Children and young people with persistent post-COVID-19 condition over 24 months: a mixed-methods study

Area of Science:

• Pediatric Health
• Infectious Diseases
• Psychological Impact of Illness

Background:

• Post-COVID-19 condition (PCC) affects a subset of children and young people (CYP) after SARS-CoV-2 infection.
• Understanding the long-term health and well-being implications of PCC in CYP is crucial.

Purpose of the Study:

• To identify distinct symptom subgroups in CYP with persistent PCC and assess their stability up to 24 months postinfection.
• To determine if impairments differ across identified symptom subgroups.
• To explore the evolving impact of the pandemic and lockdowns on the health experiences of CYP with PCC over 24 months.

Main Methods:

• Latent class analysis was used to identify symptom subgroups in a cohort of 68 CYP with PCC.
• EuroQol Five Dimensions Youth was employed to measure impairments and their association with symptom subgroups.
• Thematic analysis of free-text responses captured the evolving experiences of six CYP over four follow-up points.

Main Results:

• Two symptom subgroups were identified: frequent (6.5-9 symptoms, including shortness of breath and tiredness) and less frequent (4-5 symptoms, mainly tiredness).
• No significant association was found between symptom subgroups and measured impairments.
• Persistent anxiety, respiratory issues, and concerns about lockdown relaxation were reported, while school worries were transient.

Conclusions:

• CYP with persistent PCC, even with fewer symptoms, face long-term anxiety and significant health impacts.
• The findings underscore that even mild symptom presentations can be debilitating.
• Personalized management approaches are essential for addressing the multifaceted needs of CYP with PCC.