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

IF 3.1 3区医学 Q1 PEDIATRICS Pediatric Research Pub Date : 2024-09-27 DOI:10.1038/s41390-024-03597-3

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

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Abstract

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.

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COVID-19后的儿童状况：按急性疾病严重程度分层的流行病学证据。

背景：确定小儿COVID-19后病情（PPCC）的发病率、识别风险因素并评估急性COVID-19后儿童的生活质量：目的：确定小儿COVID-19后症状（PPCC）的发病率，识别风险因素，并评估不同严重程度的急性COVID-19患儿的生活质量：在一项为期 1 年的前瞻性纵向研究中，我们将未住院（轻度）和住院（重度）的 COVID-19 病例与阴性对照组进行了比较：本研究共纳入 579 名儿童。其中，260 名儿童患有轻度急性疾病（中位年龄：8 岁，IQR：6-10 岁），60 名儿童患有重度急性疾病（中位年龄：1 岁，IQR：0.1-4.0 岁），259 名儿童的 SARS-CoV-2 (NT) 检测呈阴性（中位年龄：8 岁，IQR：5-10 岁）。三个月后，SARS-CoV-2 阳性的轻度组中有 14.6%（RR:6.31（CI 95%：2.71-14.67））和重度组中有 29.2%（RR:12.95（CI 95%：5.37-31.23））报告有后遗症，而 NT 组只有 2.3%。轻度组的 PPCC 患病率从一个月时的 16.1%降至一年时的 4.4%。与NT儿童相比，PPCC患儿的身体健康相关生活质量评分较低，疲劳评分较高：结论：与轻度病例相比，重度急性 COVID-19 儿童的 PPCC 患病率更高。随着时间的推移，PPCC发病率会逐渐降低。三个月时的风险因素包括既往病史、入院和检测阳性一个月后的持续疲劳：我们的研究表明，与轻度感染或未感染的儿童相比，重度 COVID-19 儿童更有可能出现后 COVID-19 症状，并强调了风险因素。在此，我们根据急性疾病的严重程度进行了分层，前瞻性地纳入了阴性对照组，并利用各种最新的后 COVID 定义证明了患病率的异质性。确定小儿后COVID的风险因素，并根据目前对后COVID的各种定义强调发病率的异质性，应有助于正确识别潜在的小儿后COVID病例，从而帮助进行早期干预。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Research 医学-小儿科

CiteScore

6.80

自引率

5.60%

发文量

473

审稿时长

3-8 weeks

期刊介绍： Pediatric Research publishes original papers, invited reviews, and commentaries on the etiologies of children''s diseases and disorders of development, extending from molecular biology to epidemiology. Use of model organisms and in vitro techniques relevant to developmental biology and medicine are acceptable, as are translational human studies