# Clinical characteristics and outcomes of COVID-19 in pediatric patients with rheumatic diseases

## TL;DR

This study examines how children with rheumatic diseases in China experience and recover from COVID-19, finding that most cases are not severe and vaccination helps reduce hospitalization.

## Contribution

The study provides a detailed analysis of clinical outcomes and symptom correlations in vaccinated and unvaccinated pediatric rheumatic disease patients with COVID-19.

## Key findings

- Fever and cough were the most common symptoms in pediatric patients with rheumatic diseases infected with COVID-19.
- Vaccinated children had shorter time to negative virus conversion and lower hospitalization rates.
- Older age and systemic lupus erythematosus were associated with prolonged symptom duration.

## Abstract

This study investigates the clinical characteristics and outcomes of pediatric patients with rheumatic diseases infected with COVID-19 in China.

We conducted a retrospective analysis of pediatric patients with rheumatic diseases who contracted COVID-19. Data were collected via a comprehensive questionnaire with a 14-day follow-up. Multivariable logistic regression was used to assess severe outcomes, and network analyses evaluated symptom correlations.

A total of 1070 cases were collected. Fever (88.05%) and cough (62.75%) were the most common symptoms. Cough, nasal congestion, and runny nose exhibited a stronger correlation with each other. A higher incidence of fever reduced the incidence of two single symptoms (nasal congestion [r = −0.833], runny nose [r = −0.762]). Vaccinated children showed a shorter time to negative COVID-19 conversion (7.21 days vs. 7.63 days, p < 0.05) and lower hospitalization rates (p = 0.025). Prolonged symptom duration was associated with older age (OR: 1.07 [1.04–1.11]; p < 0.001) and systemic lupus erythematosus (OR: 1.47 [1.01–2.12]; p = 0.046).

Pediatric patients with rheumatic diseases exhibited a wide range of clinical symptoms after COVID-19 infection. The infection generally did not lead to severe outcomes in this study. COVID-19 vaccination was associated with reduced hospitalization risk and expediting the time to negativity for virus.

This manuscript demonstrates a comprehensive analysis of the clinical characteristics and outcomes of COVID-19 infection in pediatric patients with rheumatic diseases in China. It provides critical insights into the specific challenges faced by this vulnerable population and offers practical recommendations for improving patient management during periods of increased infectious risk.