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Master of Public Health

Health Impairments in Children and Adolescents After Hospitalization for Acute COVID-19 or MIS-C

AUTHORS

Maddux AB , Berbert L , Young CC , Feldstein LR , Zambrano LD , Kucukak S , Newhams MM , Miller K , FitzGerald MM , He J , Halasa NB , Cvijanovich NZ , Loftis LL , Walker TC , Schwartz SP , Gertz SJ , Tarquinio KM , Fitzgerald JC , Kong M , Schuster JE , Mack EH , Hobbs CV , Rowan CM , Staat MA , Zinter MS , Irby K , Crandall H , Flori H , Cullimore ML , Nofziger RA , Shein SL , Gaspers MG , Hume JR , Levy ER , Chen SR , Patel MM , Tenforde MW , Weller E , Campbell AP , Randolph AG , . Pediatrics. 2022 6 29; ().

ABSTRACT

OBJECTIVE: To evaluate risk factors for post-discharge sequelae in children and adolescents after hospitalization for acute COVID-19 or multisystem inflammatory syndrome in children (MIS-C).

METHODS: Multicenter prospective observational cohort study conducted in 25 US pediatric hospitals. Patients <21-years-old, hospitalized May 2020 to May 2021 for acute COVID-19 or MIS-C with follow-up 2-4 months after admission. We assessed readmissions, caregiver-reported persistent symptoms or activity impairment, and new morbidities identified by the Functional Status Scale. Multivariable regression was used to calculate adjusted risk ratios (aRR).

RESULTS: Of 358 eligible patients, 2-4 month survey data were available for 119/155 (76.8%) with acute COVID-19 and 160/203 (78.8%) with MIS-C. Thirteen (11%) patients with acute COVID-19 and 12 (8%) with MIS-C had a readmission. Thirty-two (26.9%) patients with acute COVID-19 had persistent symptoms (22.7%) or activity impairment (14.3%) and 48 (30.0%) patients with MIS-C had persistent symptoms (20.0%) or activity impairment (21.3%). For patients with acute COVID-19, persistent symptoms (aRR, 1.29[95% CI, 1.04-1.59]) and activity impairment (aRR, 1.37[95% CI, 1.06-1.78]) were associated with more organs systems involved. Patients with MIS-C and pre-existing respiratory conditions more frequently had persistent symptoms (aRR, 3.09[95% CI, 1.55-6.14]) and those with obesity more frequently had activity impairment (aRR, 2.52[95% CI, 1.35-4.69]). New morbidities were infrequent (9% COVID-19 and 1% MIS-C).

CONCLUSIONS: Over one in four children hospitalized with acute COVID-19 or MIS-C experienced persistent symptoms or activity impairment for at least 2 months. Patients with MIS-C and respiratory conditions or obesity are at higher risk of prolonged recovery.

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