COVID-19 symptom surveillance in immunocompromised children and young people in the UK: a prospective observational cohort study. Issue 3 (17th March 2021)

• Record Type: Journal Article
• Authors: Shaunak, Meera; Patel, Ravin; Driessens, Corine; Mills, Lynne; Leahy, Alice; Gbesemete, Diane; Owens, Daniel R; Lucas, Jane S; Faust, Saul N; de Graaf, Hans
• Is Part Of: BMJ open. Volume 11:Issue 3(2021)
• Publication Date: 2021-03-17
• Subjects: COVID-19 -- paediatrics -- paediatric infectious disease & immunisation -- immunology; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2020-044899
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: To describe the frequency of symptoms compatible with SARS-CoV-2 infection in immunocompromised children and young people in the UK during the SARS-CoV-2 pandemic. To describe patient/parent anxiety regarding SARS-CoV-2 infection in this cohort. Design: A prospective observational cohort study. Setting: 46 centres across the UK between 16 March and 4 July 2020. A weekly online questionnaire based on the International Severe Acute Respiratory and emerging Infections Consortium-WHO Case Report Form was used to collect participant reported data on symptoms, test results, National Health Service attendance, hospital admission and impact on daily life. Participants: 1490 immunocompromised children, defined as those requiring an annual influenza vaccination due to their underlying condition or medication. Main outcome measures: Incidence of SARS-CoV-2-like symptoms and patient/parent anxiety score. Results: Over 16 weeks during the first wave of the pandemic, no SARS-CoV-2 infection was diagnosed in this large immunocompromised paediatric cohort (median age 11 years, 54.4% female). 110 symptomatic participants underwent a test for SARS-CoV-2; all were negative. 922 (67.4%) participants reported at least one symptom consistent with suspected SARS-CoV-2 infection over the study period. 476 (34.8%) reported three or more symptoms. The most frequently reported symptoms included joint pain, fatigue, headache, nausea and muscle pain. SARS-CoV-2 testing during this period was performed on admitted patients only. 137 participants had their medication suspended or changed during the study period due to assumed COVID-19 disease risk. 62% reported high levels of anxiety (scores of 7–10 out of 10) at the start of the study, with anxiety levels remaining high throughout the study period. Conclusions: Although symptoms related to SARS-CoV-2 infection in children were common, there were no positive tests in this large immunocompromised cohort. Symptom-based screening to facilitate early detection of SARS-CoV-2 infection may not be helpful in these individuals. Patient/parent anxiety about SARS-CoV-2 infection was high. Trial registration number: NCT04382508 .