Nationwide follow-up identifies risk factors for prolonged COVID-19 recovery

In one of the largest follow-up studies to date involving 25 pediatric hospitals, more than a quarter of children and adolescents hospitalized with coronavirus infection early in the pandemic remained healthy two to four months later. I had the above problem.Boston Children’s Hospital-led study to be published in journal Aug. 12 Pediatrics.

Adrienne Randolph, MD, Boston Children, who investigated family caregivers of patients under the age of 21 hospitalized with COVID-19 or childhood multisystem inflammatory syndrome (MIS-C) as part of a national study to beat COVID-19 Investigators led by MSc. The study period was from May 2020 to May 2021, before a vaccine was available. Of the 358 patients, the researcher got her 279, or 78% survey responses.

Of these children and adolescents, approximately 40% were hospitalized with acute COVID-19 and approximately 60% with MIS-C. 50% and 86%, respectively, were admitted to the intensive care unit.

At 2-4 months follow-up, 27% of acute COVID-19 patients and 30% of MIS-C patients had persistent symptoms, disability, or both.

Nearly three-quarters are back to baseline, which is encouraging. But unfortunately, more than one in four he did not. This is much better than many reports of hospitalized elderly people, but it is still very worrying. is also higher. “

Adrienne Randolph, Boston Children’s Hospital

Among children and adolescents with prolonged symptoms, the most common symptoms are:

• Fatigue or weakness affecting 11.3% of COVID-19 patients and 20% of MIS-C patients
• Shortness of breath (9.2% and 2.5% respectively)
• Cough (9.2 and 2.5%)
• Headache (8.4 and 7.5%)
• Muscle and body pain (5 and 3.1%)
• Fever (2.5 and 0.6 percent).

Disability was somewhat more common after MIS-C (21.3% affected) than after acute COVID-19 (14.3%). Caregivers report:

• 6.7% of the COVID-19 group and 14.4% of the MIS-C group were unable to walk or exercise as much as before.
• 6.7% and 7.5%, respectively, slept much more than usual.
• 4.2% and 3.8%, respectively, found it difficult to complete schoolwork or were too distracted to concentrate.

Three factors predicted increased risk of long-term recovery or disability.

• More organ system involvement in acute COVID-19 patients
• Underlying respiratory disease (usually asthma) in patients with MIS-C
• Obesity in MIS-C patients.

Randolph said the study was limited to children and adolescents requiring hospitalization and was done early in the pandemic. Most were hospitalized before the delta surge.

“We are in the process of analyzing more recent data covering some of the Delta and Omicron periods, including health-related quality-of-life effects,” says Randolph. I think it’s possible, and it’s important to understand how all the different variants affect children and track how effective vaccination is in preventing long-term complications. .”

An ongoing study led by Boston Children is also looking at neurological complications of acute COVID-19 and MIS-C using in-depth neurocognitive testing, Randolph said.

“Now that vaccines are available, I highly recommend that children and young people get vaccinated,” she says. We know that, and we have previously shown that vaccination can prevent MIS-C and severe COVID-19.”

Aline Maddux, M.D., Ph.D., of the University of Colorado School of Medicine and Children’s Hospital of Colorado, was the lead author of the current study. This study was funded by the Centers for Disease Control and Prevention (Boston Children’s) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23HD096018, Maddux).