The effect of COVID-19 in children with rheumatic diseases

There are limited data on the effect of COVID-19 disease caused by SARS-CoV-2 on pediatric rheumatology patients. In our study, Anti-SARS-CoV-2 IgA and IgG seroprevalence of pediatric patients followed up with a diagnosis of rheumatological disease during the COVID-19 pandemic and its relationship with the primary diagnosis, medical treatments used, and disease activities were investigated. At the same time, the level of knowledge about COVID-19 was learned and the problems experienced in the follow-up of the current disease during the pandemic period were examined. 170 patients aged 2-18 years, who were followed up in the Pediatric Rheumatology Outpatient Clinic with the diagnosis of rheumatological disease, were included in the study. During the application to the outpatient clinic, the demographic characteristics of the patients, the disease process and the COVID-19 contact inquiry were collected using previously created forms. Laboratory results were scanned from the hospital registry system. Serum samples were taken from the patients who agreed to participate in the study, stored under appropriate conditions and studied. In our study, 18.9% of pediatric rheumatology patients were suspected of COVID-19 infection and investigated by PCR method, 2.4% had positive PCR results. All patients with a diagnosis of COVID-19 showed a mild clinical course and were discharged with full clinical recovery. As a result of serum analysis, Anti-SARS-CoV-2 Ig G antibody was detected as 23.5% and Anti-SARS-CoV-2 Ig A antibody was detected as 11.1%. No correlation was observed between age, gender, diagnosis of primary disease and seropositivity rates of pediatric rheumatology patients. Similarly, MEFV carrier was similar between seropositive and seronegative groups (p=0.991). It was observed that steroid use was higher in the seronegative group (68.0% vs 32.0%, p=0.202). On the other hand, no effect of colchicine and biological agents on seropositivity rates was found (p=0.396 and p=0.505, respectively). Primary disease activation was found to be increased in IgG seropositive patients during the pandemic period compared to the seronegative group (p=0.046). Contrary to expectations, the frequency of SARS-CoV-2 infection in children with a diagnosis of rheumatic disease did not increase. The effects of primary disease diagnoses and treatments on antibody development could not be demonstrated. Our study is an important report on the seroprevalence and clinical outcomes of COVID-19 infection in the pediatric rheumatology patient group. Multicenter and large-scale studies are needed to examine the long-term effects of SARS-CoV-2 infection in rheumatology patients. Key Words: Pediatric rheumatology, COVID-19, Juvenile idiopathic arthritis, Familial Mediterranean Fever, Biological agent, Colchicine.