Post-COVID-19 condition in children: epidemiological evidence stratified by acute disease severity

期刊论文
发表日期：

2024年9月27日

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Coen R. Lap,
Caroline L. H. Brackel,
Angelique M. A. M. Winkel,
Simone Hashimoto,
Milly Haverkort,
Lieke C. E. Noij,
Mattijs W. Alsem,
Erik G. J. von Asmuth,
Michiel A. G. E. Bannier,
Emmeline P. Buddingh,
Johannes B. van Goudoever,
Lotte Haverman,
Anke H. Maitland–van der Zee,
Miriam G. Mooij,
Kim Oostrom,
Mariëlle W. Pijnenburg,
Sanne Kloosterman,
Lorynn Teela,
Michiel Luijten,
Adam J. Tulling,
Gertjan Lugthart,
Debby Bogaert,
Giske Biesbroek,
Marlies A. van Houten,
Suzanne W. J. Terheggen-Lagro

摘要

Background

To determine the prevalence of pediatric Post-COVID-19 condition (PPCC), identify risk factors, and assess the quality of life in children with differing severities of acute COVID-19.

Methods

During a prospective longitudinal study with a 1-year follow-up, we compared non-hospitalized (mild) and hospitalized (severe) COVID-19 cases to a negatively tested control group.

Results

579 children were included in this study. Of these, 260 had mild acute disease (median age:8, IQR:6–10), 60 had severe acute disease (median age:1, IQR:0.1–4.0), and 259 tested negative for SARS-CoV-2 (NT) (median age:8, IQR:5-10).

At three months, 14.6% of the SARS-CoV-2 positive mild group (RR:6.31 (CI 95%: 2.71–14.67)) and 29.2% of the severe group (RR:12.95 (CI 95%: 5.37–31.23)) reported sequelae, versus 2.3% of the NT group. PPCC prevalence in the mild group decreased from 16.1% at one month to 4.4% at one year. Children with PPCC exhibited lower physical health-related quality of life scores and higher fatigue scores than the NT children.

Conclusions

Severe acute COVID-19 in children leads to a higher PPCC prevalence than in mild cases. PPCC prevalence decreases over time. Risk factors at three months include prior medical history, hospital admission, and persistent fatigue one month after a positive test.

Impact

We demonstrate children with severe COVID-19 are more likely to develop Post-COVID-19 condition than those with mild or no infections, and highlights the risk factors.

Here we have stratified by acute disease severity, prospectively included a negative control group, and have demonstrated the heterogeneity in prevalence when utilizing various recent definitions of post-COVID.

Identifying risk factors for pediatric post-COVID and highlighting the heterogeneity in prevalence based on various current definitions for post-COVID should aid in correctly identifying potential pediatric post-COVID cases, aiding in early intervention.