Comparison of Long-Term Complications of COVID-19 Illness among a Diverse Sample of Children by MIS-C Status

Abstract

Most pediatric COVID-19 cases are asymptomatic; however, a small number of children are diagnosed with multisystem inflammatory syndrome in children (MIS-C), a rare but severe condition that is associated with SARS-CoV-2 infection. Persistent symptoms of COVID-19 illness in children diagnosed with/without MIS-C is largely unknown. A retrospective EHR review of patients with COVID-19 illness from one pediatric healthcare system to assess the presence of acute (<30 days) and chronic (≥30, 60–120, and >120 days) long-term COVID symptoms was conducted. Patients/caregivers completed a follow-up survey from March 2021 to January 2022 to assess the presence of long COVID. Results showed that non-MIS-C children (n = 286; 54.49% Hispanic; 19.23% non-Hispanic Black; 5.77% other ethnicity; 79.49% government insurance) were younger (mean age 6.43 years [SD 5.95]) versus MIS-C (n = 26) children (mean age 9.08 years, [SD 4.86]) (p = 0.032). A share of 11.5% of children with MIS-C and 37.8% without MIS-C reported acute long COVID while 26.9% and 15.3% reported chronic long COVID, respectively. Females were almost twice as likely to report long symptoms versus males and those with private insurance were 66% less likely to report long symptoms versus those with government insurance. In conclusion, a substantial proportion of ethnically diverse children from low resource backgrounds with severe COVID illness are reporting long-term impacts. Findings can inform pediatric professionals about this vulnerable population in post-COVID-19 recovery efforts.

Cardiopulmonary Exercise Testing in Children and Young Adolescents after a Multisystem Inflammatory Syndrome: Physical Deconditioning or Residual Pathology?

“…After MIS-C, it is also possible to run into the typical disturbances of long COVID [ 7 ]. In the study of Messiah et al, 27% of children with MIS-C examined reported chronic long COVID symptoms, with the three most reported symptoms being tiredness, headache, and difficulty thinking [ 7 ].…”

“…Indeed, cardiac involvement is frequent, and some patients may have residual heart lesions, a progression of coronary involvement even after discharge and the onset or progression of arrhythmic disorders after the initial diagnosis [ 6 ]. After MIS-C, it is also possible to run into the typical disturbances of long COVID [ 7 ]. All these conditions can affect the well-being of young patients and impose the need for long-term follow-up [ 8 ].…”

True prevalence of long COVID in children: a narrative review

“…In this regard, results of the prospective study by Morello et al showed that age more than 10 years, prexisting conditions and hospitalization during the acute phase due to severity of disease increased the risk of developing LC of about 4, 2 and 3 times, respectively ( Morello et al, 2023 ). Moreover, recent data indicate that persistent clinical manifestations after COVID-19 are more common in children with MIS-C. At this regard, Messiah et al reported that 26.9% of children that have suffered from MIS-C reported chronic LC compared to 15.3% of those without Messiah et al (2022) .…”

Impact of Long-COVID on Health Care Burden: A Case Control Study

“…These studies, conducted with information from Electronic Health Recordings (EHR), also used different approaches in selecting the control groups and focus on specific objectives: health care utilization [ 21 ], prevalence and incidence of symptoms after 12 weeks of acute disease and persistence of previous symptoms [ 22 ], mortality and use of health care services [ 23 ]. In addition, most studies did not include children [ 24 , 25 , 26 ].…”