Outcomes of the international database on SARS-CoV-2 infections in
children with Esophageal Atresia/Tracheoesophageal Fistula
Abstract
Background and Aim To assess the outcomes of children born with
esophageal atresia/tracheoesophageal fistula (EA-TEF) with concomitant
SARS-CoV-2 infection. Methods An international survey was
circulated to the International Network of Esophageal Atresia
(INoEA) members from April 2020 to May 2022. Information on
demography, type of EA-TEF, co-morbidities, complications,
hospitalization, and therapies administered for SARS-CoV-2 infection was
collected for all patients. Results Forty-two patients from
April 2020-May 2022, with a mean age of 6.8 years were reported from
Argentina, Switzerland, Netherlands, Canada, France, Italy, Australia
and Turkey. 34 patients (81%) had a type C, EA-TEF. 30 had respiratory
comorbidities, 14 had associated cardiac malformations and 14 had a
history of recurrent anastomotic stricture. Reported medications
included proton-pump inhibitors (n=14), inhaled bronchodilators (n=3)
and inhaled corticosteroids (n=4). Six patients (14%) were
hospitalised. Three required respiratory support and one required
extra-corporal membranous oxygenation. There were no deaths.
Respiratory, cardiac and gastrointestinal comorbidities were not
associated with increased risk of hospitalization. Concomitant
medication at time of infection was associated with increased risk for
hospitalization with SARS-CoV-2 infection (p=0.0035), however PPI alone
was not significantly associated with increased risk for hospitalization
(p=0.16). Conclusion Rates of hospitalization with SARS-CoV-2
are higher for patients with EA-TEF than the general pediatric
population, with increased risk in those on medication in patients. 67%
of those admitted required respiratory support. Infection likely does
not represent a risk for severe respiratory complications or severe
outcome.