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Post coronavirus disease 2019 condition in children at a children's hospital in Japan
Yuho Horikoshi1, Meiwa Shibata1, Hanako Funakoshi1
1Division of Infectious Diseases, Department of Pediatrics, Tokyo Metropolitan Children's Medical Center, Fuchu, Japan.
Insights
Post COVID-19 condition in children is characterized by symptoms like fatigue and brain fog. Most cases resolved or improved within 4.5 months, though one-third of referred patients did not meet the condition criteria.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- The post COVID-19 condition, characterized by persistent symptoms after acute infection, is increasingly recognized.
- Limited data exists on the characteristics and outcomes of this condition specifically in pediatric populations.
- Understanding post COVID-19 condition in children is crucial for effective management and public health strategies.
Purpose of the Study:
- To investigate the clinical characteristics of children experiencing the post COVID-19 condition.
- To identify common symptoms, duration, and factors associated with the post COVID-19 condition in a pediatric cohort.
- To evaluate treatment approaches and outcomes for children with post COVID-19 condition.
Main Methods:
- Retrospective analysis of demographic and clinical data from children referred to a dedicated long COVID-19 clinic.
- Inclusion criteria focused on children meeting the definition of post COVID-19 condition, excluding those with alternative diagnoses.
- Data collection spanned from October 2021 to July 2022 at Tokyo Metropolitan Children's Medical Center.
Main Results:
- Twenty-four out of 33 referred children met the criteria for post COVID-19 condition (median age 12.5 years, 29.2% girls).
- Common symptoms included malaise, headache, dysgeusia, and dysosmia, with school absenteeism exceeding 4 weeks in 41.6%.
- Median duration was 4.5 months, with symptom resolution or improvement observed in 29.2% and 54.2% of patients, respectively.
Conclusions:
- A significant proportion (one-third) of children referred for long COVID did not meet the established criteria for the post COVID-19 condition.
- The majority of pediatric post COVID-19 condition cases showed resolution or improvement after a median follow-up of 4.5 months.
- Pacing-based counseling and pain management were common interventions, suggesting a multimodal approach to care.
Background:
Acute coronavirus disease 2019 (COVID-19) is associated with chronic symptoms. These have been termed the "post COVID-19 condition." The data on this condition in children are still limited. We therefore aimed to elucidate the characteristics of this post COVID-19 condition.
Methods:
Children referred to a long COVID-19 clinic were included at Tokyo Metropolitan Children's Medical Center between October 2021 and July 2022. Children with another diagnosis and those who failed to meet criteria for post COVID-19 condition were excluded. Demographic and clinical data were collected retrospectively.
Results:
Of 33 referrals, nine were excluded, and 24 fulfilled the criteria for post COVID-19 condition. The median age and percentage of girls were 12.5 (IQR: 11-13) years and 29.2%, respectively. All the patients had mild, acute COVID-19. Dysgeusia and brain fog was observed more frequently during the Delta and Omicron variant periods, respectively. School absenteeism >4 weeks was observed in 41.6% of the patients. Common symptoms included malaise, headache, dysgeusia, and dysosmia. The median duration of post COVID-19 condition was 4.5 (IQR: 2.8-5.2) months. Pain management and counseling using the pacing approach were the most commonly offered treatments. Symptom resolution and improvement was observed in 29.2% and 54.2% of the patients, respectively.
Conclusions:
One third of the patients referred for long COVID did not fit the definition of the post COVID-19 condition. After a median follow up of 4.5 months, the majority of the cases resolved or improved.
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