Evaluation of a pediatric post-acute sequelae of SARS-CoV-2 index score

Objective: This study aims to assess the performance of the Researching COVID-19 to Enhance Recovery (RECOVER) initiative's proposed post-acute sequelae of COVID-19 (PASC) index in a cohort of children evaluated for SARS-CoV-2 infection, 6-12 months after exposure. Study design: We conducted a multicenter, prospective cohort study with 6- and 12-month follow-up in 14 Canadian tertiary-care pediatric emergency departments (EDs) in the Pediatric Emergency Research Canada network. Eligible children were 6 to <18 years of age who were tested for acute SARS-CoV-2 infection. We assessed the score validity and reliability and evaluated the associations between PASC index scores dichotomized using threshold values (≥5.5 for ages 6 to <12 years and ≥5.0 for ages 12 to <18 years) and SARS-CoV-2 infection. Results: Participants included 785 children, with a median age of 9 years (IQR: 7-13), enrolled between August 2020 and February 2022. Factor analysis identified characteristics that accounted for 32%-40% of variance. Strong correlations were identified between PASC index scores and PedsQL™ and overall health status; Cronbach's α ranged from 0.49 to 0.67. Changes in PASC index scores across time points accounted for 71% (6 to <12 years) and 63% (12 to <18 years) of total variance. The proportion of children exceeding PASC index score thresholds did not differ between children positive and negative for SARS-CoV-2 test in the 6 to <12 (25% vs. 22%; aOR: 1.2; 95% CI: 0.6, 2.5) and 12 to <18 (18% vs. 10%; aOR: 2.2; 95% CI: 0.5, 10.4) age groups at 6 months. Similar results were reported at 12 months. Conclusions: While scores correlated with quality of life and overall health, internal reliability was low to acceptable. The PASC index was not associated with previous SARS-CoV-2 infection.