Risk factors for long covid in previously hospitalised children using the ISARIC Global follow-up protocol: A prospective cohort study

Abstract

Background The long-term sequelae of coronavirus disease 2019 (Covid-19) in children remain poorly characterised. This study aimed to assess long-term outcomes in children previously hospitalised with Covid-19 and associated risk factors. Methods This is a prospective cohort study of children (18 years old and younger) admitted with confirmed Covid-19 to Z.A. Bashlyaeva Children's Municipal Clinical Hospital in Moscow, Russia. Children admitted to the hospital during the first wave of the pandemic, between April 2, 2020 and August 26, 2020, were included. Telephone interview using the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) Covid-19 Health and Wellbeing paediatric follow up survey. Persistent symptoms (>5 months) were further categorised by system(s) involved. Findings Overall, 518 of 853 (61%) of eligible children were available for the follow-up assessment and included in the study. Median age was 10.4 years (IQR, 3-15.2) and 270 (52.1%) were girls; median follow-up since hospital discharge was 256 (223-271) days. At the time of the follow-up interview 126 (24.3%) participants reported persistent symptoms among which fatigue (53, 10.7%), sleep disturbance (36, 6.9%,) and sensory problems (29, 5.6%) were the most common. Multiple symptoms were experienced by 44 (8.4%) participants. Risk factors for persistent symptoms were: age "6-11 years" (odds ratio 2.74 (95% confidence interval 1.37 to 5.75) and "12-18 years" (2.68, 1.41 to 5.4), and a history of allergic diseases (1.67, 1.04 to 2.67). Interpretation A quarter of children experienced persistent symptoms months after hospitalization with acute covid-19 infection, with almost one in ten experiencing multi-system involvement. Older age and allergic diseases were associated with higher risk of persistent symptoms at follow-up. Our findings highlight the need for replication and further investigation of potential mechanisms as well as clinical support to improve long term outcomes in children. Funding None.

Intriguing new faces of Covid-19: persisting clinical symptoms and cardiac effects in children

“…IP address: 44.224.250.200, on 30 Aug 2021 at 02:24:36, subject to the Cambridge Core terms of use, available at recovery, 8 bringing up a type of Covid-19 infection referred to as long Covid or Post-Covid-19 syndrome. 9 This case can also be seen among children 10 , as supported by a pediatric cohort study done in Russia, in which fatigue, sleep disturbance, sensory, gastrointestinal, dermatological, neurological, respiratory, cardiovascular, and musculoskeletal problems were observed in children with Covid-19 in the long term 19 . Our findings were also in line with these, as shown in Figure 2, evoking long Covid in our study group.…”

Post COVID-19 in children, adolescents, and adults: results of a matched cohort study including more than 150,000 individuals with COVID-19

“…The vast majority of these studies focused solely on adults [3][4][5][6][7]. Results of these studies are heterogenous, due to large methodological differences with regard to study design, data sources, data collection modes, and the definition of health outcomes [3,4,[8][9][10]. Clinical studies of patients hospitalized for COVID-19 have consistently reported that high proportions of patients continue to suffer from one or more health complaints for months after discharge.…”

“…Symptoms frequently observed include fatigue, weakness, muscle pain, sleep disorders, depressive symptoms, dizziness, lack of memory and concentration, and shortness of breath. This has been observed mainly among adults [8,9,11], whereas evidence on pediatric populations is still very limited [10,12,13].…”

Prevalence of persistent symptoms in children during the COVID-19 pandemic: evidence from a household cohort study in England and Wales

“…4 Generally, the estimated prevalence of persistent symptoms in children with SARS-CoV-2 infection presenting in secondary care have been higher, ranging from 8% to 25% 3-7 months after infection onset. 5 6 We estimated the prevalence of persistent symptoms reported in children during the summer, autumn and winter of 2020-2021, and their association with SARS-CoV-2 infection, in a large household-based community cohort study.…”