ABSTRACT
Background: The aim of this study was to describe the prevalence of persistent symptoms of COVID in hospitalized pediatric population one year after admission compared to a control group. Method(s): Prospective observational study conducted in 2 hospitals. We included patients aged 0-18 years hospitalized for acute COVID-19 more than a year ago and controls, matched by age and sex, hospitalized for causes other than COVID-19, and who had never COVID-19 at recruitment or during the follow-up. Families were contacted and a standardized survey was conducted. Persistent COVID/disease was defined as the presence of symptoms with onset in the first 3 months after COVID-19 and with persistence for more than 2 months. Result(s): 50 cases and 46 controls were analyzed, 58.3% male, 36% <5 years. Families were interviewed a median of 1.89 years (interquartile range;1.25-2.07) after hospitalization. The definition of persistent COVID-19/disease was met in 34% of cases vs. 37% of controls (p=0.767). Symptoms persisted >=11 months in 24% (12/50) of cases vs. 13% (6/46) of controls (p=0.182), with no differences by age group. The most frequent symptoms at 1 year in cases were fatigue (8%), headache (6%), poor appetite (6%), abdominal pain (6%) and variations in heart rate (6%). In controls, persistent symptoms were mostly abdominal pain (6%) and poor appetite (6%). The number of readmissions was 11/50 (22%) and 6/46 (13%) (p=0.267), respectively. On emotional/behavioral items, 16/50 (32%) of cases reported that their emotional state was worse or much worse than before admission, compared to 16/46 (34.7%). No risk factors associated with the development of persistent symptoms were found, except the length of hospital admission (p=0.043). Conclusion(s): In this study, the prevalence of persistent symptoms was not different in patients with and without COVID-19. 1-year persistence was higher in COVID-19 cases but did not reach significance. Persistence correlated with length of hospitalization.
ABSTRACT
Background: Little is understood about which comorbidities are associated with severe outcomes in children hospitalized with acute COVID-19. Some confusion lies especially for cancer or diabetes. Method(s): Data from 2 multicenter prospective cohort studies of hospitalized children (aged 0-18 years) with confirmed SARS-CoV-2 in Spain and Colombia were combined for this analysis. Data were obtained from 116 hospitals. Outcome was classified as (in decreasing order of severity): death, mechanical ventilation (MV), pediatric intensive care unit (PICU) admission, high flow/CPAP, oxygen therapy with nasal prong (NP) and hospitalization without respiratory support. Risk factors for severity, adjusting for age and gender, were identified using multinominal logistic regression and a backwards selection process. Result(s): A total of 1,753 patients were included, 734 (41.8%) in Spain and 1,019 (58.1%) in Colombia. The most frequent comorbidities were asthma (9.0%), chronic neurological disorder (NRL) (7.4%), immunosuppressive medication (7.2%), malignant neoplasms (5.4%) and chronic lung disease (not asthma) (CLD) (4.5%). Comorbidities associated with the different endpoints are summarized in Figure 1. Asthma was associated with a significantly increased risk of death (OR: 4.17;95%CI 1.34-12.97), MV (OR: 7.94 (3.59-17.56)), PICU admission (OR: 3.37 (1.91- 5.96)), high flow/CPAP (OR: 6.65 (2.69-16.46)), and NP (OR: 3.85 (2.57-5.77)) compared to hospitalization without respiratory support. NRL was associated with increased risk of death (OR: 7.34 (3.01-17.90)), MV (OR: 3.07 (1.20-7.82)) and high flow/CPAP (OR: 4.36 (1.68-11.29)). CLD was associated with increased risk of death (OR: 6.22 [2.28-16.94]) and NP (OR: 3.1 (1.74-5.58)) and in addition, chronic cardiac disease was associated with increased risk of MV (OR: 5.21 (1.76-15.41)) and PICU (OR: 2.78 (1.27-6.08)). Risks of death (OR: 4.49 (2.03-9.05)), MV (OR: 2.97 (1.52-5.81)), PICU (OR: 4.27 (2.89-6.33)), and NP (OR: 4.67 (3.64-5.99)) were higher in the Colombia Cohort. Conclusion(s): Asthma, chronic neurological, cardiac and lung disease;and belonging to the Colombia cohort were consistently associated with multiple severe outcomes of COVID-19. Cancer and diabetes association with selected endpoints rather than with most endpoints may be more related to the baseline disease than with the actual COVID-19.