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LONG-TERM IMPACT OF SARS-COV-2 INFECTION IN CHILDREN PRESENTING TO TYGERBERG HOSPITAL DURING THE COVID-19 PANDEMIC IN CAPE TOWN, SOUTH AFRICA
Abstract
Background
Little is known about long-term impact of COVID-19 in children in low- middle income countries.
Aims
To determine long-term consequences in SARS-CoV-2 PCR positive children versus SARS-CoV-2 negative children.
Methods
In this prospective observational cohort study, children aged 0-13 years were recruited from Tygerberg Hospital in Cape Town, South Africa between June 2020 and September 2021, presenting with either 1) an acute respiratory illness, 2) confirmed COVID-19 PCR or 3) a COVID-19 contact. Clinical data and serum samples were obtained at baseline and children were followed 3 months and 1 year later.
Results
A total of 100 children were enrolled, median age 7 months (interquartile range 2.0-31.5 months), 61 (61%) male; 2 (2%) HIV-infected and 25 (25 %) HIV-exposed. A total of 44 (44%) children tested COVID-19 positive on PCR. Underlying comorbidities were seen more frequently in COVID PCR positive cases (40.9%) compared to COVID negative cases (33.9%). One year after initial enrolment 12/41 (29.3%) children had persistent or recurrent symptoms and were more likely to be COVID-19 PCR positive (p=0.01). A total of 40/100 (40%) children were readmitted, with no significant difference between children with or without previous COVID-19 diagnosis. At baseline SARS-CoV-2 antibodies were found in 43/85 (50.6%) and after 1 year 31/39 (79.5%) were SARS-CoV-2 antibody positive.
Conclusions
Children who had confirmed SARS-CoV-2 infection were more likely to have symptoms 1 year later. The vast majority of this cohort had evidence of SARS-CoV-2 infection by 1 year after enrolment.