COVID-19 in Children With Severe Lung Disease-A Tertiary Center Cohort Study in Denmark.

Background: Severe lung disease such as chronic pulmonary disease (CPD), severe asthma and cystic fibrosis (CF) in children is associated with increased risk of severe COVID-19. Information regarding SARS-CoV-2 infection, disease severity and outcome of COVID-19 is limited in this pediatric population.

Objectives: We captured the number of SARS-CoV-2 infected children and evaluated COVID-19 disease severity in non-immunized children with CPD, asthma, and CF in a cohort at a Danish tertiary center.

Methods: The number of children with PCR-verified SARS-CoV-2 infection in the cohort and in the age-related background population was identified through the Danish Microbiology Database. Clinical data were retrieved from the electronic medical health records and from the Danish Health Authority.

Results: In a cohort of 664 children with severe lung disease 594 were either PCR-tested or had an antibody test for SARS-CoV-2 infection due to symptoms or exposure and 18 (3%) had verified SARS-CoV-2 infection. The total number of verified SARS-CoV-2 infection was at that time 34.575(4.342%) thus, not significantly different from the reference population (p = 0.152). The symptoms ranged from asymptomatic to mild symptoms, and none of the children with severe lung disease required hospitalization due to COVID-19. None of the children were treated with antiviral treatment during the acute infection.

Conclusion: Of the 664 children in the Danish cohort with severe lung disease, none were hospitalized with COVID-19. Our findings imply that this particular group of patients do not experience increased risk of severe COVID-19.