Clinical Characteristics and Histopathology of Coronavirus Disease 2019-Related Deaths in African Children
Globally, very few childhood deaths have been attributed to coronavirus disease 2019 (COVID-19). We evaluated clinical, microbiologic and postmortem histopathologic findings in childhood deaths in whom severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified antemortem or postmort...
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| Vydáno v: | The Pediatric infectious disease journal Ročník 40; číslo 9; s. e323 |
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| Médium: | Journal Article |
| Jazyk: | angličtina |
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01.09.2021
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| ISSN: | 1532-0987, 1532-0987 |
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| Abstract | Globally, very few childhood deaths have been attributed to coronavirus disease 2019 (COVID-19). We evaluated clinical, microbiologic and postmortem histopathologic findings in childhood deaths in whom severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified antemortem or postmortem.BACKGROUNDGlobally, very few childhood deaths have been attributed to coronavirus disease 2019 (COVID-19). We evaluated clinical, microbiologic and postmortem histopathologic findings in childhood deaths in whom severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified antemortem or postmortem.Surveillance of childhood deaths was ongoing during the initial COVID-19 outbreak in South Africa from April 14, 2020, to August 31, 2020. All children hospitalized during this time had a SARS-CoV-2 test done as part of standard of care. Postmortem sampling included minimally invasive tissue sampling (MITS) of lung, liver and heart tissue; blood and lung samples for bacterial culture and molecular detection of viruses (including SARS-CoV-2) and bacteria. The cause of death attribution was undertaken by a multidisciplinary team and reported using World Health Organization framework for cause of death attribution.METHODSSurveillance of childhood deaths was ongoing during the initial COVID-19 outbreak in South Africa from April 14, 2020, to August 31, 2020. All children hospitalized during this time had a SARS-CoV-2 test done as part of standard of care. Postmortem sampling included minimally invasive tissue sampling (MITS) of lung, liver and heart tissue; blood and lung samples for bacterial culture and molecular detection of viruses (including SARS-CoV-2) and bacteria. The cause of death attribution was undertaken by a multidisciplinary team and reported using World Health Organization framework for cause of death attribution.SARS-CoV-2 was identified on antemortem and/or postmortem sampling in 11.7% (20/171) of deceased children, including 13.2% (12/91) in whom MITS was done. Eighteen (90%) of 20 deaths with SARS-CoV-2 infection were <12 months age. COVID-19 was attributed in the causal pathway to death in 91.7% (11/12) and 87.5% (7/8) cases with and without MITS, respectively. Lung histopathologic features in COVID-19-related deaths included diffuse alveolar damage (n = 6, 54.5%), type 2 pneumocyte proliferation (n = 6, 54.5%) and hyaline membrane formation (n = 5, 36.4%). Culture-confirmed invasive bacterial disease was evident in 54.5% (6/11) of COVID-19 attributed deaths investigated with MITS.RESULTSSARS-CoV-2 was identified on antemortem and/or postmortem sampling in 11.7% (20/171) of deceased children, including 13.2% (12/91) in whom MITS was done. Eighteen (90%) of 20 deaths with SARS-CoV-2 infection were <12 months age. COVID-19 was attributed in the causal pathway to death in 91.7% (11/12) and 87.5% (7/8) cases with and without MITS, respectively. Lung histopathologic features in COVID-19-related deaths included diffuse alveolar damage (n = 6, 54.5%), type 2 pneumocyte proliferation (n = 6, 54.5%) and hyaline membrane formation (n = 5, 36.4%). Culture-confirmed invasive bacterial disease was evident in 54.5% (6/11) of COVID-19 attributed deaths investigated with MITS.COVID-19 was in the causal pathway of 10.5% (18/171) of all childhood deaths under surveillance. The postmortem histopathologic features in fatal COVID-19 cases in children were consistent with reports on COVID-19 deaths in adults; although there was a high prevalence of invasive bacterial disease in the children.CONCLUSIONSCOVID-19 was in the causal pathway of 10.5% (18/171) of all childhood deaths under surveillance. The postmortem histopathologic features in fatal COVID-19 cases in children were consistent with reports on COVID-19 deaths in adults; although there was a high prevalence of invasive bacterial disease in the children. |
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| AbstractList | Globally, very few childhood deaths have been attributed to coronavirus disease 2019 (COVID-19). We evaluated clinical, microbiologic and postmortem histopathologic findings in childhood deaths in whom severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified antemortem or postmortem.BACKGROUNDGlobally, very few childhood deaths have been attributed to coronavirus disease 2019 (COVID-19). We evaluated clinical, microbiologic and postmortem histopathologic findings in childhood deaths in whom severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified antemortem or postmortem.Surveillance of childhood deaths was ongoing during the initial COVID-19 outbreak in South Africa from April 14, 2020, to August 31, 2020. All children hospitalized during this time had a SARS-CoV-2 test done as part of standard of care. Postmortem sampling included minimally invasive tissue sampling (MITS) of lung, liver and heart tissue; blood and lung samples for bacterial culture and molecular detection of viruses (including SARS-CoV-2) and bacteria. The cause of death attribution was undertaken by a multidisciplinary team and reported using World Health Organization framework for cause of death attribution.METHODSSurveillance of childhood deaths was ongoing during the initial COVID-19 outbreak in South Africa from April 14, 2020, to August 31, 2020. All children hospitalized during this time had a SARS-CoV-2 test done as part of standard of care. Postmortem sampling included minimally invasive tissue sampling (MITS) of lung, liver and heart tissue; blood and lung samples for bacterial culture and molecular detection of viruses (including SARS-CoV-2) and bacteria. The cause of death attribution was undertaken by a multidisciplinary team and reported using World Health Organization framework for cause of death attribution.SARS-CoV-2 was identified on antemortem and/or postmortem sampling in 11.7% (20/171) of deceased children, including 13.2% (12/91) in whom MITS was done. Eighteen (90%) of 20 deaths with SARS-CoV-2 infection were <12 months age. COVID-19 was attributed in the causal pathway to death in 91.7% (11/12) and 87.5% (7/8) cases with and without MITS, respectively. Lung histopathologic features in COVID-19-related deaths included diffuse alveolar damage (n = 6, 54.5%), type 2 pneumocyte proliferation (n = 6, 54.5%) and hyaline membrane formation (n = 5, 36.4%). Culture-confirmed invasive bacterial disease was evident in 54.5% (6/11) of COVID-19 attributed deaths investigated with MITS.RESULTSSARS-CoV-2 was identified on antemortem and/or postmortem sampling in 11.7% (20/171) of deceased children, including 13.2% (12/91) in whom MITS was done. Eighteen (90%) of 20 deaths with SARS-CoV-2 infection were <12 months age. COVID-19 was attributed in the causal pathway to death in 91.7% (11/12) and 87.5% (7/8) cases with and without MITS, respectively. Lung histopathologic features in COVID-19-related deaths included diffuse alveolar damage (n = 6, 54.5%), type 2 pneumocyte proliferation (n = 6, 54.5%) and hyaline membrane formation (n = 5, 36.4%). Culture-confirmed invasive bacterial disease was evident in 54.5% (6/11) of COVID-19 attributed deaths investigated with MITS.COVID-19 was in the causal pathway of 10.5% (18/171) of all childhood deaths under surveillance. The postmortem histopathologic features in fatal COVID-19 cases in children were consistent with reports on COVID-19 deaths in adults; although there was a high prevalence of invasive bacterial disease in the children.CONCLUSIONSCOVID-19 was in the causal pathway of 10.5% (18/171) of all childhood deaths under surveillance. The postmortem histopathologic features in fatal COVID-19 cases in children were consistent with reports on COVID-19 deaths in adults; although there was a high prevalence of invasive bacterial disease in the children. |
| Author | Govender, Nelesh P Okudo, Grace Mabaso, Theodore M Maroane, Basetsana V Mthembu, Nonhlanhla Madhi, Shabir A Nakwa, Firdose L du Plessis, Jeanine Verwey, Charl Nunes, Marta C Mabena, Fikile C Serafin, Natali Dangor, Ziyaad Wadula, Jeannette Moore, David P Thwala, Bukiwe N Els, Toyah Baillie, Vicky L Hale, Martin J Swart, Peter Petersen, Karen L Moosa, Fatima Y Velaphi, Sithembiso C |
| Author_xml | – sequence: 1 givenname: Fikile C surname: Mabena fullname: Mabena, Fikile C – sequence: 2 givenname: Vicky L surname: Baillie fullname: Baillie, Vicky L – sequence: 3 givenname: Martin J surname: Hale fullname: Hale, Martin J – sequence: 4 givenname: Bukiwe N surname: Thwala fullname: Thwala, Bukiwe N – sequence: 5 givenname: Nonhlanhla surname: Mthembu fullname: Mthembu, Nonhlanhla – sequence: 6 givenname: Toyah surname: Els fullname: Els, Toyah – sequence: 7 givenname: Natali surname: Serafin fullname: Serafin, Natali – sequence: 8 givenname: Jeanine surname: du Plessis fullname: du Plessis, Jeanine – sequence: 9 givenname: Peter surname: Swart fullname: Swart, Peter – sequence: 10 givenname: Sithembiso C surname: Velaphi fullname: Velaphi, Sithembiso C – sequence: 11 givenname: Karen L surname: Petersen fullname: Petersen, Karen L – sequence: 12 givenname: Jeannette surname: Wadula fullname: Wadula, Jeannette – sequence: 13 givenname: Nelesh P surname: Govender fullname: Govender, Nelesh P – sequence: 14 givenname: Charl surname: Verwey fullname: Verwey, Charl – sequence: 15 givenname: David P surname: Moore fullname: Moore, David P – sequence: 16 givenname: Fatima Y surname: Moosa fullname: Moosa, Fatima Y – sequence: 17 givenname: Firdose L surname: Nakwa fullname: Nakwa, Firdose L – sequence: 18 givenname: Basetsana V surname: Maroane fullname: Maroane, Basetsana V – sequence: 19 givenname: Grace surname: Okudo fullname: Okudo, Grace – sequence: 20 givenname: Theodore M surname: Mabaso fullname: Mabaso, Theodore M – sequence: 21 givenname: Ziyaad surname: Dangor fullname: Dangor, Ziyaad – sequence: 22 givenname: Marta C surname: Nunes fullname: Nunes, Marta C – sequence: 23 givenname: Shabir A surname: Madhi fullname: Madhi, Shabir A |
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