Is Cardiorespiratory Disease associated with increased susceptibility of
SARS-CoV-2 in Children?
Background There are limited data in paediatric populations evaluating
whether chronic cardiorespiratory conditions are associated with
increased risk of COVID-19. We aimed to compare the rates of chronic
cardiac and respiratory disease in children testing positive
(SARS-CoV-2[+]) compared to those testing negative
(SARS-CoV-2[-]) at our institution. Method Prospective cohort with
nested case-control study of all children tested by 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% female, median age 3.5
yrs, range 0.1 to 19.0 yrs) were matched to 391 SARS-CoV-2[-]
children (42% female, median age 3.7 yrs, range 0.1 to 18.3 yrs). The
commonest co-morbidities 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 amongst children with and without cardiorespiratory
comorbidities (n = 12, 75% vs n = 103, 57%, p = 0.35) who tested
positive. A high proportion of children hospitalised with SARS-CoV-2
infection had cardiac comorbidities (23.8%). Conclusions In this single
site dataset, rates of pre-existing cardiorespiratory disease were
similar in SARS-CoV-2[+] and SARS-CoV-2[-] children. High rates
of comorbid cardiac disease were observed amongst hospitalised children
with COVID-19, warranting further research to inform public health
measures and vaccine prioritisation.