Related Experiment Video
Updated: Sep 4, 2025
Nasal Brushing Sampling and Processing Using Digital High Speed Ciliary Videomicroscopy – Adaptation for the COVID-19 Pandemic
Published on: November 7, 2020
Post-COVID-19 Conditions Among Children 90 Days After SARS-CoV-2 Infection
Anna L Funk1, Nathan Kuppermann2,3, Todd A Florin4,5
1Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Insights
Children with SARS-CoV-2 infection are more likely to develop post-COVID-19 conditions (PCCs) within 90 days. Hospitalization and numerous acute symptoms increase PCC risk in children, necessitating targeted guidance and follow-up.
Area of Science:
- Pediatric Infectious Diseases
- Public Health
- Epidemiology
Background:
- Post-COVID-19 conditions (PCCs) in children remain poorly understood.
- Identifying risk factors for PCCs in pediatric populations is crucial for effective management.
Purpose of the Study:
- To estimate the incidence of PCCs in children 90 days post-SARS-CoV-2 infection.
- To compare PCC rates between SARS-CoV-2-positive and negative children.
- To identify factors associated with PCC development in children.
Main Methods:
- Prospective cohort study in 36 emergency departments across 8 countries.
- Included 1884 SARS-CoV-2-positive children and 1701 SARS-CoV-2-negative controls.
- Follow-up conducted 90 days post-index visit to assess for PCCs.
Main Results:
- 5.8% of SARS-CoV-2-positive children reported PCCs at 90 days.
- Hospitalized children and those with more acute symptoms had higher PCC rates.
- Older children (≥14 years) and those hospitalized for ≥48 hours faced increased risk.
Conclusions:
- SARS-CoV-2 infection is associated with an increased risk of developing PCCs in children.
- Hospitalized children with multiple acute symptoms and older children require focused follow-up.
- Further research and clinical guidance are needed for pediatric PCCs.
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.
Related Concept Videos
01:17Pulmonary Cycle: Exhalation
01:24Asthma-III: Symptoms and Complications
Classification of Asthma
01:30Pneumonia III: Complications and Assessment
01:20COPD: Pathogenesis and Clinical Features
The primary cause for the onset of COPD is cigarette smoking and exposure to air pollution. These hazardous factors initiate a chain reaction within the lungs, resulting in chronic inflammation, damage to the airways, and a...
01:25Chronic Obstructive Pulmonary Disease-III: Symptoms and Complications.
Symptoms of COPD can be classified as primary or systemic. Primary symptoms relate to reduced airflow, while systemic or extrapulmonary symptoms relate to COPD's broader impact on the body.
Primary Symptoms of COPD:
01:26Stages of Infection