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Clinical assessment of children with long COVID syndrome
Réka Garai1,2,3, Péter Krivácsy4,5,6, Vivien Herczeg1,2
11st Department of Pediatrics, Semmelweis University, Budapest, Hungary.
Insights
Pediatric long COVID syndrome significantly impacts children's quality of life, though specific medical conditions are found in a minority. Further research is needed for evidence-based clinical guidelines.
Area of Science:
- Pediatric Medicine
- Infectious Diseases
- Public Health
Background:
- Pediatric long COVID syndrome (LCS) lacks clear case definitions and clinical care guidelines.
- Understanding LCS is crucial for effective management and support of affected children.
Purpose of the Study:
- To systematically collect and analyze data on pediatric LCS patients.
- To describe the clinical presentation, findings, and quality of life impacts in children with LCS.
- To inform the development of evidence-based guidelines for pediatric LCS.
Main Methods:
- Descriptive analysis of medical records from a dedicated pediatric LC clinic.
- Diagnosis of exclusion through multi-disciplinary medical examinations.
- Data collection included history, clinical presentation, and findings without a control group.
Main Results:
- Most children experienced at least minor quality of life impairment (23% moderate/severe).
- Symptom-related conditions were found in a minority (average 18%), with respiratory symptoms being most frequent (37%).
- Specific conditions like autoimmune thyroiditis were identified in a small percentage (7%).
Conclusions:
- Pediatric LCS significantly affects children's quality of life, often without clearly identifiable medical conditions.
- Controlled studies are necessary to differentiate pandemic era effects from direct infection impacts.
- Developing evidence-based pediatric guidelines is essential for rationalizing diagnostic approaches.
Background:
There is a need for further understanding pediatric long COVID syndrome (LCS) to be able to create specific case definitions and guidelines for providing good clinical care.
Methods:
Medical records of all LCS patients who presented at our designated LC clinic were collected. We carried out descriptive analyses summarizing the history, clinical presentation, and findings of children, while doing a diagnosis of exclusion with multi-disciplinary medical examinations (physical, laboratory, and radiological examinations, specialist consultations, etc.) without a control group.
Results:
Most children reported at least minor impairment to their quality of life, of which 17 (23%) had moderate or severe difficulties. Findings that could be directly connected to the linked complaint category were observed in an average of 18%, respiratory symptoms with objective alterations being the most frequent (37%). Despite our detecting mostly non-specific conditions, in a smaller number we identified well-described causes such as autoimmune thyroiditis (7%).
Conclusions:
The majority of children stated an impairment in their quality of life, while symptom-related conditions were detected only in a minority. Controlled studies are needed to separate the effect of the pandemic era from the infection itself. Evidence-based pediatric guidelines could aid to rationalize the list of recommended examinations.
Impact:
Long COVID syndrome is a complex entity with a great impact on children's everyday lives. Still, there is no clear guidance for pediatric clinical management. Systematic, detailed studies with medical assessment findings could aid the process of creating evidence-based guidelines. We present validated systematic information collected during in-person medical assessments with detailed medical findings and quality of life changes. While making a diagnosis of exclusion, we could confirm symptom-related conditions only in a minority of children; however, the majority reported at least minor impairment to their quality of life.
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