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Characterisation and Management of Children and Young People Referred to a Paediatric Tertiary Post-COVID Service
Anne-Lise Goddings1, Rebecca Johnston2, Elizabeth Wortley2
1Department of Paediatrics, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Population, Policy and Practice Department, University College London Great Ormond Street Institute of Child Health, London, United Kingdom; River Island Academic Centre, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, United Kingdom.
Insights
Post-COVID condition (PCC) significantly impacts children and young people, causing functional impairment and school attendance issues. Specialist care shows promise, with over half improving within six months, though some require longer support.
Area of Science:
- Pediatric Health
- Infectious Diseases
- Public Health
Background:
- Post-COVID condition (PCC) emerged after the 2020 coronavirus pandemic, necessitating rapid development of specialized services for affected children and young people.
- The study focuses on a tertiary service established to manage pediatric PCC cases.
Purpose of the Study:
- To describe the demographics, medical history, management strategies, and six-month outcomes of pediatric patients with PCC-related symptoms.
- To evaluate the effectiveness of a specialist tertiary service for managing children and young people with PCC.
Main Methods:
- Retrospective data collection from referral information and medical records.
- Analysis of demographic, clinical, and functional data for 176 referred patients aged 6-18 years.
Main Results:
- The study included 176 patients (61% female, aged 6-18) with an average of 8.2 PCC symptoms affecting daily functioning (97%) and school attendance (86%).
- 10% of patients had autism spectrum disorder, a higher prevalence than the national average. Specialist tertiary clinics managed 59% of patients.
- At six months, 40/73 patients reported improved daily functioning, and 43/67 showed increased school attendance. A subset experienced persistent symptoms or functional decline.
Conclusions:
- Patients referred for PCC specialist care exhibit significant functional impairment and educational challenges.
- The specialist service model demonstrates benefits, with over half of patients showing functional and school attendance improvements within six months.
- The findings suggest the service is beneficial but requires adequate resourcing for extended patient support and further research into symptom variability.
Purpose:
Post-COVID condition (PCC) emerged following the 2020 coronavirus pandemic and required rapid service development to manage affected patients. This evaluation describes the demographics, medical background, management and six-month outcomes of children and young people with PCC-related symptoms referred to one specialist tertiary service between June 2020 and August 2022.
Methods:
Data were retrospectively collected from referral information and medical notes.
Results:
176 patients (61% female) aged 6-18 years were referred, with a mean 8.2 PCC-related symptoms impacting on functioning (97%) and school attendance (86%). 10% patients had an autistic spectrum disorder diagnosis, above the ∼2% national prevalence, while rates of atopy and mental health were similar to national prevalence. 59% patients were managed in specialist tertiary clinics by clinicians with input from allied health professionals. At 6 month review, 40/73 patients reported improvement in their daily functioning, with 30/73 reporting no change and 3/73 reporting functional deterioration. School attendance increased over 6 months for 43/67 patients, with 12/67 reporting no change and 4/67 reporting reduced school attendance.
Discussion:
Patients referred for PCC-related specialist input have significant functional impairment and challenges accessing education. More than half of those seen in specialist clinics showed functional improvement and increased school attendance over 6 months, while a subgroup had persistent symptoms. This suggests that the service model is beneficial for this complex patient group overall, although needs to be resourced for longer input for some. Further work is needed to understand the variability in presentation and symptom course.
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