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Long-Term Outcomes of Survivors of COVID-19 with Moderate to Severe Infection and Children with Multisystem
Raman Singla1, Jhuma Sankar2, Anshula Tayal1
1Division of Pediatric Pulmonology and Intensive Care, Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, 110029, India.
Insights
Children hospitalized with COVID-19 or MIS-C showed significant recovery in functional and cardiac outcomes one year post-discharge. Most experienced improved disability scores, with few long-term pulmonary or cardiac issues observed.
Area of Science:
- Pediatrics
- Infectious Diseases
- Cardiology
Background:
- COVID-19 and Multisystem Inflammatory Syndrome in Children (MIS-C) can have severe acute effects.
- Long-term outcomes in pediatric populations require further investigation.
- Understanding post-hospitalization sequelae is crucial for comprehensive care.
Purpose of the Study:
- To assess long-term functional, pulmonary, and non-pulmonary outcomes in children 1-2 years after hospitalization for COVID-19 or MIS-C.
- To evaluate the resolution of cardiac abnormalities and neurological disability.
- To identify any new morbidities that developed post-discharge.
Main Methods:
- A cohort of children with moderate to severe COVID-19 or MIS-C were followed for 1-2 years.
- Functional status was assessed using the Pediatric Cerebral Performance Category (PCPC) scale.
- Echocardiography was performed at baseline and follow-up to evaluate cardiac function and coronary arteries.
Main Results:
- Most children demonstrated improved PCPC scores at follow-up, indicating reduced disability.
- Baseline cardiac abnormalities, including dysfunction and coronary dilatation, resolved in all affected children.
- No pulmonary morbidities were reported; one case of new-onset bone tuberculosis was observed.
Conclusions:
- Children hospitalized with COVID-19 or MIS-C generally show favorable long-term functional and cardiac recovery.
- Pulmonary complications appear uncommon in the long term.
- Further research in diverse populations is needed to confirm these findings and understand broader implications.
Abstract:
The study aims to evaluate the long-term outcomes - functional, pulmonary and non-pulmonary (other organs) - in children hospitalized with COVID-19 infection or with Multisystem inflammatory syndrome (MIS-C) after 1-2 y of discharge. All children with moderate or severe COVID-19 or MIS-C were enrolled. Out of 45 enrolled subjects, 19.8% had COVID-19 infection and 82% had MIS-C. Four children (8.9%) had abnormal baseline echocardiography; two each with cardiac dysfunction and coronary dilatation. At baseline, 44% had moderate disability and 24% had mild disability as per Pediatric Cerebral Performance Category (PCPC). On follow-up, only 8.9% (n = 4) had mild and 2.2% (n = 1) had moderate disability as per the PCPC score. One child developed new onset tuberculosis of the bone. None had any pulmonary morbidities. Follow-up echocardiogram was also within normal limits for children with abnormal findings. Further studies in different populations (settings) are required to draw meaningful conclusions about long-term effects of COVID-19 on children.
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