Clinical-based phenotypes in children with pediatric post-COVID-19 condition

Abstract

Background Pediatric post coronavirus disease 2019 (COVID-19) condition (PPCC) is a heterogeneous syndrome, which can significantly affect the daily lives of children. This study aimed to identify clinically meaningful phenotypes in children with PPCC, to better characterize and treat this condition. Methods Participants were children with physician-diagnosed PPCC, referred to the academic hospital Amsterdam UMC in the Netherlands between November 2021 and March 2023. Demographic factors and information on post-COVID symptoms, comorbidities, and impact on daily life were collected. Clinical clusters were identified using an unsupervised and unbiased approach for mixed data types. Results Analysis of 111 patients (aged 3–18 years) revealed three distinct clusters within PPCC. Cluster 1 (n = 62, median age = 15 years) predominantly consisted of girls (74.2%). These patients suffered relatively more from exercise intolerance, dyspnea, and smell disorders. Cluster 2 (n = 33, median age = 13 years) contained patients with an even gender distribution (51.5% girls). They suffered from relatively more sleep problems, memory loss, gastrointestinal symptoms, and arthralgia. Cluster 3 (n = 16, median age = 11 years) had a higher proportion of boys (75.0%), suffered relatively more from fever, had significantly fewer symptoms (median age of 5 years compared to 8 and 10 years for clusters 1 and 2 respectively), and experienced a lower impact on daily life. Conclusions This study identified three distinct clinical PPCC phenotypes, with variations in sex, age, symptom patterns, and impact on daily life. These findings highlight the need for further research to understand the potentially diverse underlying mechanisms contributing to post-COVID symptoms in children. Graphical abstract

Impact of Long SARS-CoV-2 Omicron on Health Care Burden: A Case-control Comparative Study with the Pre-Omicron Waves (Preprint)

“…Subsequent to the prevalence of the Alpha and Delta variants during the initial pandemic waves in the pre-Omicron period, SARS-CoV-2 Omicron (PANGO B.1.1.529) swiftly propagated across Europe from December 2021 to February 2022. Clinically, Omicron variant induced less severe acute illness than its predecessors, and certain studies reported a reduced incidence of post-acute phase impacts [13][14][15][16][17][18][19], both in adults and children [20][21][22][23][24]. Nevertheless, conflicting data have surfaced in the literature [25], and the potential influence of prior vaccination remains uncertain [26][27][28].Valuating the genuine repercussions of SARS-CoV-2 infection in the realm of LONG COVID following the acute phase proves intricate due to myriad factors.…”