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International Care programs for Pediatric Post-COVID Condition (Long COVID) and the way forward
Caroline L H Brackel1,2, Lieke C E Noij3, Susanne J H Vijverberg3,4
1Department of Pediatric Pulmonology, Emma Children's Hospital, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands. C.l.brackel@amsterdamumc.nl.
Insights
Pediatric Post-COVID Condition (PPCC) care varies widely, with common symptoms like fatigue and brain fog impacting children
Area of Science:
- Pediatric medicine
- Infectious diseases
- Public health
Background:
- Pediatric Post-COVID Condition (PPCC) clinics operate with limited scientific evidence.
- The International Post-COVID-Condition in Children Collaboration (IP4C) investigated real-world PPCC management.
- The study aimed to guide future PPCC care strategies.
Purpose of the Study:
- To explore current definitions and organizational structures of PPCC care programs.
- To characterize patient demographics and common symptoms in pediatric Long COVID.
- To identify priorities for improving PPCC care and research.
Main Methods:
- A cross-sectional, international, multicenter study was conducted.
- Data from PPCC care programs and COVID-19 follow-up cohorts were aggregated.
- Analysis included 584 pediatric patients diagnosed with PPCC.
Main Results:
- Common symptoms include fatigue (71%), headache (55%), and concentration difficulties (53%).
- 31% of patients experienced severe daily life limitations.
- Diagnostic testing and treatments showed heterogeneity, often limited to physical therapy and psychological support.
Conclusions:
- Significant heterogeneity exists in PPCC diagnostics and management due to scarce evidence and lack of standardization.
- Future guidelines should address identified components for PPCC care.
- Priorities for PPCC care, research, and international collaboration are outlined to improve outcomes.
Background:
Pediatric Post-COVID-Condition (PPCC) clinics treat children despite limited scientific substantiation. By exploring real-life management of children diagnosed with PPCC, the International Post-COVID-Condition in Children Collaboration (IP4C) aimed to provide guidance for future PPCC care.
Methods:
We performed a cross-sectional international, multicenter study on used PPCC definitions; the organization of PPCC care programs and patients characteristics. We compared aggregated data from PPCC cohorts and identified priorities to improve PPCC care.
Results:
Ten PPCC care programs and six COVID-19 follow-up research cohorts participated. Aggregated data from 584 PPCC patients was analyzed. The most common symptoms included fatigue (71%), headache (55%), concentration difficulties (53%), and brain fog (48%). Severe limitations in daily life were reported in 31% of patients. Most PPCC care programs organized in-person visits with multidisciplinary teams. Diagnostic testing for respiratory and cardiac morbidity was most frequently performed and seldom abnormal. Treatment was often limited to physical therapy and psychological support.
Conclusions:
We found substantial heterogeneity in both the diagnostics and management of PPCC, possibly explained by scarce scientific evidence and lack of standardized care. We present a list of components which future guidelines should address, and outline priorities concerning PPCC care pathways, research and international collaboration.
Impact:
Pediatric Post-COVID Condition (PPCC) Care programs have been initiated in many countries. Children with PPCC in different countries are affected by similar symptoms, limiting many to participate in daily life. There is substantial heterogeneity in diagnostic testing. Access to specific diagnostic tests is required to identify some long-term COVID-19 sequelae. Treatments provided were limited to physical therapy and psychological support. This study emphasizes the need for evidence-based diagnostics and treatment of PPCC. The International Post-COVID Collaboration for Children (IP4C) provides guidance for guideline development and introduces a framework of priorities for PPCC care and research, to improve PPCC outcomes.
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