Clinical-based phenotypes in children with pediatric post-COVID-19 condition

Area of Science:

• Pediatric medicine
• Infectious diseases
• Public health

Background:

• Pediatric post coronavirus disease 2019 (COVID-19) condition (PPCC) is a complex syndrome impacting children's daily lives.
• Understanding PPCC's heterogeneity is crucial for effective clinical management.

Purpose of the Study:

• To identify distinct clinical phenotypes in children experiencing PPCC.
• To characterize these phenotypes based on demographic factors, symptoms, and impact on daily life.
• To inform targeted treatment approaches for pediatric long COVID.

Main Methods:

• Retrospective analysis of 111 children diagnosed with PPCC at a Dutch academic hospital (November 2021-March 2023).
• Collection of demographic data, post-COVID symptoms, comorbidities, and daily life impact.
• Application of unsupervised clustering for mixed data types to identify patient subgroups.

Main Results:

• Three distinct PPCC clusters were identified among children aged 3-18 years.
• Cluster 1 (predominantly girls) exhibited exercise intolerance, dyspnea, and smell disorders.
• Cluster 2 (balanced gender distribution) presented with sleep issues, memory loss, GI symptoms, and arthralgia.
• Cluster 3 (predominantly boys) experienced fever, fewer symptoms, and less impact on daily life.

Conclusions:

• This study successfully delineated three unique clinical phenotypes within pediatric post-COVID conditions.
• These findings underscore the diverse nature of PPCC, necessitating further investigation into underlying mechanisms.
• Phenotypic characterization is essential for advancing the understanding and treatment of long COVID in children.