Researchers Find Lower Risk of Severe COVID-19 Infection in Most Children with Juvenile Idiopathic Arthritis

BOSTON, March 31, 2022 /PRNewswire/ -- Despite a COVID-19 disease diagnosis, hospitalization and severe outcomes from COVID-19 illness in children and young people with childhood-onset rheumatic diseases were not commonly reported, announced the Childhood Arthritis and Rheumatology Research Alliance (CARRA).

In collaboration with the University of Manchester (UK), CARRA investigators at Boston Children's Hospital (US) teamed to conduct the largest-ever study of COVID-19 in children and teens with childhood-onset rheumatic diseases. The findings, published in the Annals of the Rheumatic Diseases, involved reports on patients from investigators across 25 countries.

The Arthritis Foundation estimates there are nearly 300,000 children and teens with arthritis in the United States.

Researchers found that less than 10% of pediatric patients with rheumatic diseases who were diagnosed with COVID-19 required hospitalization. Those patients receiving treatment with TNF-alpha inhibitor "biologic" medication did not appear to face increased risk of hospitalization or death when compared to children with childhood-onset rheumatic diseases not receiving these drugs.

The international research team evaluated patient records collected by the CARRA Registry, the CARRA-sponsored COVID-19 Global Pediatric Rheumatology Database (COVID-19 GPRD), and the European Alliance of Associations for Rheumatology (EULAR) COVID-19 Registry.

The study examined records of 607 children and youth below age 19, including a majority with juvenile idiopathic arthritis (JIA, 378 patients) as well as systemic lupus erythematosus/mixed connective tissue disease (SLE/MCTD), vasculitis, and other related rheumatic diseases (87 patients), and auto-inflammatory syndromes (78 patients). Patients with SLE/MCTD or vasculitis were more likely to be hospitalized due to COVID, as were those with obesity (body mass index ≥30) who also had any rheumatic disease.

Dr. Marc Natter, assistant professor of pediatrics at Harvard Medical School and Boston Children's Hospital, and a pediatric rheumatologist at MassGeneral Hospital for Children, led the study for CARRA and said, "The collective experience is that children, especially younger children, with juvenile idiopathic arthritis appear less likely to develop severe COVID-19 than adults with rheumatic disease, and reports of severe disease and death occur much less commonly than in adults with rheumatic diseases."

Min-Lee Chang, co-author of the paper from Boston Children's Hospital, who led the data analysis for the CARRA data sets, commented, "We of course agree that protective measures remain important to follow to minimize the risk of acquiring SARS-CoV-2 infection."

Dr. Lianne Kearsley-Fleet, an epidemiologist at The University of Manchester and co-author who led the data analysis for the EULAR and combined data, said, "We know from research that most children and young people, unlike vulnerable adults, do not experience severe COVID-19, with many of these children being asymptomatic or showing only mild symptoms."

"However, we as pediatric rheumatology researchers felt it was important to find out if the same was true for children with arthritis and other musculoskeletal diseases. The good news is that most children do appear to do well and experience only mild COVID-19 disease," Dr. Kearsley-Fleet said.

Professor Kimme Hyrich from The University of Manchester and a consultant rheumatologist said, "The data are very reassuring, but do show again the important association between obesity and more severe COVID-19 outcomes, supporting the view that protection measures in those children should be strictly followed."

All cases of COVID-19 occurred before vaccinations were available in the young people in this study.

Although the majority of children did well, 43 patients (7%) were hospitalized. Where hospitalizations did occur, they were less likely to occur in patients with JIA and more likely among those with rheumatic musculoskeletal diseases that are often more severe, such as lupus or vasculitis and require involve greater suppression of their immune system. As in other studies, it was also found that obese children were four times more likely to be hospitalized. However, even among those hospitalized, most patients avoided severe illness, with less than one-in-five needing oxygen or mechanical breathing support.

About Childhood-onset Rheumatic Diseases

Childhood-onset rheumatic diseases include different types of arthritis and other rheumatic and inflammatory diseases that develop in children and teens. These conditions are estimated to affect nearly 300,000 kids and teens in the United States (Arthritis Foundation).

About Childhood Arthritis and Rheumatology Research Alliance (CARRA)

Formed in 2002, CARRA's mission is to conduct collaborative research to prevent, treat, and cure pediatric rheumatic diseases. CARRA is a 501(c)3 registered non-profit organization. For more information, please visit https://carragroup.org/.

Media Contact:
John Seng
Childhood Arthritis and Rheumatology Research Alliance (CARRA)
(202) 468-7682
[email protected] 

SOURCE Childhood Arthritis and Rheumatology Research Alliance (CARRA)