Pediatric COVID-19 risk factors in Southeast Asia-Singapore and Malaysia: A test-negative case-control study

Wong, Judith Ju Ming and Gan, Chin Seng and Kaushal, Sanghvi Heli and Chuah, Soo Lin and Sultana, Rehena and Tan, Natalie Woon Hui and Eg, Kah Peng and Thoon, Koh Cheng and Lee, Jan Hau and Yung, Chee Fu (2022) Pediatric COVID-19 risk factors in Southeast Asia-Singapore and Malaysia: A test-negative case-control study. American Journal of Tropical Medicine snd Hygiene, 106 (4). pp. 1113-1120. ISSN 0002-9637, DOI

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There is a scarcity of population-level data of pediatric COVID-19 infection from Southeast Asia. This study aims to describe and compare epidemiological, clinical, laboratory and outcome data among pediatric COVID-19 cases versus controls in two neighboring countries, Singapore and Malaysia. We used a test-negative case-control study design recruiting all suspected COVID-19 cases (defined by either clinical or epidemiological criteria) from January 2020 to March 2021 admitted to two main pediatric centers in Singapore and Malaysia. Data were collected using a standardized registry (Pediatric Acute and Critical Care COVID-19 Registry of Asia). The primary outcome was laboratory-confirmed COVID-19. Univariate and multivariable logistic regression analysis was used to determine factors associated with COVID-19. This study included 923 children with median age of 4 (interquartile range 2-9) years. Of these, 35.3% were COVID-19 cases. Children with COVID-19 were more likely to be asymptomatic compared with controls (49.4 versus 18.6%; P < 0.0001). They were also less likely to develop respiratory complications, such as bronchitis or pneumonia, or organ dysfunction. Four (1.2%) of our COVID-19 patients required respiratory support compared with 14.2% of controls needing respiratory support. COVID-19 cases tended to have lower neutrophil count but higher hemoglobin compared with controls. There were no reported deaths of COVID-19 infection; in contrast, 0.7% of the control group died. In the multivariable analysis, older age, travel history, and close contact with an infected household member were associated with COVID-19 infection. This study shows that the majority of pediatric COVID-19 cases were of lesser severity compared with other community acquired respiratory infections.

Item Type: Article
Funders: SingHealth Duke-NUS Global Health Institute [Grant No: Duke-NUS/SDGHI_RGA(Khoo)/2020/0006], SingHealth Duke-NUS Academic Medicine COVID-19 Rapid Response Research Grant) [Grant No: AM/COV001/2020 (SRDUKAMC2001)]
Uncontrolled Keywords: Pediatric COVID-19 infection; Southeast Asia; Respiratory infections
Subjects: R Medicine > RJ Pediatrics
R Medicine > RJ Pediatrics > Child health. Child health services
Divisions: Faculty of Medicine
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 12 Oct 2023 03:34
Last Modified: 12 Oct 2023 03:34

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