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COVID-19, children and non-communicable diseases: translating evidence into action
  1. Zulfiqar A Bhutta1,2,
  2. Marie Hauerslev3,
  3. Mychelle Farmer4,
  4. Laura Lewis-Watts1
  1. 1 Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
  2. 2 Institute for Global Health & Development, The Aga Khan University, Karachi, Pakistan
  3. 3 Department of Pediatrics, Herlev Hospital, Copenhagen, Denmark
  4. 4 Advancing Synergy, LLC, Baltimore, Maryland, USA
  1. Correspondence to Dr Zulfiqar A Bhutta, Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; zulfiqar.bhutta{at}

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The world faces an existential, once in a lifetime pandemic due to a novel coronavirus (SARS-CoV-2) which has to date infected over 25 million people across the world, with nearly 850 000 deaths.1 The disease, labelled COVID-19 by the WHO, has now spread to almost all the countries of the world and crippled the global economy. While high-income countries have been able to tap into their resources and reserves, for many low-income and middle-income countries, rising unemployment, population lock downs and closure of businesses have inflicted crippling damage on fragile economies, with rising inequalities and worsening poverty.

While early reports of the infection2 3 suggested that the infection may be generally mild in children with COVID-19, with general case fatality rate less than 1%, there are increasing reports of complications among children and adolescents.4 In addition, a recent series of cases with multisystem inflammatory response merits reconsideration of these risks.5 There are also clear signals of predictors for adverse outcomes from COVID-19 infections. The disease has disproportionately taken a toll among the elderly population in long-term care facilities, with many dying without even being tested for COVID-19 infection.6 There is clear evidence of excess mortality in subgroups, especially those with comorbidities, most commonly related to non-communicable diseases (NCDs), such as diabetes, hypertension, obesity, heart disease and cancer.7 The same appears to be true among paediatric COVID-19 infections. A systematic review analysed a total of 7780 paediatric COVID-19 positive cases globally, and found that patients with information on underlying conditions (n=655) included the following comorbidities: immunosuppression (30.5%), respiratory conditions (20%) and cardiovascular disease (14%).8 A recent report from the UK of 651 hospitalised children with COVID-19 from 260 hospitals identified comorbidities in 42% (276/651) of cases.9 Comorbidities most commonly associated with …

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  • Correction notice This paper has been corrected since it was published online. The last author's surname was mis-spelt.

  • Contributors The lead author ZAB and coauthors contributed to drafting and approved the final version of manuscript for submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.