Age differences in prevalence and symptoms of post-COVID-19 condition among children: a prospective cohort study

Some individuals experience unexplained, persistent, or newly developed symptoms after coronavirus disease 2019 (COVID-19), known as post-COVID-19 condition (PCC). We explored the age-related prevalence, symptoms, and associated factors for PCC in children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This prospective cohort study enrolled children with SARS-CoV-2 infection between December 7, 2022, and January 31, 2023. The participants were assessed via telephone 6 months post-SARS-CoV-2 diagnosis. PCC in children was diagnosed according to the World Health Organization definition. In total, 1084 patients were eligible for matching and follow-up. Eventually, 785 patients (follow-up rate, 72.4%) completed the follow-up. The incidence of PCC among pediatric patients with COVID-19 was 8%. The most common symptom reported by children diagnosed with PCC in all age groups was fatigue. For patients aged 0-2 years, the presence of gastrointestinal symptoms (OR,6.323; 95% CI, 1.549-25.818) and neurological symptoms (OR, 3.816; 95% CI, 1.075-13.545) at the onset of COVID-19 were associated factors for PCC. For patients aged 3-6 years, no associated factors associated with PCC were identified. For patients aged 7-12 years, preexisting comorbidities (OR, 6.869; 95% CI, 2.209-21.360) were associated factors for PCC. For patients aged 13-17 years, female sex (OR, 3.635; 95% CI, 1.164-11.355) and preexisting comorbidities (OR, 6.295; 95% CI, 2.052-19.316) were associated factors for PCC.

The incidence of PCC among pediatric patients with COVID-19 was 8%, with fatigue being the most commonly reported symptom across all age groups. The associated factors for PCC varied according to age groups.

• Post-COVID-19 condition (PCC) can significantly affect the psychological and physiological health of children. •The characteristics of persistent symptoms and the incidence of PCC varied among children of different age groups.

• Fatigue is the most common symptom of PCC in children of all age groups. • The associated factors for PCC varied according to age group.