biostudies-literatureGoga AWellcome Trust04009https://www.ebi.ac.uk/biostudies/studies/S-EPMC12856961biostudies-literatureUnknown16<h4>Background</h4>Knowledge gaps persist regarding paediatric COVID-19 clinical presentation, treatment and outcomes in high HIV prevalence settings, with low COVID-19 vaccine coverage.<h4>Methods</h4>An ambi-directional cohort study was conducted in 13 South African public sector hospitals. Hospitalised children with SARS-CoV-2 infection or post-infection syndrome were included. Main outcomes measures included severe disease and primary COVID-19 (hospitalisation for SARS-CoV-2 infection).<h4>Results</h4>There were 2363 SARS-CoV-2 positive children included (March 2020 through May 2023); median age 23.6 months (interquartile range (IQR) = 4.3-98.2 months). Excluding missing values, 1618 (68.9%) children had primary COVID-19; 1121 (69.3%) of these had severe primary COVID-19. In the primarJournal of global healthSevere, primary, and incidental COVID-19 in hospitalised children, South Africa: 2020-2023.PMC12856961221372/Z/20/ZRamraj TWaggie ZDonald KAChetty TCloete JScott CVan Zyl RChinniah KMawela DCawood SDangor ZReubenson GMorrow BMStrehlau RZuhlke LFeucht UTabane NEdu Plessis NMMoore DPAldersley TJeena PMchunu NZar HJWebb KArchary MReddy TVelaphi SGoga AfalseSevere, primary, and incidental COVID-19 in hospitalised children, South Africa: 2020-2023.<h4>Background</h4>Knowledge gaps persist regarding paediatric COVID-19 clinical presentation, treatment and outcomes in high HIV prevalence settings, with low COVID-19 vaccine coverage.<h4>Methods</h4>An ambi-directional cohort study was conducted in 13 South African public sector hospitals. Hospitalised children with SARS-CoV-2 infection or post-infection syndrome were included. Main outcomes measures included severe disease and primary COVID-19 (hospitalisation for SARS-CoV-2 infection).<h4>Results</h4>There were 2363 SARS-CoV-2 positive children included (March 2020 through May 2023); median age 23.6 months (interquartile range (IQR) = 4.3-98.2 months). Excluding missing values, 1618 (68.9%) children had primary COVID-19; 1121 (69.3%) of these had severe primary COVID-19. In the primar2026-01-01T00:00:00Z2026 Jan2026-07-16T06:47:40.725Z2026-07-09T10:42:18.313ZS-EPMC128569614161455910.7189/jogh.16.04009