Persistent symptoms and decreased health-related quality of life after symptomatic pediatric COVID-19: A prospective study in a Latin American tertiary hospital

Fink, Thais T.; Marques, Heloísa Helena de Souza; Gualano, Bruno; Lindoso, Lívia; Bain, Vera; Astley, Camilla; Martins, Fernanda; Matheus, Denise; Matsuo, Olivia Mari; Suguita, Priscila; Trindade, Vitor; Paula, Camila Sanson Yoshino de; Farhat, Sylvia Costa Lima; Palmeira, Patrícia; Leal, Gabriela Nunes; Suzuki, Lisa; Filho, Vicente Odone; Carneiro‐Sampaio, Magda; Duarte, Alberto J. S.; Antonângelo, Leila; Batisttella, Linamara Rizzo; Polanczyk, Guilherme Vanoni; Pereira, Rosa Maria Rodrigues; Carvalho, Carlos Roberto Ribeiro; Buchpiguel, Carlos Alberto; Xavier, Ana Claudia Latronico; Seelaender, Marília Cerqueira Leite; Silva, Clóvis A.; Pereira, Maria Fernanda Bádue; Sallum, Adriana Maluf Elias; Brentani, Alexandra; Santos-Neto, Álvaro José; Ihara, Amanda; Santos, Andrea R; Canton, Ana Pinheiro Machado; Watanabe, Andréia; Santos, Angélica Carreira dos; Pastorino, Antônio Carlos; Franco, Bernadette D.G.M.; Caruzo, Bruna; Ceneviva, Carina; Martins, Carolina Campagnoli Machado Freire; Prado, Danilo Marcelo Leite do; Abellan, Deipara Monteiro; Benatti, Fabiana Braga; Smaria, Fabiana; Gonçalves, Fernanda T.; Penteado, Fernando Domingues; Castro, Gabriela Salim de; Gonçalves, Guilherme Salles De Escobar; Roschel, Hamilton; Disi, Ilana Roitman; Marques, Isabela G.; Castro, Inar A.; Buscatti, Izabel M.; Faiad, Jaline Zandonato; Fiamoncini, Jarlei; Rodrigues, Joaquim Carlos; Carneiro, J.D.A.; Paz, José Albino da; Ferreira, Juliana Carvalho; Silva, Katia Regina da; Bastos, Karina L M; Kozu, Kátia; Cristófani, Lílian Maria; Souza, Lucas V B; Campos, Lúcia M A; Filho, Luiz Vicente R F Silva; Sapienza, Marcelo Tatit; Lima, Maria João; Garanito, Marlene Pereira; Santos, Marcos Ferreira; Dorna, Mayra B.; Aikawa, Nádia E.; Litvinov, Nadia; Sakita, Neusa Keico; Gaiolla, Paula V V; Pasqualucci, Paula Lage; Toma, Ricardo Katsuya; Correa‐Silva, Simone; Sieczkowska, Sofia Mendes; Imamura, Marta; Forsait, Silvana; Santos, Vera Aparecida dos; Zheng, Yingying

doi:10.6061/clinics/2021/e3511

Cited by 39 publications

(45 citation statements)

References 36 publications

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“…Two studies did not report the proportion of children affected by long COVID symptoms in the control group. 6 , 18 …”

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confidence: 99%

“…Two studies did not report the proportion of children affected by long COVID symptoms in the control group. 6,18 Although many studies included a control group, they all had other deficiencies meaning their results need to be viewed with caution. Many had low response rates or differences in response and inclusion rates between children with and without SARS-CoV-2 infection (Table, Supplemental Digital Content 1, http:// links.lww.com/INF/E684).…”

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confidence: 99%

“…Nine of the 27 studies included an uninfected control group. [5][6][7][8][18][19][20][21][22] Six studies compared the proportion of children and adolescents with persistent symptoms in those with and without evidence of prior SARS-CoV-2 infection. 5,8,[19][20][21][22] The difference in proportions varied between Please replace by -0.5% and 13.2% (median 3.0%, IQR 1.4%-3.6%) (Fig.…”

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confidence: 99%

“…We identified 27 studies (13 cross-sectional studies, 5–17 9 prospective cohort studies, 18–26 4 case series 27–30 and 1 retrospective cohort study 31 ) investigating persistent symptoms in a total of 34,664 SARS-CoV-2-infected and 38,988 uninfected children and adolescents. The number of children in each study varied from 5 to 30,117 [median 105, interquartile range (IQR) 30–859].…”

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confidence: 99%

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The Challenge of Studying Long COVID: An Updated Review

Zimmermann

Pittet

Curtis

2022

Pediatric Infectious Disease Journal

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Accurately determining the risk of long COVID is challenging. Existing studies in children and adolescents have considerable limitations and distinguishing long-term SARS-CoV-2 infection-associated symptoms from pandemic-related symptoms is difficult. Over half of individuals in this age group, irrespective of COVID-19, report physical and psychologic symptoms, highlighting the impact of the pandemic. More robust data is needed to inform policy decisions.

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“…Two studies did not report the proportion of children affected by long COVID symptoms in the control group. 6 , 18 …”

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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The Challenge of Studying Long COVID: An Updated Review

Zimmermann

Pittet

Curtis

2022

Pediatric Infectious Disease Journal

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“…[2][3][4] While there is an increasing understanding of the multi-organ damage of Covid-19 beyond the acute phase of infection 5 , the nature, frequency and definition of post-acute sequelae in children and adolescents still remains undetermined with a discrepancy in clinical appearance and objective findings. 6 A major proportion of pediatric studies have lately prioritized research in mental health issues during the Covid-19 pandemic [7][8][9][10] , while other studies have already raised concerns on ongoing disease manifestations, including increased thrombotic state, microangiopathy and inflammation. [11][12][13] As the lung is a primary target of the SARS-CoV-2 virus, 14 computed tomography aided in the diagnosis of pulmonary manifestation of Covid-19 in adults.…”

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confidence: 99%

Persisting pulmonary dysfunction in pediatric post-acute Covid-19

Heiß

Wagner

Tan

et al. 2022

Preprint

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The frequency and extent of persistent sequelae in children and adolescents after infection with SARS-CoV-2 still needs to be comprehensively determined. In this cross-sectional clinical trial, we used non-invasive, label-free morphologic and free-breathing phase-resolved functional low-field magnetic resonance imaging (LF-MRI) to identify pulmonary changes in children and adolescents from 5 to <18 years after previously PCR-confirmed SARS-CoV-2 infection. While morphological pathologies were less frequent in children, functional LF-MRI visualized widespread ventilation, perfusion and combined ventilation/perfusion defects compared to healthy controls. The loss of functional lung parenchyma was more pronounced in long Covid than recovered patients. While pulmonary dysfunction was persistent even month after primary infection, LF-MRI demonstrated high capability to visualize and detect these changes in children and adolescents. (Clinicaltrials.org ID NCT04990531)

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Psychometric validation of the Chinese versions of EQ-5D-Y-3L and the experimental EQ-TIPS in children and adolescents with COVID-19

Zhou,

Li,

Busschbach

et al. 2024

Eur J Health Econ

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Objectives Respiratory infectious diseases like COVID-19 profoundly impacts the health of children and adolescents, but validated instruments to measure their impacts on health-related quality of life (HRQoL) are lacking. The EQ-5D-Y-3L, widely used for youth HRQoL, now features a Chinese value set. The experimental EQ-TIPS addresses HRQoL assessment for toddlers and infants. This study tested the psychometric properties of both instruments in paediatric COVID-19 patients, and compared the performance of self-complete and proxy EQ-5D-Y-3L. Methods This longitudinal study recruited 861 COVID-19 patients aged 0–18 years and their parental caregivers, with 311 dyads completing the follow-up. Digital administration included the EQ-TIPS, the EQ-5D-Y-3L, and Overall Health Assessment (OHA). Controls comprised 231 healthy children. Analysis encompassed known-group validity, child-parent agreement, and responsiveness to change in disease severity and OHA. Results COVID-19 children exhibited lower HRQoL than non-infected peers. The EQ-TIPS and the EQ-5D-Y-3L distinguished groups by disease presence, severity and symptoms, showing moderate to good known-group validity (ESs: 0.45–1.39 for EQ-TIPS, 0.44–1.91 for self-complete EQ-5D-Y-3L, and 0.32–1.67 for proxy EQ-5D-Y-3L). Child-parent agreement was moderate to good for EQ-5D-Y-3L (ICC: 0.653–0.823; Gwet’s AC1: 0.470–0.738), and responsiveness was good for both EQ-TIPS Level Sum Score (LSS) (ESs: 1.21–1.39) and EQ-5D-Y-3L index scores (ESs: 1.00–1.16). Conclusions This study demonstrates the reliability, validity, and responsiveness of the experimental EQ-TIPS and the EQ-5D-Y-3L in paediatric COVID-19 patients. It is the first evidence of the EQ-TIPS’ responsiveness, supporting its use in assessing the impact of COVID-19 on paediatric HRQoL.

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Persistent symptoms and decreased health-related quality of life after symptomatic pediatric COVID-19: A prospective study in a Latin American tertiary hospital

Cited by 39 publications

References 36 publications

The Challenge of Studying Long COVID: An Updated Review

The Challenge of Studying Long COVID: An Updated Review

Persisting pulmonary dysfunction in pediatric post-acute Covid-19

Psychometric validation of the Chinese versions of EQ-5D-Y-3L and the experimental EQ-TIPS in children and adolescents with COVID-19

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