Post–COVID-19 Conditions Among Children 90 Days After SARS-CoV-2 Infection Academic Article uri icon

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abstract

  • ImportanceLittle is known about the risk factors for, and the risk of, developing post–COVID-19 conditions (PCCs) among children.ObjectivesTo estimate the proportion of SARS-CoV-2–positive children with PCCs 90 days after a positive test result, to compare this proportion with SARS-CoV-2–negative children, and to assess factors associated with PCCs.Design, Setting, and ParticipantsThis prospective cohort study, conducted in 36 emergency departments (EDs) in 8 countries between March 7, 2020, and January 20, 2021, included 1884 SARS-CoV-2–positive children who completed 90-day follow-up; 1686 of these children were frequency matched by hospitalization status, country, and recruitment date with 1701 SARS-CoV-2–negative controls.ExposureSARS-CoV-2 detected via nucleic acid testing.Main Outcomes and MeasuresPost–COVID-19 conditions, defined as any persistent, new, or recurrent health problems reported in the 90-day follow-up survey.ResultsOf 8642 enrolled children, 2368 (27.4%) were SARS-CoV-2 positive, among whom 2365 (99.9%) had index ED visit disposition data available; among the 1884 children (79.7%) who completed follow-up, the median age was 3 years (IQR, 0-10 years) and 994 (52.8%) were boys. A total of 110 SARS-CoV-2–positive children (5.8%; 95% CI, 4.8%-7.0%) reported PCCs, including 44 of 447 children (9.8%; 95% CI, 7.4%-13.0%) hospitalized during the acute illness and 66 of 1437 children (4.6%; 95% CI, 3.6%-5.8%) not hospitalized during the acute illness (difference, 5.3%; 95% CI, 2.5%-8.5%). Among SARS-CoV-2–positive children, the most common symptom was fatigue or weakness (21 [1.1%]). Characteristics associated with reporting at least 1 PCC at 90 days included being hospitalized 48 hours or more compared with no hospitalization (adjusted odds ratio [aOR], 2.67 [95% CI, 1.63-4.38]); having 4 or more symptoms reported at the index ED visit compared with 1 to 3 symptoms (4-6 symptoms: aOR, 2.35 [95% CI, 1.28-4.31]; ≥7 symptoms: aOR, 4.59 [95% CI, 2.50-8.44]); and being 14 years of age or older compared with younger than 1 year (aOR, 2.67 [95% CI, 1.43-4.99]). SARS-CoV-2–positive children were more likely to report PCCs at 90 days compared with those who tested negative, both among those who were not hospitalized (55 of 1295 [4.2%; 95% CI, 3.2%-5.5%] vs 35 of 1321 [2.7%; 95% CI, 1.9%-3.7%]; difference, 1.6% [95% CI, 0.2%-3.0%]) and those who were hospitalized (40 of 391 [10.2%; 95% CI, 7.4%-13.7%] vs 19 of 380 [5.0%; 95% CI, 3.0%-7.7%]; difference, 5.2% [95% CI, 1.5%-9.1%]). In addition, SARS-CoV-2 positivity was associated with reporting PCCs 90 days after the index ED visit (aOR, 1.63 [95% CI, 1.14-2.35]), specifically systemic health problems (eg, fatigue, weakness, fever; aOR, 2.44 [95% CI, 1.19-5.00]).Conclusions and RelevanceIn this cohort study, SARS-CoV-2 infection was associated with reporting PCCs at 90 days in children. Guidance and follow-up are particularly necessary for hospitalized children who have numerous acute symptoms and are older.

authors

  • Funk, Anna L
  • Kuppermann, Nathan
  • Florin, Todd A
  • Tancredi, Daniel J
  • Xie, Jianling
  • Kim, Kelly
  • Finkelstein, Yaron
  • Neuman, Mark I
  • Salvadori, Marina I
  • Yock-Corrales, Adriana
  • Breslin, Kristen A
  • Ambroggio, Lilliam
  • Chaudhari, Pradip P
  • Bergmann, Kelly R
  • Gardiner, Michael A
  • Nebhrajani, Jasmine R
  • Campos, Carmen
  • Ahmad, Fahd A
  • Sartori, Laura F
  • Navanandan, Nidhya
  • Kannikeswaran, Nirupama
  • Caperell, Kerry
  • Morris, Claudia R
  • Mintegi, Santiago
  • Gangoiti, Iker
  • Sabhaney, Vikram J
  • Plint, Amy C
  • Klassen, Terry P
  • Avva, Usha R
  • Shah, Nipam P
  • Dixon, Andrew C
  • Lunoe, Maren M
  • Becker, Sarah M
  • Rogers, Alexander J
  • Pavlicich, Viviana
  • Dalziel, Stuart R
  • Payne, Daniel C
  • Malley, Richard
  • Borland, Meredith L
  • Morrison, Andrea K
  • Bhatt, Maala
  • Rino, Pedro B
  • Beneyto Ferre, Isabel
  • Eckerle, Michelle
  • Kam, April
  • Chong, Shu-Ling
  • Palumbo, Laura
  • Kwok, Maria Y
  • Cherry, Jonathan C
  • Poonai, Naveen
  • Waseem, Muhammad
  • Simon, Norma-Jean
  • Freedman, Stephen B
  • Gómez-Vargas, Jessica
  • Lerman, Bethany
  • Chamberlain, James
  • Owolabi, Adebola
  • Schanche-Perret Gentil, Camilla
  • Ringold, Sofie
  • Perez, Jocy
  • Vander Velden, Heidi
  • Crawford, Tyrus
  • Schultz, Steven E
  • Ross, Kimberly
  • Monroe, Kathy
  • Stillwell, Karly
  • Benedetti, Jillian
  • O'Brien, Sharon
  • Pimenta, Kyle
  • Andrade, Amia
  • Isacoff, Adam
  • Sikes, Kendra
  • Gold, Nina
  • Reichard, Kathleen
  • Nemetski, Maureen
  • Avva, Pavani
  • Mistry, Rakesh
  • Young, Shanon
  • Cook, Marlena
  • Gómez Barrena, Virginia
  • Castejón Ramírez, Sandra
  • García Castellanos, María T
  • Patterson, Emma
  • Samuel, Anicka
  • Carciurmaru, Redjana
  • Fitzpatrick, Eleanor
  • Bonisch, Megan
  • Wright, Bruce
  • Sivakumar, Mithra
  • Candelaria, Patricia
  • Cervantes, Vincent
  • Manoranjithan, Shaminy
  • Khan, Nabeel
  • Harbour, Toni
  • Sethuraman, Usha
  • Spencer, Priya
  • Gupta, Neha
  • Kamboj, Amira
  • Muanamputu, Gael
  • Kohn Loncarica, Guillermo
  • Hernández, Eugenia
  • Dragovetzky, Ana
  • Carlos Miguel, Angelats
  • Torres, Sylvia
  • Zorc, Joseph
  • Haber, Rebecca
  • Hiong, Ren Mee
  • Sri Dewi, Dianna
  • Joubert, Gary
  • Coriolano Dasilva, Kamary
  • Ochs, Julie
  • Arrighini, Alberto
  • Dallavilla, Camilla
  • Kachelmeyer, Andrea
  • Marty Placencia, Daisy

publication date

  • July 2022