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264504

Impact of COVID-19 on children with rheumatic diseases: a retrospective cohort analysis

Article

Last updated: 22 Jan 2023

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Subjects

-

Tags

Autoimmunity
Immunology
Pediatrics
Rheumatology

Abstract

Background: Data concerning impact of COVID-19 on children with rheumatic disorders in developing countries are limited. Methods: We conducted a retrospective analysis, examining the medical records of 49 children (15 males, 34 females) with rheumatologic disorders who got infected with SARS-CoV2. They were recruited, over a period of 17 months, from the Children's Hospitals of Ain Shams, Mansoura and Assiut Universities in Egypt. Data recorded were the type and duration of rheumatologic, antirheumatic treatment received, and COVID-19 presentation including severity, and outcome. Complete blood count (CBC), erythrocyte sedimentation rate (ESR), C reactive protein (CRP), lactate dehydrogenase enzyme (LDH), serum ferritin, and Ddimer levels were recorded. Results: Our series included 25 SLE, 16 JIA, two polyarteritis nodosa, two dermatomyositis, two mixed connective tissue disease, one systemic sclerosis, and one HSP patients. They had a median (IQR) age of 13 (10- 14) years. Twenty-nine (59.2%) patients had active disease flare. Forty-one (83.7%) patients were on corticosteroids, and 35 (71.4%) were on add-on immunosuppressives. Twenty-nine patients were hospitalized with a median (IQR) admission duration of 25 (14-38) days. They included 8 mild/asymptomatic, 4 moderate, 6 severe, and 11 critical COVID-19 cases. Seven cases with critical COVID-19 passed away with mortality rate of 14.3 %. The deceased cases had higher neutrophil/lymphocyte ratio (p=0.003), higher CRP levels (p= 0.041) and higher D-dimer (p=0.001) and ferritin levels (0.002) as compared to survivors. Conclusion: Although reported to be milder in children, COVID-19 seems to have higher mortality among children with rheumatic disorders compared to rates reported in the general population. We could not find evidence for the impact of immunosuppressive treatment on COVID-19 related mortality, yet our findings need to be validated by wider-scale prospective studies

DOI

10.21608/ejpa.2022.264504

Keywords

COVID-19, Rheumatic diseases, mortality, children, Pediatric, hospitalized, outcomes

Authors

First Name

Rasha

Last Name

El-Owaidy

MiddleName

-

Affiliation

Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt

Email

rasha2hasan@gmail.com

City

-

Orcid

0000-0002-5609-4160

First Name

Elham

Last Name

Hossny

MiddleName

-

Affiliation

Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt

Email

elham.hossny@gmail.com

City

-

Orcid

-

First Name

Dalia

Last Name

El-Ghoneimy

MiddleName

-

Affiliation

Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt

Email

dalia.elghoneimy@gmail.com

City

-

Orcid

-

First Name

Zeinab

Last Name

El-Sayed

MiddleName

A.

Affiliation

Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt

Email

zeinabawad@gmail.com

City

-

Orcid

-

First Name

Shereen

Last Name

Reda

MiddleName

-

Affiliation

Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt

Email

shereen.m.reda@gmail.com

City

-

Orcid

-

First Name

Ihab

Last Name

El-Hakim

MiddleName

-

Affiliation

MD, PhD, AFSA. Professor of pediatrics and pediatric nephrology, Ain Shams University, Egypt.

Email

ihab.elhakim@gmail.com

City

-

Orcid

-

First Name

Hanan

Last Name

Ibrahim

MiddleName

-

Affiliation

Pediatric intensive care unit, Children's Hospital, Ain Shams University

Email

-

City

-

Orcid

-

First Name

Iman

Last Name

Ragab

MiddleName

-

Affiliation

Pediatric Hematology-Oncology Unit, Children's Hospital, AIn shams University

Email

-

City

-

Orcid

-

First Name

Nesrine

Last Name

Radwan

MiddleName

-

Affiliation

Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt

Email

nesrineradwan@yahoo.com

City

-

Orcid

0000-0002-4334-4589

First Name

Ghada

Last Name

Shousha

MiddleName

-

Affiliation

Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt

Email

gh.a.haliem@hotmail.com

City

-

Orcid

-

First Name

Amal

Last Name

Lotfy

MiddleName

-

Affiliation

Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt

Email

abdelazimlotfy@yahoo.com

City

-

Orcid

-

First Name

Amr

Last Name

Elmekkawy

MiddleName

-

Affiliation

Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt

Email

amr.elmekkawy@gmail.com

City

-

Orcid

-

First Name

Ali

Last Name

Sobh

MiddleName

-

Affiliation

Children's Hospital, Mansoura University

Email

-

City

-

Orcid

-

First Name

Naglaa

Last Name

Osman

MiddleName

-

Affiliation

Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Assuit University

Email

-

City

-

Orcid

-

First Name

Mariam

Last Name

Abdelnaby

MiddleName

-

Affiliation

Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt

Email

mariam_abdelnaby@med.asu.edu.eg

City

-

Orcid

-

First Name

Roba

Last Name

Al-Gaweesh

MiddleName

-

Affiliation

Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt

Email

r.m.gawesh88@gmail.com

City

-

Orcid

-

First Name

Rana

Last Name

Zakaria

MiddleName

-

Affiliation

Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt

Email

ranazakaria26@gmail.com

City

-

Orcid

-

First Name

Mostafa

Last Name

El-Amin

MiddleName

-

Affiliation

Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt

Email

mostafa_el_amin@hotmail.com

City

-

Orcid

-

First Name

Yehia

Last Name

El-Gamal

MiddleName

-

Affiliation

Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt

Email

yehia.elgamal@gmail.com

City

-

Orcid

-

Volume

20

Article Issue

2

Related Issue

37112

Issue Date

2022-10-01

Receive Date

2022-06-14

Publish Date

2022-10-01

Page Start

69

Page End

77

Print ISSN

1687-1642

Online ISSN

2314-8934

Article File

EJPA_Volume 20_Issue 2_Pages 69-77.pdf

PDF . 469.0kB

Link

https://ejpai.journals.ekb.eg/article_264504.html

Detail API

https://ejpai.journals.ekb.eg/service?article_code=264504

Order

4

Type

Original Article

Type Code

643

Publication Type

Journal

Publication Title

The Egyptian Journal of Pediatric Allergy and Immunology

Publication Link

https://ejpai.journals.ekb.eg/

MainTitle

-

Details

Type

Article

Created At

22 Jan 2023