POS1183 OUTCOMES OF COVID-19 INFECTION AMONG CHILDREN AND YOUNG PEOPLE WITH PRE-EXISTING RHEUMATIC AND MUSCULOSKELETAL DISEASES
Authors: L. Kearsley-Fleet, S. Lawson-Tovey, R. E. Costello, A. Belot, F. Aeschlimann, I. Melki, I. Koné-Paut, D. Clemente, M. C. Pinedo Gago, N. Svestkova, N. Vinšová, M. Hamad Saied, Y. Berkun, N. Wulffraat, S. Eulert, C. A. Scirè, A. Strangfeld, E. Mateus, P. Machado, Y. Uziel, K. Hyrich
Journal: Annals of the Rheumatic Diseases (2021)

Background: It remains unknown whether children and young people with rheumatic and musculoskeletal diseases (RMD) who acquire COVID-19 infection have a more severe COVID-19 course, due to either underlying disease or immunosuppressive treatments. Objectives: To describe outcomes among children and young people with underlying RMD who acquire COVID-19 infection. Methods: All children and young people &lt;18 years of age with COVID-19 (presumptive or confirmed) reported to the EULAR COVID-19 Database, which collects details regarding RMD diagnosis and treatment, COVID infection and outcomes, between 27 March 2020 and 29 January 2021 (cutoff date for this analysis) were included. Patient characteristics and COVID-19 outcomes are presented. Results: A total of 151 children and young people (age range 2-17 years; Table 1) have been reported to the database from 12 countries; mostly Spain (N=30), France (N=29), Israel (N=29), and Czechia (N=25). Most patients had a diagnosis of juvenile idiopathic arthritis (JIA; N=92; 61%). Other diagnoses were autoinflammatory syndrome (including TRAPS, CAPS, FMF; 12%), and systemic lupus erythematosus (4%). There were 14 (9%) hospitalisations and 1 (0.7%) death reported due to COVID-19. The most commonly reported symptoms were fever (46%), cough (34%), anosmia (19%), and headache (19%). Only 19 (13%) patients reported glucocorticoid use. DMARD therapy was used by 104 (69%) patients; 67 (44%) were on csDMARDs (methotrexate [N=54], antimalarials [N=7]), 45 (30%) on anti-TNF, 9 (6%) on IL-6 inhibitors, and 7 (5%) on IL-1 inhibitors. Among the 145 patients with hospitalisation data, patients on any DMARD therapy (cs/b/tsDMARDs) had similar odds for hospitalisation compared with those not on therapy, adjusted for age (odds ratio 0.7; 95% CI 0.2, 2.4). All Patients N 151 Gender Female 94 (62%) Male 56 (37%) Unknown 1 (&lt;1%) Age, years Median (IQR) 12 (8, 15) Range 2 to 17 Top Rheumatology Diagnoses Juvenile Idiopathic Arthritis (JIA) 92 (61%) Polyarthritis 50 (33% ) Oligoarthritis 31 (21% ) Systemic 11 (7% ) Autoinflammatory syndrome (e.g. 18 (12%) TRAPS, CAPS, FMF) 6 (4%) Systemic Lupus Erythematosus Comorbidities None stated 112 (74%) Obesity 9 (6%) Ocular inflammation Asthma 9 (6%) 3 (2%) Required Hospitalisation Yes 14 (9%) No 131 (87%) Missing 6 (4%) Top 5 Symptoms Reported Fever 69 (46%) Cough 51 (34%) Anosmia 28 (19%) Headache 28 (19%) Fatigue 23 (15%) Deaths due to COVID-19 Yes 1 (&lt;1%) Treatment at onset of COVID-19 infection Glucocorticoids 19 (13%) csDMARDs 67 (44%) Methotrexate 54 (36% ) Antimalarials 7 (5% ) Mycophenolate 5 (3% ) bDMARDs 64 (42%) Anti-TNF 45 (30% ) IL-6 9 (6% ) IL-1 8 (5% ) Any DMARD 104 (69%) Conclusion: These initial data on outcomes of COVID-19 in paediatric RMDs are very reassuring, with less than 1 in 10 patients reporting hospitalisation. Due to the database design and inherent reporting bias, this is likely an overestimate, suggesting that overall outcomes among this population appear to be generally good, with mild infection. Increasing case reports to the database will allow further exploration of drug- and disease-specific outcomes. Disclosure of Interests: None declared.