Highlights

  • UK immunocompromised paediatric patients were at no increased risk of severe COVID-19.
  • Only 4/38 PCR detected infections were admitted to hospital. None had acute severe COVID-19 or died.
  • Increasing age and immunodeficiency increased reporting of SARS-CoV-2 infection. Worsening of fever, cough and sore throat were associated with reporting SARS-CoV-2 infection.
  • Serology results suggest there was a proportion of SARS-CoV-2 infections undetected by PCR.

Abstract

Objectives

We aimed to prospectively describe the incidence and clinical spectrum of SARS-CoV-2 infection in immunocompromised paediatric patients in the UK.

Methods

From March 2020 to 2021 weekly questionnaires were sent to immunocompromised paediatric patients or their parents. Information, including symptom presentation and SARS-CoV-2 PCR test results, was collected from 1527 participants from 46 hospitals. Cross-sectional serology was investigated in February and March 2021.

Results

Until the end of September 2020, no cases were reported. From September 28th 2020 to March 2021 a total of 38 PCR-detected SARS-CoV-2 infections were reported. Of these, four children were admitted to hospital but none had acute severe COVID-19. Increasing age in association with immunodeficiency increased reporting of SARS-CoV-2 infection. Worsening of fever, cough, and sore throat were associated with participants reporting SARS-CoV-2 infection.

Serology data included 452 unvaccinated participants. In those reporting prior positive SARS-CoV-2 PCR, there were detectable antibodies in 9 of 18 (50%). In those with no prior report of infection, antibodies were detected in 32 of 434 (7•4%).

Conclusions

This study shows SARS-CoV-2 infections have occurred in immunocompromised children and young people with no increased risk of severe disease. No children died.

Source – https://www.sciencedirect.com/science/article/pii/S016344532100548X