheumatology outpatient clinic of six tertiary hospital in Madrid, Spain, with a medical diagnosis of RMD and COVID-19 were included. Main outcomes were symptomatic disease and hospital admission. The covariates were sociodemographic, clinical, and treatments. We ran a multivariable logistic regression model to assess risk factors for outcomes. Results: The study population included 77 pediatric patients. Mean age was 11.88 (4.04) years Of these, 30 patients were asymptomatic, 41 had a mild or moderate disease and other 6 patients (7.79%) required hospital admission related to COVID-19. The median length of stay was 5 (2-20) days and there was no death. Previous comorbidities increased the risk for symptomatic disease and hospital admission. Compared with outpatients, the factor independently associated with hospital admission was the use of glucocorticoids (OR 1.08; p=0.00). No statistically significant findings for symptomatic COVID-19 were found in the final model. Conclusion: Our data found no differences in COVID-19 outcomes between children-onset rheumatic diseases. Our results suggest that associated comorbidities and being in treatment with glucocorticoids increase the risk of hospital admission.
Keywords	covid19
Language	English
Publishing date	2021-05-20
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2021.05.19.21257450
Database	COVID19

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Article ; Online: Clinical manifestations and outcomes associated with PICU admission in children with multisystem inflammatory syndrome in Taiwan: A retrospective cohort study.

Tseng, Chi-Teng / Lin, Jainn-Jim / Huang, Jing-Long / Chiu, Cheng-Hsun / Wu, Chao-Yi

International journal of rheumatic diseases

2023 Volume 27, Issue 1, Page(s) e14970

Abstract: ... eight MIS-C patients, including 9 boys and 19 girls, with an average age of 5.3 ± 3.8 years old, were ... A retrospective analysis was conducted among pediatric patients diagnosed with MIS-C between June 2022 and ... enrolled. Most of the cases (78.6%) were diagnosed following the first pandemic wave of COVID-19 in Taiwan ...

Abstract	Background: Multisystem inflammatory syndrome in children (MIS-C) is a rare and serious systemic inflammatory disorder that occurs following a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This study aims to investigate the clinical manifestations, risk factors associated with pediatric intensive care unit (PICU) admission, and outcome among children with MIS-C in Taiwan. Methods: A retrospective analysis was conducted among pediatric patients diagnosed with MIS-C between June 2022 and February 2023 at Chang Gung Memorial Hospital, Linkou, Taiwan. Data on demographics, clinical features, laboratory findings, treatment modalities, and outcomes were collected and analyzed. Results: Twenty-eight MIS-C patients, including 9 boys and 19 girls, with an average age of 5.3 ± 3.8 years old, were enrolled. Most of the cases (78.6%) were diagnosed following the first pandemic wave of COVID-19 in Taiwan. The leading clinical manifestations observed were fever (100%), skin rash (64.3%), tachycardia (46.4%), and vomiting (46.4%). Nine patients (32.1%) were admitted to the PICU due to hypotension or neurological manifestations. Higher levels of band-form white blood cells, procalcitonin, ferritin, d-dimer, prothrombin time, NT-proBNP, and lower platelet levels on arrival were associated with PICU admission (p = 3.9 × 10 Conclusion: MIS-C cases in Taiwan have a favorable outcome. Although one-third of the patients required PICU admission, none of the MIS-C cases resulted in severe cardiovascular morbidity or mortality. This study provides valuable insights into the clinical manifestations and outcomes associated with PICU admission in children with MIS-C in Taiwan.
MeSH term(s)	Male ; Female ; Humans ; Child ; Infant ; Child, Preschool ; Retrospective Studies ; Taiwan/epidemiology ; Connective Tissue Diseases ; Hospitalization ; SARS-CoV-2 ; COVID-19/complications ; Systemic Inflammatory Response Syndrome
Language	English
Publishing date	2023-11-10
Publishing country	England
Document type	Journal Article
ZDB-ID	2426924-4
ISSN	1756-185X ; 1756-1841
ISSN (online)	1756-185X
ISSN	1756-1841
DOI	10.1111/1756-185X.14970
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Assessment of the outcomes of SARS-CoV-2 infection in children and young people followed at Portuguese pediatric rheumatology clinics.

Melo, Ana Teresa / Bernardo, Miguel / Pinheiro, Filipe / Rodrigues, Mariana / Torres, Rita / Mourão, Ana Filipa / Carvalho, Sónia / Nascimento, João / Sousa, Sandra / Santos, Maria José / Soares, Catarina / Cabral, Marta / Marques, Raquel Campanilho / Reis, Patrícia Costa / Ramos, Filipa Oliveira

ARP rheumatology

2022 Volume 1, Issue ARP Rheumatology, nº3 2022, Page(s) 205–209

Abstract: Introduction: Coronavirus Disease 2019 (COVID-19) generally appears to have milder ... disease modifying drugs (csDMARDs) and 10 on biologic DMARDs (bDMARDs). Five patients had an active ... inflammatory disease at the time of infection (low activity). Seven patients had an asymptomatic infection ...

Title translation	Assessment of the outcomes of SARS-CoV-2 infection in children and young people followed at Portuguese pediatric rheumatology clinics.
Abstract	Introduction: Coronavirus Disease 2019 (COVID-19) generally appears to have milder clinical symptoms and fewer laboratory abnormalities in children. It remains unknown whether children and young people with inflammatory chronic diseases who acquire SARS-CoV-2 infection have a more severe course, due to either underlying disease or immunosuppressive treatments. Objectives: To assess the epidemiological features and clinical outcomes of children and young people with inflammatory chronic diseases followed at Pediatric Rheumatology Clinics who were infected with SARS-CoV-2. Methods: A multicentric prospective observational study was performed. Data on demographic variables, clinical features and treatment were collected between March 2020 and September 2021, using the Rheumatic Diseases Portuguese Register (Reuma.pt) and complemented with data from the hospital clinical records. Results: Thirty-four patients were included, 62% were female, with a median age of 13 [8-16] years and a median time of inflammatory chronic disease of 6 [3-10] years. The most common diagnoses were juvenile idiopathic arthritis (n=22, 64.7%), juvenile dermatomyositis (n=3, 8.8%) and idiopathic uveitis (n=3, 8.8%). Twenty patients were on conventional synthetic disease modifying drugs (csDMARDs) and 10 on biologic DMARDs (bDMARDs). Five patients had an active inflammatory disease at the time of infection (low activity). Seven patients had an asymptomatic infection while 27 patients (79%) had symptoms: cough (n=12), fever (n=11), rhinorrhea (n=10), headache (n=8), malaise (n=8), fatigue (n=7), anosmia (n=5), myalgia (n=5),dysgeusia (n=4), odynophagia (n=4), chest pain (n=2), diarrhea (n=2), arthralgia (n=1), vomiting (n=1) and conjunctivitis (n=1). No patient required hospitalization or directed treatment, and all recovered without sequelae. In 8 patients there was a change in the baseline medication during the infection: suspension of bDMARDs (n=4), reduction of bDMARDs (n=1), suspension of csDMARDs (n=4) and reduction of csDMARDs (n=2). Only in one patient with juvenile dermatomyositis (who discontinued bDMARDs and csDMARDs), the underlying disease worsened. Conclusions: This is the first study involving children with inflammatory chronic diseases followed at Rheumatology Clinics and SARS-CoV-2 infection in Portugal. In our cohort, mild illness was predominant, which is consistent with the literature. There was no need for hospitalization or specific treatment, and, in most cases, no worsening of the underlying disease was identified.
MeSH term(s)	Child ; Humans ; Female ; Adolescent ; Male ; COVID-19/epidemiology ; SARS-CoV-2 ; Portugal/epidemiology ; Dermatomyositis ; Rheumatology ; Antirheumatic Agents/therapeutic use
Chemical Substances	Antirheumatic Agents
Language	English
Publishing date	2022-10-01
Publishing country	Portugal
Document type	Observational Study ; Journal Article
ISSN	2795-4552
ISSN (online)	2795-4552
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Outcomes of COVID-19 in a cohort of pediatric patients with rheumatic diseases.

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Article ; Online: Clinical characteristics and COVID-19 outcomes in a regional cohort of pediatric patients with rheumatic diseases.

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Article ; Online: Clinical characteristics and COVID-19 outcomes in a regional cohort of pediatric patients with rheumatic diseases

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Article ; Online: Clinical manifestations and outcomes associated with PICU admission in children with multisystem inflammatory syndrome in Taiwan: A retrospective cohort study.

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Article ; Online: Assessment of the outcomes of SARS-CoV-2 infection in children and young people followed at Portuguese pediatric rheumatology clinics.

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