COVID-19 symptom surveillance in immunocompromised children and young people in the UK: a prospective observational cohort study
Meera Shaunak, Ravin Patel, Corine Driessens, Lynne Mills, Alice Leahy, Diane Gbesemete, Daniel R Owens, Jane S Lucas, Saul N Faust, Hans de Graaf, ImmunoCOVID19 study group, Meera Shaunak, Ravin Patel, Corine Driessens, Lynne Mills, Alice Leahy, Diane Gbesemete, Daniel R Owens, Jane S Lucas, Saul N Faust, Hans de Graaf, ImmunoCOVID19 study group
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.
Keywords: COVID-19; immunology; paediatric infectious disease & immunisation; paediatrics.
Conflict of interest statement
Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf. HdG received grant funding from the BPAIIG for the submitted work; there are no other relationships or activities that could appear to have influenced the submitted work.
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
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Source: PubMed