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Is cardiorespiratory disease associated with increased susceptibility of SARS-CoV-2 in children?
Cassidy Du Berry1,2,3, Thomas Saunders1,2,3, Alissa McMinn1,2
1Division of Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Australia.
Insights
Children with chronic cardiorespiratory conditions did not have a higher risk of testing positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Symptomatic infection rates were similar in children with and without these conditions.
Area of Science:
- Pediatric Infectious Diseases
- Cardiorespiratory Health
- Epidemiology
Background:
- Limited data exist on the association between chronic cardiorespiratory conditions and COVID-19 risk in children.
- Understanding this relationship is crucial for managing pediatric health during the pandemic.
Purpose of the Study:
- To compare the prevalence of chronic cardiac and respiratory diseases in pediatric patients who tested positive for SARS-CoV-2 versus those who tested negative.
- To assess the impact of cardiorespiratory comorbidities on symptomatic COVID-19 in children.
Main Methods:
- A prospective cohort study with a nested case-control design was conducted.
- Children tested for SARS-CoV-2 via PCR between March and October 2020 were included.
- Age- and sex-matched SARS-CoV-2-positive children were compared to SARS-CoV-2-negative children (1:2 ratio).
Main Results:
- No significant difference in the frequency of common comorbidities like asthma, congenital heart disease, or obstructive sleep apnea was found between SARS-CoV-2-positive and negative pediatric groups.
- Symptomatic COVID-19 rates were similar in children with and without cardiorespiratory comorbidities.
- A notable proportion (23.8%) of hospitalized children with COVID-19 had cardiac comorbidities.
Conclusions:
- Pre-existing cardiorespiratory diseases were similarly distributed among pediatric SARS-CoV-2-positive and negative cases in this cohort.
- Cardiorespiratory comorbidity did not influence the likelihood of symptomatic infection.
- The high prevalence of cardiac comorbidities in hospitalized COVID-19 pediatric cases warrants further investigation for vaccine prioritization.
Background:
There are limited data in pediatric populations evaluating whether chronic cardiorespiratory conditions are associated with increased risk of coronavirus disease 2019 (COVID-19). We aimed to compare the rates of chronic cardiac and respiratory disease in children testing positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2[+]) compared with those testing negative (SARS-CoV-2[-]) at our institution.
Method:
Prospective cohort with nested case-control study of all children tested by polymerase chain reaction (PCR) for SARS-CoV-2 by nasopharyngeal/oropharyngeal sampling between March and October 2020. Children were identified prospectively via laboratory notification with age and sex-matching of SARS-CoV-2[+] to SARS-CoV-2[-] (1:2). Clinical data were extracted from the electronic medical record.
Results:
In total, 179 SARS-CoV-2[+] children (44% females, median age 3.5 years, range: 0.1-19.0 years) were matched to 391 SARS-CoV-2[-] children (42% female, median age 3.7 years, range: 0.1-18.3 years). The commonest comorbidities showed similar frequencies in the SARS-CoV-2[+] and [-] groups: asthma (n = 9, 5% vs. n = 17, 4.4%, p = 0.71), congenital heart disease (n = 6, 3.4% vs. n = 7, 1.8%, p = 0.25) and obstructive sleep apnoea (n = 4, 2.2% vs. n = 10, 2.3%, p = 0.82). In the SARS-CoV-2[+] group, the prevalence of symptomatic disease was similar among children with and without cardiorespiratory comorbidities (n = 12, 75% vs. n = 103, 57%, p = 0.35). A high proportion of children hospitalized with SARS-CoV-2 infection had cardiac comorbidities (23.8%).
Conclusions:
In this single site data set, rates of pre-existing cardiorespiratory disease were similar in SARS-CoV-2[+] and SARS-CoV-2[-] children. Rates of symptomatic infection were similar between children with and without cardiorespiratory comorbidity. High rates of comorbid cardiac disease were observed among hospitalized children with COVID-19 warranting further research to inform vaccine prioritization.
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