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Title: Pediatric COVID-19 risk factors in Southeast Asia-Singapore and Malaysia: a test-negative case–control study
Authors: Wong, Judith Ju Ming
Gan, Chin Seng
Kaushal, Sanghvi Heli
Chuah, Soo Lin
Sultana, Rehena
Tan, Natalie Woon Hui
Eg, Kah Peng
Thoon, Koh Cheng
Lee, Jan Hau
Yung, Chee Fu
Keywords: Science::Medicine
Issue Date: 2022
Source: Wong, J. J. M., Gan, C. S., Kaushal, S. H., Chuah, S. L., Sultana, R., Tan, N. W. H., Eg, K. P., Thoon, K. C., Lee, J. H. & Yung, C. F. (2022). Pediatric COVID-19 risk factors in Southeast Asia-Singapore and Malaysia: a test-negative case–control study. American Journal of Tropical Medicine and Hygiene, 106(4), 1113-1120.
Project: AM/COV001/ 2020 (SRDUKAMC2001) 
Duke- NUS/SDGHI_RGA(Khoo)/2020/0006 
Journal: American Journal of Tropical Medicine and Hygiene 
Abstract: 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.
ISSN: 0002-9637
DOI: 10.4269/ajtmh.21-1000
Schools: Lee Kong Chian School of Medicine (LKCMedicine) 
Organisations: KK Women’s and Children’s Hospital
Rights: © 2022 by The American Society of Tropical Medicine and Hygiene. This is an open-access article distributed under the terms of the Creative Commons Attribution (CC-BY) License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Fulltext Permission: open
Fulltext Availability: With Fulltext
Appears in Collections:LKCMedicine Journal Articles

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