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Published on: March 6, 2019
COVID-19 and Pediatric Lung Disease: A South African Tertiary Center Experience
Diane M Gray1,2, Mary-Ann Davies3, Leah Githinji1,2
1Department of Pediatrics and Child Health, University of Cape Town, Cape Town, South Africa.
Insights
Children with chronic lung disease in Africa experienced mild COVID-19, with no increased severe disease risk. Further research is needed on long-term impacts and specific conditions like immunosuppression.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Global Health
Background:
- The COVID-19 pandemic significantly impacted global health systems, with children generally experiencing milder disease.
- Chronic lung disease is a known risk factor for severe COVID-19, but data from African pediatric populations, burdened by co-morbidities, is limited.
- Understanding COVID-19's impact on children with chronic respiratory conditions in low-middle income countries (LMICs) is crucial.
Purpose of the Study:
- To review existing literature on COVID-19 and pediatric chronic lung disease.
- To present clinical experience from a South African pediatric pulmonary center.
- To assess the risk of severe COVID-19 in children with pre-existing respiratory conditions in Africa.
Main Methods:
- Literature review on COVID-19 and pediatric chronic lung disease.
- Analysis of epidemiological data from South Africa regarding pediatric COVID-19 cases and admissions.
- Review of patient data from a pediatric pulmonary service managing various chronic respiratory conditions.
Main Results:
- Children <18 years represented 8% of diagnosed COVID-19 cases and 3% of admissions in South Africa.
- No significant increase in COVID-19 admissions was observed among children with chronic lung conditions.
- Pediatric COVID-19 cases with pre-existing respiratory disease generally had a mild disease course.
Conclusions:
- Pre-existing respiratory conditions in children do not appear to be a significant risk factor for severe COVID-19 in the South African context.
- Longitudinal data are required to evaluate risks in children with immunosuppression and interstitial lung diseases.
- The indirect effects of pandemic response measures on child respiratory health require further investigation and quantification.
Abstract:
The COVID-19 pandemic led to rapid global spread with far-reaching impacts on health-care systems. Whilst pediatric data consistently shown a milder disease course, chronic lung disease has been identified as a risk factor for hospitalization and severe disease. In Africa, comprised predominantly of low middle-income countries (LMIC), the additional burden of HIV, tuberculosis, malnutrition and overcrowding is high and further impacts health risk. This paper reviewed the literature on COVID-19 and chronic lung disease in children and provides our experience from an African pediatric pulmonary center in Cape Town, South Africa. South African epidemiological data confirms a low burden of severe disease with children <18 years comprising 8% of all diagnosed cases and 3% of all COVID-19 admissions. A decrease in hospital admission for other viral lower respiratory tract infections was found. While the pulmonology service manages children with a wide range of chronic respiratory conditions including bronchiectasis, cystic fibrosis, asthma, interstitial lung disease and children with tracheostomies, no significant increase in COVID-19 admissions were noted and in those who developed COVID-19, the disease course was not severe. Current evidence suggests that pre-existing respiratory disease in children does not appear to be a significant risk factor for severe COVID-19. Longitudinal data are still needed to assess risk in children with immunosuppression and interstitial lung diseases. The indirect impacts of the pandemic response on child respiratory health are notable and still likely to be fully realized and quantified. Ensuring children have access to full preventive and care services during this time is priority.
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