Impact of COVID-19 infection on children and young people with rheumatic and musculoskeletal diseases

A recent notable global investigation of COVID-19 short term outcomes, published in Annals of the Rheumatic Diseases, reported that the majority of the children and young people (CYP) experience only mild COVID-19 disease and were not hospitalized, while those who were hospitalized were with severe systemic rheumatic and musculoskeletal diseases (RMDs) and obesity.

The study included 607 CYP below 19 years belonging to 25 different countries. The data of the study participants were collected from the EULAR COVID-19 Registry and Childhood Arthritis and Rheumatology Research Alliance (CARRA) datasets. The SARS-CoV-2 cases were confirmed for 499 cases of which 378, 78, 47, 16, 15 CYP were with juvenile idiopathic arthritis (JIA), autoinflammatory syndromes, systemic lupus erythematosus (SLE) mixed connective tissue disease (MCTD), vasculitis and inflammatory myopathy respectively. Forty-three (7%) patients were admitted to hospital due to COVID-19 infection, and patients with SLE/MCTD had a higher percentage of hospitalization (16%) compared to those with systemic and other JIA (15% and 4%). Patients with SLE/MCTD, vasculitis, autoinflammatory syndromes, and other pediatric were more likely to be hospitalized than that of patients with JIA, while no association was found between hospitalization and DMARD or glucocorticoid treatment.

Kearsley-Fleet and co-authors concluded that most of the CYP with RMDs did not experience any severe COVID-19 disease requiring hospitalization. It is important to know the consequences of COVID-19 infection in CYP with RMDs as it helps to improve their outcomes, awareness, and vaccination guidelines. In addition, the study for the first time showed obesity as a major comorbidity in children with RMDs hence, strict measures should be followed for protection and proper management of obese children with RMDs.

Reference: Kearsley-Fleet L, Chang ML, Lawson-Tovey et al. Outcomes of SARS-CoV-2 infection among children and young people with pre-existing rheumatic and musculoskeletal diseases. Ann Rheum Dis. 2022 Mar 25:annrheumdis-2022-222241.

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