The spectrum of measles in COVID-19 pandemic; An observational study in children.

Abstract

Objective: To assess the spectrum of measles during COVID-19 era among children. Study Design: Cohort study. Setting: Department of Pediatric, Dr. Ziauddin University Hospital, Kemari Karachi. Period: February 2019 to February 2021. Material & Methods: Clinically diagnosed measles children of either gender aged between 3 months to 5 years admitted to our tertiary care center in the 2 years marked period of the study were analyzed. Measles was labeled as the presence of high grade fever (>104 ⁰F) and maculopapular rash. Medical history was noted and clinical examination was performed in all children. Necessary laboratory investigations like complete blood count and chest X-rays (CXR) were evaluated. All patients were treated as per standard institutional protocols. Outcomes were noted in terms of successful discharge or expiry. Results: In a total of 88 children, 55 (62.5%) were male. The mean age was 1.61±1.12 years while 49 (55.7%) children were aged ≤ 1 year. Twenty four (27.3%) children were fully vaccinated appropriate to their age. Fever and rash were found among all children (100%) while respiratory distress and coryza were reported by 82 (93.2%) and 51 (58.0%) children respectively. Overall duration of hospitalization was 7.02±2.32 days. Mortality was reported in 11 (12.5%) children while 76 (86.4%) children were successfully discharged. Development of acute respiratory distress (p=0.0011) and shock (p<0.0001) proved to have significant association with mortality. Conclusion: Mortality was relatively high among children with measles during the COVID-19 pandemic era. During hospitalization, most frequent complications were pneumonia, and eye and/or mouth related complications. Development of acute respiratory distress and shock proved to have significant association with mortality.