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Comparative Analysis of Pediatric COVID-19 Infection in Southeast Asia, South Asia, Japan, and China.

ABSTRACT: There is a scarcity of data regarding coronavirus disease 2019 (COVID-19) infection in children from southeast and south Asia. This study aims to identify risk factors for severe COVID-19 disease among children in the region. This is an observational study of children with COVID-19 infection in hospitals contributing data to the Pediatric Acute and Critical Care COVID-19 Registry of Asia. Laboratory-confirmed COVID-19 cases were included in this registry. The primary outcome was severity of COVID-19 infection as defined by the World Health Organization (WHO) (mild, moderate, severe, or critical). Epidemiology, clinical and laboratory features, and outcomes of children with COVID-19 are described. Univariate and multivariable logistic regression models were used to identify risk factors for severe/critical disease. A total of 260 COVID-19 cases from eight hospitals across seven countries (China, Japan, Singapore, Malaysia, Indonesia, India, and Pakistan) were included. The common clinical manifestations were similar across countries: fever (64%), cough (39%), and coryza (23%). Approximately 40% of children were asymptomatic, and overall mortality was 2.3%, with all deaths reported from India and Pakistan. Using the multivariable model, the infant age group, presence of comorbidities, and cough on presentation were associated with severe/critical COVID-19. This epidemiological study of pediatric COVID-19 infection demonstrated similar clinical presentations of COVID-19 in children across Asia. Risk factors for severe disease in children were age younger than 12 months, presence of comorbidities, and cough at presentation. Further studies are needed to determine whether differences in mortality are the result of genetic factors, cultural practices, or environmental exposures.

SUBMITTER: Wong JJM

PROVIDER: S-EPMC8437183 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:The COVID-19 has become a pandemic. The timing and nature of the COVID-19 pandemic response and control varied among the regions and from one country to the other, and their role in affecting the spread of the disease has been debated. The focus of this work is on the early phase of the disease when control measures can be most effective. We proposed a modified susceptible-exposed-infected-removed model (SEIR) model based on temporal moving windows to quantify COVID-19 transmission patterns and compare the temporal progress of disease spread in six representative regions worldwide: three Chinese regions (Zhejiang, Guangdong and Xinjiang) vs. three countries (South Korea, Italy and Iran). It was found that in the early phase of COVID-19 spread the disease follows a certain empirical law that is common in all regions considered. Simulations of the imposition of strong social distancing measures were used to evaluate the impact that these measures might have had on the duration and severity of COVID-19 outbreaks in the three countries. Measure-dependent transmission rates followed a modified normal distribution (empirical law) in the three Chinese regions. These rates responded quickly to the launch of the 1st-level Response to Major Public Health Emergency in each region, peaking after 1-2 days, reaching their inflection points after 10-19 days, and dropping to zero after 11-18 days since the 1st-level response was launched. By March 29th, the mortality rates were 0.08% (Zhejiang), 0.54% (Guangdong) and 3.95% (Xinjiang). Subsequent modeling simulations were based on the working assumption that similar infection transmission control measures were taken in South Korea as in Zhejiang on February 25th, in Italy as in Guangdong on February 25th, and in Iran as in Xinjiang on March 8th. The results showed that by June 15th the accumulated infection cases could have been reduced by 32.49% (South Korea), 98.16% (Italy) and 85.73% (Iran). The surface air temperature showed stronger association with transmission rate of COVID-19 than surface relative humidity. On the basis of these findings, disease control measures were shown to be particularly effective in flattening and shrinking the COVID-10 case curve, which could effectively reduce the severity of the disease and mitigate medical burden. The proposed empirical law and the SEIR-temporal moving window model can also be used to study infectious disease outbreaks worldwide.

Project description:BackgroundCoronavirus has spread to almost every country since its emergence in Wuhan, China and countries have been adopted an array of measures to control the rapid spread of the epidemic. Here, we aimed to assess the person's knowledge, attitude and practices (KAP) toward the COVID-19 epidemic in Southeast and South Asia applying the mixed study design (cross-sectional and systematic review).MethodsIn the cross-sectional study, 743 respondents' socio-demographic and KAP-related information was collected through an online population-based survey from the Malaysian population. In the systematic review, the database PubMed, Web of Science and Google Scholar search engine were searched and related published articles from South and Southeast Asia were included. Frequency distribution, Chi-square association test and binary logistic regression were fitted using cross-sectional data whereas random effect model and study bias were performed in meta-analysis. We used 95% confidence interval and P <0.05 as statistical significances.ResultsThe prevalence of good knowledge, positive attitude and frequent practice toward COVID-19 epidemic were 52.6%, 51.8% and 57.1%, respectively, obtained by cross-sectional data analysis. The KAP prevalence were ranged from 26.53% (Thailand) to 95.4% (Nepal); 59.3% (Turkey) to 92.5% (Pakistan); and 50.2 (Turkey) to 97% (Afghanistan), respectively, obtained by 18 studies included in the meta-analysis. The prevalence of KAP was higher [84% vs. 79%, P heterogeneity <0.001; 83% vs. 80%, P heterogeneity <0.001; 85% vs. 83%, P heterogeneity <0.001] in South Asia compared to Southeast Asia, obtained by subgroup analysis. Some studies reported mean level instead of the proportion of the KAP where the score varied from 8.15-13.14; 2.33-33.0; and 1.97-31.03, respectively. Having more knowledge and attitude were encouraged more likely to practice toward COVID-19. Study suggests age, gender, education, place of residence and occupation as the most frequent significant risk factors of KAP toward COVID-19.ConclusionThe study sufficiently informs how other countries in Southeast and South Asia enriches their KAP behaviors during the pandemic which may help health professionals and policymakers to develop targeted interventions and effective practices.

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Comparative Analysis of Pediatric COVID-19 Infection in Southeast Asia, South Asia, Japan, and China.

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