Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.
Division of Paediatric Infectious Diseases, Department of Women's and Children's Health, University of Padua, Padua, Italy.
Curr Opin Pediatr. 2023 Apr 1;35(2):176-183. doi: 10.1097/MOP.0000000000001230. Epub 2023 Feb 20.
Three years into the coronavirus disease 2019 (COVID-19) pandemic, data on pediatric COVID-19 from African settings is limited. Understanding the impact of the pandemic in this setting with a high burden of communicable and noncommunicable diseases is critical to implementing effective interventions in public health programs.
More severe COVID-19 has been reported in African settings, with especially infants and children with underlying comorbidities at highest risk for more severe disease. Data on the role of tuberculosis and HIV remain sparse. Compared to better resourced settings more children with multisystem inflammatory disease (MISC) are younger than 5 years and there is higher morbidity in all settings and increased mortality in some settings. Several reports suggest decreasing prevalence and severity of MIS-C disease with subsequent severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) variant waves. Whether this decrease continues remains to be determined. Thus far, data on long-COVID in African settings is lacking and urgently needed considering the severity of the disease seen in the African population.
Considering the differences seen in the severity of disease and short-term outcomes, there is an urgent need to establish long-term outcomes in children with COVID-19 and MIS-C in African children, including lung health assessment.
在 2019 年冠状病毒病(COVID-19)大流行的三年中,来自非洲地区的儿科 COVID-19 数据有限。了解在这个传染病和非传染性疾病负担沉重的环境中疫情的影响,对于在公共卫生计划中实施有效的干预措施至关重要。
在非洲地区报告了更严重的 COVID-19 病例,尤其是患有潜在合并症的婴儿和儿童,面临更严重疾病的风险最高。结核病和艾滋病毒的数据仍然很少。与资源更充足的地区相比,患有多系统炎症性疾病(MISC)的儿童中有更多的年龄小于 5 岁,所有地区的发病率都更高,一些地区的死亡率也更高。有几份报告表明,随着随后出现的严重急性呼吸综合征冠状病毒-2(SARS-CoV-2)变异株,MISC 疾病的患病率和严重程度有所下降。这种下降是否会持续还有待确定。到目前为止,非洲地区缺乏关于长期 COVID-19 的数据,鉴于非洲人群中疾病的严重程度,这方面的数据非常紧迫。
考虑到疾病严重程度和短期预后的差异,迫切需要在非洲儿童中建立 COVID-19 和 MIS-C 患儿的长期预后,包括肺健康评估。