IMPACT OF PERSISTENT COVID-19 SYMPTOMS ON PHYSICAL ACTIVITY AND CARDIORESPIRATORY PERFORMANCE IN VULNERABLE CHILDREN AND ADOLESCENTS

SESSION TITLE: Late Breaking Chest Infections Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/18/2022 01:30 pm - 02:30 pm PURPOSE: The science continues to develop in terms of the epidemiology of persistent, or long COVID, especially in the pediatric population. The impact of persistent COVID-19 on cardiorespiratory fitness in the form of physical activity and athletic performance among children/adolescents is not well described, especially among vulnerable populations. METHODS: A retrospective electronic health record review identified children/adolescents with previously diagnosed COVID (N=312, 52.9% male, mean age at diagnosis 6.6 [SD 5.9] years, 20.5% non-Hispanic White [NHW], 19.2% non-Hispanic Black [NHB], and 54.5% Hispanic, 85.26% hospitalized due to COVID-19 illness) from one pediatric healthcare system that serves predominantly Medicaid-dependent families. Patients or caregivers completed a follow-up telephone survey from March 2021- February 2022 to estimate the prevalence of persistent COVID symptoms, defined as the presence of symptoms lasting ≥ 30 days. Multiple logistic regression models explored the association between physical activity and the presence of long COVID. RESULTS: 71 (22.8%) patients reported long COVID and the most prevalent symptoms included tiredness (21 [6.7%]), shortness of breath (18 [5.8%]), cough (16 [5.1%]), headache (14 [4.5%]), difficulty with thinking/concentration (14 [4.5%]), disrupted sleep (14 [4.5%]), other symptoms (12 [3.8%]), anxiety (11 [3.5%]), body aches (11 [3.5%]), joint pain (10 [3.2%]) chest pain (9 [2.9%]), intermittent fever (6 [1.9%]), and loss taste/smell (5 [1.6%]). Almost a third (32%, N = 24) of patients who participated in any athletics or physical activity in or outside of school reported a negative impact on physical or athletic performance, and 66.7% reported it was directly related to COVID-19 illness. Specific complaints when returning to physical activity post-COVID illness included tiredness (7 [36.8%]) and shortness of breath (2 [10.5%]). The odds of a decline in physical activity performance was over twice that (OR 2.17, 95% CI 0.54-8.71, p = 0.28) among children with long COVID versus those reporting no long COVID after adjusting for demographics. There was no difference by age (mean 9.8 vs. 9.7 years, p = 0.93), sex (50% girls vs. 50% boys, p =0.71), or race/ethnicity (25% NHW vs. 25% NHB vs. 37.5% Hispanic, p = 0.25) in terms of decline in physical activity performance. Two children were recommended to delay re-entry into physical activity. CONCLUSIONS: A substantial proportion of ethnically diverse children from low resource backgrounds who had severe COVID illness are reporting long-term impacts on physical activity and cardiorespiratory fitness. Findings can inform pediatricians about this vulnerable population in post-COVID-19 recovery efforts. CLINICAL IMPLICATIONS: Pediatric pulmonologists and other sub-specialists should screen and monitor patients who have had previous severe COVID-19 illness for persistent cardiorespiratory impacts. DISCLOSURES: No relevant relationships by Kubra Melike Bozkanat No relevant relationships by Jackson Francis No relevant relationships by Weiheng He No relevant relationships by Alejandra Lozano No relevant relationships by Matthew Mathew No relevant relationships by Sarah Messiah No relevant relationships by Angela Rabl No relevant relationships by Sumbul shaikH No relevant relationships by Nimisha Srikanth No relevant relationships by Apurva Veeraswamy No relevant relationships by Sitara Weerakoon No relevant relationships by Luyu Xie

Allelic variation in class I HLA determines CD8(+) T cell repertoire shape and cross-reactive memory responses to SARS-CoV-2

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COVID-19 in kidney transplant recipients at New England's largest safety-net hospital

Background: The coronavirus disease 2019 (COVID-19) has led to a global pandemic as announced by the World Health Organization. Kidney transplant patients are thought to constitute a unique high risk group for severe COVID19 infection. Furthermore, disparities in health care have led to COVID-19 disproportionately affecting minority groups including African Americans and Hispanics. Methods: We identified adult kidney transplant recipients who were admitted with COVID-19 between March, 15th and May 1st, 2020. We evaluated the demographic, clinical and laboratory data of all admitted patients. We also evaluated the presence of co-infections as well as decisions regarding immunosuppressant management. Results: 23 kidney transplant recipients who were hospitalized for COVID-19 were evaluated. 91% of our patients were of minority groups. 35% of patients required ICU admission, and 30% required mechanical ventilation. 40% of patients had associated coinfections in addition to COVID19. 87% of patients had variable degrees of AKI, 26% of patients with AKI required renal replacement therapy. Mortality rate in our population was 22%. Upon admission to the hospital, our immunosuppressant therapeutic approach included stopping the antimetabolites and continuing with the calcineurin inhibitors (targeting trough level of 4 to 6 ng/dl for tacrolimus and 50 ng/dl for cyclosporine), and prednisone if patients were on steroids. Conclusions: This report demonstrates higher rate of AKI, coinfection and mortality in kidney transplant patients in the setting of COVID19 as compared to general population.