key: cord-0838955-ok9dwsa9
authors: Du Berry, Cassidy; Saunders, Thomas; McMinn, Alissa; Tosif, Shidan; Shanthikumar, Shivanthan; Vandeleur, Moya; Harrison, Joanne; Burgner, David; Ranganathan, Sarath; Crawford, Nigel; Wurzel, Danielle
title: Is cardiorespiratory disease associated with increased susceptibility of SARS‐CoV‐2 in children?
date: 2021-09-02
journal: Pediatr Pulmonol
DOI: 10.1002/ppul.25642
sha: 5da54b26a38290efa1958c06e453a6cb49f5888f
doc_id: 838955
cord_uid: ok9dwsa9

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.

. [1] [2] [3] [4] The aims of this study were to evaluate the prevalence of asthma and other cardiorespiratory diseases in a pediatric cohort attending a major tertiary pediatric facility (The Royal Children's Hospital [RCH] Melbourne, Australia) for SARS-CoV-2 testing. Our specific objectives were to (1) determine whether children with cardiac or respiratory comorbidities were more likely to test positive for SARS-CoV-2 than those without, and (2) if children with these pre-existing comorbidities experienced a higher rate of symptomatic infection than those without comorbidities.

This prospective cohort, within a nested case-control study, included all children consecutively tested with reverse-transcriptase polymerase chain reaction (RT-PCR) for SARS-CoV-2 from nasopharyngeal/oropharyngeal samples collected at RCH between February 1 and October 31, 2020. SARS-CoV-2 positive (SARS-CoV-2[+]) children were age and sex-matched to consecutively tested SARS- 

In this single-center prospective cohort study with nested case-control, similar rates of cardiac and respiratory disease were observed in children infected with SARS-CoV-2 compared with those uninfected. In addition, those with a history of cardiac or respiratory disease were no more likely, than those without, to present with symptomatic infection. Our findings support those of other studies indicating that children with SARS-CoV-2 infection overwhelmingly experience mild symptoms and many are asymptomatic. [5] [6] [7] [8] Interestingly, we also observed a high proportion of hospitalized in hospitalized children and adolescents with COVID-19 requiring mechanical ventilation. 10 Furthermore, the authors also reported that cardiac disease requiring prior surgical intervention was associated with more severe forms of SARS-CoV-2 infection and higher rates of hospitalization. Cardiac disease was also shown to be associated with ICU admission in a recent European multicentre study. 11 In contrast, while asthma was relatively common in the SARS-CoV-2[+] cohort, two (9.5%) children who were hospitalized with COVID-19 reported a history of asthma, though both had mild disease. A recent large cross-sectional study by Kompaniyets 

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