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Risk factors of COVID-19 related hospitalization of paediatric patients with rheumatic diseases: a systematic review

Qianzi Zhao1, Beth Wallace2, Tova Ronis3

  • 1Internal Medicine, Trinity Health Ann Arbor, Ann Arbor, MI, USA.

Rheumatology (Oxford, England)
|December 10, 2024
PubMed

Insights

Children with rheumatic diseases (RDs) face higher COVID-19 hospitalization risks. Juvenile idiopathic arthritis (JIA) patients on TNFα inhibitors may have a lower risk, indicating potential protective effects.

Area of Science:

  • Pediatric Rheumatology
  • Infectious Diseases
  • Public Health

Background:

  • Adults with rheumatic diseases (RDs) show similar COVID-19 hospitalization rates to those without RDs.
  • Data on COVID-19 hospitalization risk in pediatric patients with RDs is limited due to the rarity of severe outcomes in this group.

Purpose of the Study:

  • To investigate risk factors associated with COVID-19 hospitalization in pediatric patients diagnosed with rheumatic diseases.

Main Methods:

  • A systematic literature search was performed across major databases (MEDLINE, EMBASE, Web of Science, CNKI) from December 2019 to January 2024.
  • Included observational studies were analyzed using odds ratios (ORs) with 95% confidence intervals (CIs) to assess hospitalization risk.

Main Results:

  • Eight cohort studies involving 1501 pediatric RD patients and 118 hospitalizations were analyzed.
  • Children with RDs had increased odds of COVID-19 hospitalization compared to healthy children.
  • Specific treatments like glucocorticoids, rituximab, mycophenolate mofetil, hydroxychloroquine, and IL-1 inhibitors were linked to higher hospitalization odds, while TNFα inhibitors were associated with reduced odds. Systemic JIA also increased hospitalization risk, contrasting with overall JIA.

Conclusions:

  • Pediatric patients with rheumatic diseases are at an elevated risk for severe COVID-19 outcomes.
  • The use of TNFα inhibitors in children with juvenile idiopathic arthritis may confer a protective effect against COVID-19 hospitalization.
Abstract

Keywords:
COVID-19hospitalizationpaediatricsrheumatic diseasesrisk factors

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