Post-acute sequelae of SARS-CoV-2 infection (PASC): peripheral, autonomic, and central nervous system features in a child

Younger, David S.

doi:10.1007/s10072-021-05345-5

Cited by 18 publications

(13 citation statements)

References 31 publications

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“…Further, the observation period in the study aligned with the phase of the pandemic when viral testing was still widely performed in the healthcare setting. Patients were considered SARSCOV-2 uninfected if (1) all available diagnostic tests (PCR, Ag, serology) during the study period were negative and (2) the patient did not have any diagnosis codes indicating SARS-COV-2 infection, MIS-C, or PASC in any setting.…”

Section: Methodsmentioning

confidence: 99%

“…Cohort entry date for incident PASC cases was defined as: (1) the date of the first positive PCR or antigen test, or (2) 4 weeks before the date of the first positive serology test, or (3) 4 weeks before the first occurrence of a diagnosis of PASC if no preceding confirmatory test was available. We recognize that imposing a date of infection may misclassify the risk window between initial infection and PASC diagnosis if no testing data is available but chose to be overly inclusive of patients rather than exclude patients with the diagnosis based on unavailability of testing data (only 533 of 1309 patients with PASC [40.7%] had evidence of SARS-CoV-2 infection prior to their earliest PASC diagnosis).…”

Section: Methodsmentioning

confidence: 99%

“…The National Institutions of Health (NIH) launched the new RECOVER initiative in 2021 (1) to leverage electronic health record (EHR) data to better identify and characterize patients with post-acute sequelae of SARS-CoV-2 infection (PASC), defined by the NIH as failure to recover from COVID-19, or those persistently symptomatic for >30 days. (2) In the adult literature, advances have been made to predict PASC among COVID-19 affected patients (3) and to describe etiology, risk factors, and outcomes (4)(5)(6)(7). In contrast, there is currently a paucity of rigorous studies that accurately describe PASC in children (8).…”

Section: Background and Significancementioning

confidence: 99%

See 2 more Smart Citations

Understanding pediatric long COVID using a tree-based scan statistic approach: An EHR-based cohort study from the RECOVER Program

Lorman

Razzaghi

Rao

et al. 2022

Preprint

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Objectives Post-acute sequalae of SARS-CoV-2 infection (PASC) is not well defined in pediatrics given its heterogeneity of presentation and severity in this population. The aim of this study is to use novel methods that rely on data mining approaches rather than clinical experience to detect signals associated with PASC. Materials and Methods We used a propensity-matched cohort design comparing children identified using the new PASC ICD10CM diagnosis code (U09.9) (N=1250) to children with (N=6250) and without (N=6250) SARS-CoV-2 infection. We used a tree-based scan statistic to identify potential condition clusters co-occurring more frequently in cases than controls. Results We found significant enrichment among children with PASC in cardiac, respiratory, neurologic, psychological, endocrine, gastrointestinal, and musculoskeletal systems, the most significant related to circulatory and respiratory such as dyspnea, difficulty breathing, and fatigue and malaise. Discussion Our study addresses methodological limitations of prior studies that rely on pre-specified clusters of potential PASC-associated diagnoses driven by clinician experience. Future studies are needed to identify patterns of diagnoses and their associations to derive clinical phenotypes. Conclusion We identified multiple conditions and body systems associated with pediatric PASC. Because we rely on a data-driven approach, several new or under-reported conditions and symptoms were detected that warrant further investigation.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Background and Significancementioning

confidence: 99%

See 1 more Smart Citation

Understanding pediatric long COVID using a tree-based scan statistic approach: An EHR-based cohort study from the RECOVER Program

Lorman

Razzaghi

Rao

et al. 2022

Preprint

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“…Information on pediatric post-COVID OI is more limited. One case report describes a previously healthy 12-year-old girl who contracted COVID-19 in March 2020; orthostatic symptoms progressed until she became bedbound by July 2020 [ 44 ]. Testing revealed severely symptomatic OI associated with a drop in blood pressure and resting tachycardia.…”

Section: Orthostatic Intolerance After Covid-19 Infectionmentioning

confidence: 99%

Long-Term COVID 19 Sequelae in Adolescents: the Overlap with Orthostatic Intolerance and ME/CFS

et al. 2022

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Purpose of Review To discuss emerging understandings of adolescent long COVID or post-COVID-19 conditions, including proposed clinical definitions, common symptoms, epidemiology, overlaps with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and orthostatic intolerance, and preliminary guidance on management. Recent Findings The recent World Health Organization clinical case definition of post-COVID-19 condition requires a history of probable or confirmed SARS-CoV-2 infection, with symptoms starting within 3 months of the onset of COVID-19. Symptoms must last for at least 2 months and cannot be explained by an alternative diagnosis. Common symptoms of the post-COVID-19 condition include, but are not limited to, fatigue, shortness of breath, and cognitive dysfunction. These symptoms generally have an impact on everyday functioning. The incidence of prolonged symptoms following SARS-CoV-2 infection has proven challenging to define, but it is now clear that those with relatively mild initial infections, without severe initial respiratory disease or end-organ injury, can still develop chronic impairments, with symptoms that overlap with conditions like ME/CFS (profound fatigue, unrefreshing sleep, post-exertional malaise, cognitive dysfunction, and orthostatic intolerance). Summary We do not yet have a clear understanding of the mechanisms by which individuals develop post-COVID-19 conditions. There may be several distinct types of long COVID that require different treatments. At this point, there is no single pharmacologic agent to effectively treat all symptoms. Because some presentations of post-COVID-19 conditions mimic disorders such as ME/CFS, treatment guidelines for this and related conditions can be helpful for managing post-COVID-19 symptoms. Supplementary Information The online version contains supplementary material available at 10.1007/s40124-022-00261-4.

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“…Approximately 30% and 80% of patients affected by COVID-19 and hospitalized for COVID-19, respectively; however, even those not hospitalized experience post-acute COVID-19 sequelae [ 15 ]. PASC does not discriminate and has been reported to affect children, adults, and those with mild and severe COVID-19 infections [ 16 ]. PASC symptoms range from mild to severe and can persist for months affecting one’s day to day life [ 17 ].…”

Section: Cognitive and Neuropsychiatric Manifestations In Pascmentioning

confidence: 99%

Rehabilitation Strategies for Cognitive and Neuropsychiatric Manifestations of COVID-19

Rolin

Chakales

Verduzco‐Gutierrez

2022

Curr Phys Med Rehabil Rep

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Purpose of Review Extrapulmonary manifestations of COVID-19 are abundant, including after recovery of acute SARS-CoV-2 infection. This review seeks to explore the cognitive and neuropsychiatric manifestations of COVID-19 and post-acute sequelae of SARS-CoV-2 (PASC), including Long COVID syndromes. Furthermore, the review will discuss rehabilitation strategies for the emerging neurological consequences of COVID-19 to help those experiencing long-term effects of COVID-19. Recent Findings There is emerging evidence depicting the neural involvement of COVID-19. Health priorities have shifted from understanding pathogenesis and treatment of pulmonary symptoms to targeting the acute and chronic sequelae of COVID-19, including cognitive and neuropsychiatric symptoms. The sequelae of COVID-19 often co-occur with other medical problems and is best managed by assessment and care across multiple disciplines. Symptoms following infection are similar to those found by other syndromes and disorders that disrupt the central nervous system. Summary The acute and chronic sequelae of COVID-19 have become major targets of current health care providers given its significant public health impact, inclusive of cognitive and neuropsychiatric sequelae. Assessment and referral to rehabilitation based on each individual’s needs and symptoms can decrease morbidity and improve quality of life.

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Post-acute sequelae of SARS-CoV-2 infection (PASC): peripheral, autonomic, and central nervous system features in a child

Cited by 18 publications

References 31 publications

Understanding pediatric long COVID using a tree-based scan statistic approach: An EHR-based cohort study from the RECOVER Program

Understanding pediatric long COVID using a tree-based scan statistic approach: An EHR-based cohort study from the RECOVER Program

Long-Term COVID 19 Sequelae in Adolescents: the Overlap with Orthostatic Intolerance and ME/CFS

Rehabilitation Strategies for Cognitive and Neuropsychiatric Manifestations of COVID-19

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