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Evaluation of a pediatric post-acute sequelae of SARS-CoV-2 index score
Frederick Dun-Dery1, Jianling Xie2, Kathleen Winston1
1Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Insights
The post-acute sequelae of COVID-19 (PASC) index shows low to acceptable reliability in children. The PASC index did not correlate with SARS-CoV-2 infection status in pediatric patients.
Area of Science:
- Pediatric Emergency Medicine
- Infectious Diseases
- Clinical Epidemiology
Background:
- The Researching COVID-19 to Enhance Recovery (RECOVER) initiative developed a Post-Acute Sequelae of COVID-19 (PASC) index to assess long-term effects.
- Validating this index in diverse pediatric populations is crucial for understanding and managing PASC in children.
Purpose of the Study:
- To evaluate the performance, validity, and reliability of the RECOVER PASC index in a Canadian pediatric cohort.
- To determine the association between PASC index scores and SARS-CoV-2 infection status in children aged 6 to 18 years.
Main Methods:
- A multicenter, prospective cohort study involving 785 children evaluated in Canadian pediatric emergency departments.
- Assessment of PASC index score validity and reliability using factor analysis and Cronbach's alpha.
- Analysis of associations between dichotomized PASC index scores and SARS-CoV-2 infection at 6 and 12 months post-exposure.
Main Results:
- Factor analysis explained 32%-40% of variance in PASC index scores.
- PASC index scores demonstrated strong correlations with PedsQL™ and overall health status.
- Cronbach's alpha for reliability ranged from 0.49 to 0.67, indicating low to acceptable internal consistency.
- No significant difference was found in the proportion of children exceeding PASC index thresholds between SARS-CoV-2 positive and negative groups at 6 and 12 months.
Conclusions:
- The PASC index shows potential utility in correlating with quality of life and overall health in children.
- The internal reliability of the PASC index in this pediatric cohort was found to be low to acceptable.
- The study did not find an association between the PASC index and previous SARS-CoV-2 infection in children.
Objective:
This study aims to assess the performance of the Researching COVID-19 to Enhance Recovery (RECOVER) initiative's proposed post-acute sequelae of COVID-19 (PASC) index in a cohort of children evaluated for SARS-CoV-2 infection, 6-12 months after exposure.
Study Design:
We conducted a multicenter, prospective cohort study with 6- and 12-month follow-up in 14 Canadian tertiary-care pediatric emergency departments (EDs) in the Pediatric Emergency Research Canada network. Eligible children were 6 to <18 years of age who were tested for acute SARS-CoV-2 infection. We assessed the score validity and reliability and evaluated the associations between PASC index scores dichotomized using threshold values (≥5.5 for ages 6 to <12 years and ≥5.0 for ages 12 to <18 years) and SARS-CoV-2 infection.
Results:
Participants included 785 children, with a median age of 9 years (IQR: 7-13), enrolled between August 2020 and February 2022. Factor analysis identified characteristics that accounted for 32%-40% of variance. Strong correlations were identified between PASC index scores and PedsQL™ and overall health status; Cronbach's α ranged from 0.49 to 0.67. Changes in PASC index scores across time points accounted for 71% (6 to <12 years) and 63% (12 to <18 years) of total variance. The proportion of children exceeding PASC index score thresholds did not differ between children positive and negative for SARS-CoV-2 test in the 6 to <12 (25% vs. 22%; aOR: 1.2; 95% CI: 0.6, 2.5) and 12 to <18 (18% vs. 10%; aOR: 2.2; 95% CI: 0.5, 10.4) age groups at 6 months. Similar results were reported at 12 months.
Conclusions:
While scores correlated with quality of life and overall health, internal reliability was low to acceptable. The PASC index was not associated with previous SARS-CoV-2 infection.
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