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Post-COVID-19 Conditions Among Children 90 Days After SARS-CoV-2 Infection.


ABSTRACT:

Importance

Little is known about the risk factors for, and the risk of, developing post-COVID-19 conditions (PCCs) among children.

Objectives

To 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 participants

This 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.

Exposure

SARS-CoV-2 detected via nucleic acid testing.

Main outcomes and measures

Post-COVID-19 conditions, defined as any persistent, new, or recurrent health problems reported in the 90-day follow-up survey.

Results

Of 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 relevance

In 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.

SUBMITTER: Funk AL 

PROVIDER: S-EPMC9308058 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature

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Publications

Post-COVID-19 Conditions Among Children 90 Days After SARS-CoV-2 Infection.

Funk Anna L AL   Kuppermann Nathan N   Florin Todd A TA   Tancredi Daniel J DJ   Xie Jianling J   Kim Kelly K   Finkelstein Yaron Y   Neuman Mark I MI   Salvadori Marina I MI   Yock-Corrales Adriana A   Breslin Kristen A KA   Ambroggio Lilliam L   Chaudhari Pradip P PP   Bergmann Kelly R KR   Gardiner Michael A MA   Nebhrajani Jasmine R JR   Campos Carmen C   Ahmad Fahd A FA   Sartori Laura F LF   Navanandan Nidhya N   Kannikeswaran Nirupama N   Caperell Kerry K   Morris Claudia R CR   Mintegi Santiago S   Gangoiti Iker I   Sabhaney Vikram J VJ   Plint Amy C AC   Klassen Terry P TP   Avva Usha R UR   Shah Nipam P NP   Dixon Andrew C AC   Lunoe Maren M MM   Becker Sarah M SM   Rogers Alexander J AJ   Pavlicich Viviana V   Dalziel Stuart R SR   Payne Daniel C DC   Malley Richard R   Borland Meredith L ML   Morrison Andrea K AK   Bhatt Maala M   Rino Pedro B PB   Beneyto Ferre Isabel I   Eckerle Michelle M   Kam April J AJ   Chong Shu-Ling SL   Palumbo Laura L   Kwok Maria Y MY   Cherry Jonathan C JC   Poonai Naveen N   Waseem Muhammad M   Simon Norma-Jean NJ   Freedman Stephen B SB  

JAMA network open 20220701 7


<h4>Importance</h4>Little is known about the risk factors for, and the risk of, developing post-COVID-19 conditions (PCCs) among children.<h4>Objectives</h4>To 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.<h4>Design, setting, and participants</h4>This prospective cohort study, conducted in 36 emergency departments (EDs) in 8 countries  ...[more]

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