Impact of COVID-19 on children with rheumatic diseases: a retrospective cohort analysis
El-Owaidy, R., Hossny, E., El-Ghoneimy, D., El-Sayed, Z., Reda, S., El-Hakim, I., Ibrahim, H., Ragab, I., Radwan, N., Shousha, G., Lotfy, A., Elmekkawy, A., Sobh, A., Osman, N., Abdelnaby, M., Al-Gaweesh, R., Zakaria, R., El-Amin, M., El-Gamal, Y. (2022). Impact of COVID-19 on children with rheumatic diseases: a retrospective cohort analysis. EKB Journal Management System, 20(2), 69-77. doi: 10.21608/ejpa.2022.264504
Rasha El-Owaidy; Elham Hossny; Dalia El-Ghoneimy; Zeinab A. El-Sayed; Shereen Reda; Ihab El-Hakim; Hanan Ibrahim; Iman Ragab; Nesrine Radwan; Ghada Shousha; Amal Lotfy; Amr Elmekkawy; Ali Sobh; Naglaa Osman; Mariam Abdelnaby; Roba Al-Gaweesh; Rana Zakaria; Mostafa El-Amin; Yehia El-Gamal. "Impact of COVID-19 on children with rheumatic diseases: a retrospective cohort analysis". EKB Journal Management System, 20, 2, 2022, 69-77. doi: 10.21608/ejpa.2022.264504
El-Owaidy, R., Hossny, E., El-Ghoneimy, D., El-Sayed, Z., Reda, S., El-Hakim, I., Ibrahim, H., Ragab, I., Radwan, N., Shousha, G., Lotfy, A., Elmekkawy, A., Sobh, A., Osman, N., Abdelnaby, M., Al-Gaweesh, R., Zakaria, R., El-Amin, M., El-Gamal, Y. (2022). 'Impact of COVID-19 on children with rheumatic diseases: a retrospective cohort analysis', EKB Journal Management System, 20(2), pp. 69-77. doi: 10.21608/ejpa.2022.264504
El-Owaidy, R., Hossny, E., El-Ghoneimy, D., El-Sayed, Z., Reda, S., El-Hakim, I., Ibrahim, H., Ragab, I., Radwan, N., Shousha, G., Lotfy, A., Elmekkawy, A., Sobh, A., Osman, N., Abdelnaby, M., Al-Gaweesh, R., Zakaria, R., El-Amin, M., El-Gamal, Y. Impact of COVID-19 on children with rheumatic diseases: a retrospective cohort analysis. EKB Journal Management System, 2022; 20(2): 69-77. doi: 10.21608/ejpa.2022.264504

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

The Egyptian Journal of Pediatric Allergy and Immunology
Article 4, Volume 20, Issue 2, October 2022, Page 69-77  XML PDF (458.03 K)
Document Type: Original Article
DOI: 10.21608/ejpa.2022.264504
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Authors
Rasha El-Owaidy email orcid 1; Elham Hossny1; Dalia El-Ghoneimyorcid 1; Zeinab A. El-Sayed1; Shereen Reda1; Ihab El-Hakim2; Hanan Ibrahim3; Iman Ragab4; Nesrine Radwanorcid 1; Ghada Shousha1; Amal Lotfy1; Amr Elmekkawy1; Ali Sobh5; Naglaa Osman6; Mariam Abdelnaby1; Roba Al-Gaweesh1; Rana Zakaria1; Mostafa El-Amin1; Yehia El-Gamal1
1Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt
2MD, PhD, AFSA. Professor of pediatrics and pediatric nephrology, Ain Shams University, Egypt.
3Pediatric intensive care unit, Children's Hospital, Ain Shams University
4Pediatric Hematology-Oncology Unit, Children's Hospital, AIn shams University
5Children's Hospital, Mansoura University
6Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Assuit University
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
Keywords
COVID-19; rheumatic diseases; mortality; children; pediatric; hospitalized, outcomes
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