Clinical outcome of SARS-CoV-2 infection in immunosuppressed children in Spain
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SHORT COMMUNICATION
Clinical outcome of SARS-CoV-2 infection in immunosuppressed children in Spain Antonio Pérez-Martinez 1 & Pilar Guerra-García 1 & Marta Melgosa 2 & Esteban Frauca 3 & Carlota Fernandez-Camblor 2 & Agustin Remesal 4 & Cristina Calvo 5,6 Received: 5 May 2020 / Revised: 6 July 2020 / Accepted: 25 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Limited information is available regarding SARS-CoV-2 infections in children with underlying diseases. A retrospective study of children less than 15 years old with primary or secondary immunosuppression infected with SARSCoV-2 during March 2020 was performed. In this series, 8 immunocompromised patients with COVID-19 disease are reported, accounting for 15% of the positive cases detected in children in a reference hospital. The severity of the symptoms was mild-moderate in the majority with a predominance of febrile syndrome, with mild radiological involvement and in some cases with mild respiratory distress that required oxygen therapy. The rational and prudent management of these patients is discussed, evaluating possible treatments and options for hospitalization or outpatient follow-up. Conclusion: In our experience, monitoring of children with immunosuppression and COVID-19 disease can be performed as outpatients if close monitoring is possible. Hospitalization should be assessed when high fever, radiological involvement, and/or respiratory distress are present. What is Known: • SARS-CoV-2 infection is usually mild in children. What is New: • Outcome of immunosuppressed children with COVID-19 is generally good, with a mild-moderate course.
Keywords COVID-19 . Transplant . Cancer . Immunosuppression
Communicated by Nicole Ritz * Cristina Calvo [email protected]
1
Pediatric Hemato-Oncology Department, Hospital Universitario La Paz, Madrid, Spain
Antonio Pérez-Martinez [email protected]
2
Pediatric Nephrology Department, Hospital Universitario La Paz, Madrid, Spain
Pilar Guerra-García [email protected]
3
Pediatric Hepatology Department, Hospital Universitario La Paz, Madrid, Spain
4
Pediatric Rheumatology Department, Hospital Universitario La Paz, Madrid, Spain
5
Pediatric and Infectious Diseases Department, Hospital Universitario La Paz, Paseo de la Castellana, 261 28046 Madrid, Spain
6
Fundación IdiPaz, Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain
Marta Melgosa [email protected] Esteban Frauca [email protected] Carlota Fernandez-Camblor [email protected] Agustin Remesal [email protected]
Eur J Pediatr
Abbreviations ACE2 Angiotensin-converting enzyme 2 ESPGHAN European Society for Gastroenterology sHLH Hemophagocytic lymphohistiocytosis-like syndrome SIOP International Society of Pediatric Oncology IQR interquartile range PCR Polymerase chain reaction
Introduction SARS-CoV-2 infection in children younger than 10 years of age has been described in around 1% of identified cases in Chi
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