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Post-COVID-19 Condition in Children 6 and 12 Months After Infection
Frederick Dun-Dery1, Jianling Xie2, Kathleen Winston1
1Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Insights
Few children developed post-COVID-19 condition (PCC) after SARS-CoV-2 infection, with no significant difference in quality of life compared to uninfected children. This study tracked long-term outcomes in pediatric patients.
Area of Science:
- Pediatric Emergency Medicine
- Infectious Diseases
- Public Health
Background:
- Understanding long-term outcomes in children infected with SARS-CoV-2 is crucial.
- Post-COVID-19 condition (PCC) prevalence in pediatric populations requires quantification.
Purpose of the Study:
- To quantify the prevalence of post-COVID-19 condition (PCC) in children tested for SARS-CoV-2 infection.
- To assess long-term symptoms and quality of life (QoL) in pediatric patients post-infection.
Main Methods:
- A multicenter, prospective cohort study was conducted across 14 Canadian tertiary pediatric emergency departments (EDs).
- Children under 18 tested for SARS-CoV-2 between August 2020 and February 2022 were followed for 90 days, 6 months, and 12 months.
- PCC was defined by ongoing symptoms and QoL reductions affecting daily functioning within 3 months of infection.
Main Results:
- At 6-month follow-up, PCC was present in 0.52% of SARS-CoV-2 positive children versus 0.10% of negative controls.
- At 12-month follow-up, PCC was present in 0.67% of SARS-CoV-2 positive children versus 0.16% of negative controls.
- No significant difference in PedsQL scores was observed between infected and non-infected children at 12 months.
Conclusions:
- While children infected with SARS-CoV-2 reported increased chronic symptoms, very few developed PCC.
- Overall quality of life did not differ between children with and without SARS-CoV-2 infection at 12 months.
- The study highlights a low incidence of PCC in children presenting to pediatric EDs.
Importance:
There is a need to understand the long-term outcomes among children infected with SARS-CoV-2.
Objective:
To quantify the prevalence of post-COVID-19 condition (PCC) among children tested for SARS-CoV-2 infection in pediatric emergency departments (EDs).
Design, Setting, And Participants:
Multicenter, prospective cohort study at 14 Canadian tertiary pediatric EDs that are members of the Pediatric Emergency Research Canada network with 90-day, 6-month, and 12-month follow-up. Participants were children younger than 18 years who were tested for SARS-CoV-2 infection between August 2020 and February 2022. Data were analyzed from May to November 2023.
Exposure:
The presence of SARS-CoV-2 infection at or within 14 days of the index ED visit.
Main Outcomes And Measures:
Presence of symptoms and QoL reductions that meet the PCC definition. This includes any symptom with onset within 3 months of infection that is ongoing at the time of follow-up and affects everyday functioning. The outcome was quantified at 6 and 12 months following the index ED visit.
Results:
Among the 5147 children at 6 months (1152 with SARS-CoV-2 positive tests and 3995 with negative tests) and 5563 children at 12 months (1192 with SARS-CoV-2 positive tests and 4371 with negative tests) who had sufficient data regarding the primary outcome to enable PCC classification, the median (IQR) age was 2.0 (0.9-5.0) years, and 2956 of 5563 (53.1%) were male. At 6-month follow-up, symptoms and QoL changes consistent with the PCC definition were present in 6 of 1152 children with positive SARS-CoV-2 tests (0.52%) and 4 of 3995 children with negative SARS-CoV-2 tests (0.10%; absolute risk difference, 0.42%; 95% CI, 0.02% to 0.94%). The PCC definition was met at 12 months by 8 of 1192 children with positive SARS-CoV-2 tests (0.67%) and 7 of 4371 children with negative SARS-CoV-2 tests (0.16%; absolute risk difference, 0.51%; 95% CI, 0.06 to 1.08%). At 12 months, the median (IQR) PedsQL Generic Core Scale scores were 98.4 (90.0-100) among children with positive SARS-CoV-2 tests and 98.8 (91.7-100) among children with negative SARS-CoV-2 tests (difference, -0.3; 95% CI, -1.5 to 0.8; P = .56). Among the 8 children with SARS-CoV-2 positive tests and PCC at 12-month follow-up, children reported respiratory (7 of 8 patients [88%]), systemic (3 of 8 patients [38%]), and neurologic (1 of 8 patients [13%]) symptoms.
Conclusions And Relevance:
In this cohort study of children tested for SARS-CoV-2 infection in Canadian pediatric EDs, although children infected with SARS-CoV-2 reported increased chronic symptoms, few of these children developed PCC, and overall QoL did not differ from children with negative SARS-CoV-2 tests.
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