Is Cardiorespiratory Disease associated with increased susceptibility of SARS-CoV-2 in Children?

Abstract

Background There are limited data in paediatric populations evaluating\nwhether chronic cardiorespiratory conditions are associated with\nincreased risk of COVID-19. We aimed to compare the rates of chronic\ncardiac and respiratory disease in children testing positive\n(SARS-CoV-2[+]) compared to those testing negative\n(SARS-CoV-2[-]) at our institution. Method Prospective cohort with\nnested case-control study of all children tested by PCR for SARS-CoV-2\nby nasopharyngeal/oropharyngeal sampling between March and October 2020.\nChildren were identified prospectively via laboratory notification with\nage and sex-matching of SARS-CoV-2[+] to SARS-CoV-2[-] (1:2).\nClinical data were extracted from the electronic medical record. Results\nIn total, 179 SARS-CoV-2[+] children (44% female, median age 3.5\nyrs, range 0.1 to 19.0 yrs) were matched to 391 SARS-CoV-2[-]\nchildren (42% female, median age 3.7 yrs, range 0.1 to 18.3 yrs). The\ncommonest co-morbidities showed similar frequencies in the\nSARS-CoV-2[+] and [-] groups: asthma (n = 9, 5% vs n = 17,\n4.4%, p = 0.71), congenital heart disease (n = 6, 3.4% vs n = 7,\n1.8%, p = 0.25) and obstructive sleep apnoea (n = 4, 2.2% vs n = 10,\n2.3%, p = 0.82). In the SARS-CoV-2 group, the prevalence of symptomatic\ndisease was similar amongst children with and without cardiorespiratory\ncomorbidities (n = 12, 75% vs n = 103, 57%, p = 0.35) who tested\npositive. A high proportion of children hospitalised with SARS-CoV-2\ninfection had cardiac comorbidities (23.8%). Conclusions In this single\nsite dataset, rates of pre-existing cardiorespiratory disease were\nsimilar in SARS-CoV-2[+] and SARS-CoV-2[-] children. High rates\nof comorbid cardiac disease were observed amongst hospitalised children\nwith COVID-19, warranting further research to inform public health\nmeasures and vaccine prioritisation.