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. 2024 Jan 1;1(1):27-33.
doi: 10.5588/ijtldopen.23.0053. eCollection 2024 Jan.

Clinical spectrum of disease and outcomes in children with Omicron SARS-COV-2 infection in Cape Town, South Africa

C Bekker  1 , I Dewandel  1 , A Redfern  2 , C McKenzie  1 , J Lishman  2 , L M Verhagen  2   3   4 , M Claassen  5   6 , S Wilson  1   5 , R Dunbar  1 , C Bosch  1 , G van Zyl  5   6 , W Preiser  5   6 , P Goussard  2 , H Rabie  2 , M M van der Zalm  1
Affiliations

Clinical spectrum of disease and outcomes in children with Omicron SARS-COV-2 infection in Cape Town, South Africa

C Bekker et al. IJTLD Open. .

Abstract
in English, French

Introduction: Children with underlying comorbidities and infants are most severely affected by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, including in low- and middle-income countries with a high prevalence of HIV and TB. We describe the clinical presentation of SARS-CoV-2 infection in children during the Omicron wave, in Cape Town, South Africa.

Methods: We analysed routine care data from a prospective cohort of children aged 0-13 years, with a positive SARS-CoV-2 real-time reverse-transcription polymerase chain reaction (rRT-PCR) or SARS-CoV-2 antigen test, admitted to Tygerberg Hospital between 1 November 2021 until 1 March 2022. Risk factors for severity of disease were assessed.

Results: Ninety-five children tested positive for SARS-CoV-2, of whom 87 (91.6%) were symptomatic. Clinical data were available for 86 children. The median age was 11 months (IQR 3.0-60.0), 37 (43.0%) were females, 21 (24.7%) were HIV-exposed and 7 (8.1%) were living with HIV (CLHIV). In total, 44 (51.2%) children had at least one underlying comorbidity. TB co-infection was seen in 11 children, 6 children were newly diagnosed and 5 children were already on TB treatment at the time of admission.

Conclusion: There was no evidence of more severe disease in children living with HIV or TB.

Introduction: Les enfants et les nourrissons présentant des comorbidités sous-jacentes sont les plus gravement touchés par l'infection par le coronavirus-2 du syndrome respiratoire aigu sévère (SARS-CoV-2), y compris dans les pays à revenu faible ou intermédiaire où la prévalence du VIH et de la TB est élevée. Nous décrivons la présentation clinique de l'infection par le SARS-CoV-2 chez les enfants pendant la vague Omicron, au Cap, en Afrique du Sud.

Méthodes: Nous avons analysé les données de soins de routine d'une cohorte prospective d'enfants âgés de 0 à 13 ans, avec un test positif de réaction en chaîne de la polymérase de transcription inverse en temps réel (rRT-PCR) ou d'antigène du SARS-CoV-2, admis à l'hôpital Tygerberg entre le 1er novembre 2021 et le 1er mars 2022. Les facteurs de risque de gravité de la maladie ont été évalués.

Résultats: Quatre-vingt-quinze enfants ont été testés positifs au SARS-CoV-2, dont 87 (91,6%) étaient symptomatiques. Des données cliniques étaient disponibles pour 86 enfants. L'âge médian était de 11 mois (IQR 3,0–60,0), 37 (43,0%) étaient des filles, 21 (24,7%) étaient exposés au VIH et 7 (8,1%) vivaient avec le VIH (CLHIV). Au total, 44 (51,2%) enfants présentaient au moins une comorbidité sous-jacente. La co-infection par la TB a été observée chez 11 enfants, 6 enfants ont été nouvellement diagnostiqués et 5 enfants étaient déjà sous traitement antituberculeux au moment de l'admission.

Conclusion: Il n'y a pas de preuve d'une maladie plus grave chez les enfants vivant avec le VIH ou la TB.

Keywords: Omicron; children living with HIV; comorbidities; paediatric; tuberculosis.

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Figures

Figure 1.
Figure 1.
Flowchart of children with SARS-CoV-2 infection during the Omicron wave. In total, 95 SARS-CoV-2 positive RT-PCR and antigen tests were done; 8 were done for surveillance purposes and 87 were persons under investigation. In total, 81 samples were PCR-positive. RT-PCR = reverse transcription polymerase chain reaction.
Figure 2.
Figure 2.
Point prevalence of viral co-infections detected in children with SARS-CoV-2 infection during the Omicron Wave. HRV = human rhinovirus; HEV = human enterovirus; PIV1-3 = para-influenza virus; HboV = human bocavirus; flu = influenza virus A and B.
See this image and copyright information in PMC

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