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Pediatric SARS-CoV-2 outcomes study (PECOS): 12-month longitudinal analysis of post-COVID symptoms in infected versus
Gina A Montealegre Sanchez1, Alexandra B Yonts2,3,4, Allyson Mateja5
1Division of Clinical Research, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, MD, USA.
Insights
This study identified 20 symptoms more common in children after SARS-CoV-2 infection, with variations by age. Some symptoms persisted for a year, highlighting the need for ongoing research into pediatric post-COVID conditions.
Area of Science:
- Pediatric Infectious Diseases
- Longitudinal Health Studies
- Public Health
Background:
- SARS-CoV-2 infection can lead to prolonged symptoms in children.
- Prospective, longitudinal studies with control groups are needed to characterize these post-COVID symptoms.
- This study addresses the gap by comparing infected and uninfected pediatric cohorts.
Purpose of the Study:
- To identify symptoms occurring in children after SARS-CoV-2 infection.
- To track the trajectory of these symptoms over the first year post-enrollment.
- To investigate the relationship between symptoms, age, and SARS-CoV-2 infection.
Main Methods:
- A longitudinal study comparing children (0-21 years) with confirmed SARS-CoV-2 infection to an uninfected cohort.
- Data collected at baseline and 12-month post-enrollment visits.
- Primary outcome measured was the presence or absence of symptoms.
Main Results:
- 20 symptoms were more frequent in infected children compared to controls at baseline or 12 months.
- Symptom presentation varied significantly by age.
- Some symptoms like fever and weight loss were more frequent at baseline, while others like dysmenorrhea and persistent headaches were more frequent at 12 months.
Conclusions:
- Post-SARS-CoV-2 infection, 20 symptoms were more likely reported by infected children compared to uninfected.
- Age is a critical factor influencing the type and frequency of post-COVID symptoms in children.
- Ongoing 3-year data collection will further elucidate long-term pediatric post-COVID symptoms and their trajectory.
Background:
The goal of this study was to identify symptoms that occur in children post-SARS-CoV-2 infection, their trajectory over the first-year post-enrollment, and relationship to age.
Methods:
Longitudinal comparison of infected and uninfected cohorts. Participants (0-21 years) with laboratory-confirmed SARS-CoV-2 infection were enrolled as infected. The uninfected cohort was individuals without laboratory evidence of SARS-CoV-2 infection. Primary outcome was presence or absence of symptoms.
Results:
852 participants (705 infected, 147 uninfected) completed baseline visits. Of those, 558 infected subjects completed a 12-month post-enrollment visit. Twenty symptoms were identified as more common in infected participants compared to uninfected, at either baseline or 12-months, with symptoms varying by age. Some symptoms in the infected were more frequent at baseline (e.g. fever, weight loss), whereas many symptoms persisted through 12-months. Several symptoms were more frequent at 12-months (e.g. dysmenorrhea, persistent headache). Presence of symptoms at 12-months was not significantly associated with the wave of circulating virus at original infection.
Conclusions:
Interim analysis at one-year post-enrollment identifies 20 symptoms that infected participants were more likely to report post SARS-CoV-2 infection compared to uninfected, at either visit. Type of symptoms varies by age. Ongoing longitudinal data up to 3-years post-enrollment will increase understanding of long-term symptoms of SARS-CoV-2 infection in children and their trajectory.
Clinical Trial Registration:
NCT04830852.
Impact:
Although most children recover fully from SARS-CoV-2 infection, some children experience a variety of prolonged symptoms following infection. Many studies attempting to characterize these symptoms and trajectory are not prospective nor longitudinal and lack comparison to uninfected controls. This longitudinal analysis identifies and characterizes post-COVID symptoms in children and adolescents and their trajectory through the first-year post enrollment compared to an uninfected cohort. 20 post-infection symptoms were identified as occurring more frequently in the infected as compared to uninfected cohort. Age played a critical role in the type and frequency of symptoms after SARS-CoV-2 infection. Gastrointestinal symptoms were prominent.
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