Department of Kidney Transplant, Hospital Estadual da Criança, Rua Luiz Beltrão, 147, Vila Valqueire, Rio de Janeiro, RJ, 21330-320, Brazil.
Department of Nephrology, Hospital Universitario Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Eur J Pediatr. 2021 Oct;180(10):3237-3241. doi: 10.1007/s00431-021-04044-9. Epub 2021 Mar 26.
Clinical presentation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pediatric immunosuppressed patients is unknown. Emerging data describe a milder or asymptomatic course in children compared with adults in this scenario. We present the seroprevalence and clinical features of coronavirus disease 2019 in a prospective cohort of 114 immunosuppressed children and adolescents from three groups: kidney transplantation, liver transplantation, and cancer patients. Among the thirty-five (30.7%) patients who had a positive serological test for SARS-CoV-2, 77% did not report previous symptoms and none of them developed any complications of coronavirus disease 2019 (COVID-19) after 30 or more days of follow-up. Among those who were symptomatic, diarrhea, fever, and cough were the most common findings.Conclusion: Seroprevalence of SARS-CoV-2 infection is high among immunosuppressed children and adolescents. COVID-19 has a mild or asymptomatic course in most of these patients. What is Known: • The number of immunosuppressed patients with coronavirus disease 2019 is increasing. • Viral infections have the potential for greater severity in immunocompromised children. What is New: • Seroprevalence for severe acute respiratory syndrome coronavirus 2 in immunocompromised pediatric patients was 31%. • A quarter of the serology-positive patients reported mild symptoms and none of them developed multisystem inflammatory syndrome in children associated with coronavirus disease 2019.
严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染在儿科免疫抑制患者中的临床表现尚不清楚。在此情况下，新出现的数据表明儿童的病情比成年人轻或呈无症状。我们报告了来自三组免疫抑制儿童和青少年（肾移植、肝移植和癌症患者）的 114 名患者的前瞻性队列中 2019 年冠状病毒病的血清阳性率和临床特征。在 35 名（30.7%）血清 SARS-CoV-2 检测呈阳性的患者中，77%的患者未报告先前有症状，且在 30 天或更长时间的随访后，他们均未发生任何 2019 年冠状病毒病（COVID-19）并发症。在有症状的患者中，腹泻、发热和咳嗽是最常见的发现。结论：免疫抑制儿童和青少年中 SARS-CoV-2 感染的血清阳性率很高。在大多数这些患者中，COVID-19 的病程较轻或呈无症状。已知：• 患有 2019 年冠状病毒病的免疫抑制患者人数正在增加。• 病毒感染在免疫功能低下的儿童中可能更严重。新发现：• 免疫抑制儿科患者中严重急性呼吸综合征冠状病毒 2 的血清阳性率为 31%。• 四分之一的血清学阳性患者报告有轻微症状，且他们均未发生与 COVID-19 相关的儿童多系统炎症综合征。
