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

ABSTRACT

SESSION TITLE Late Breaking Chest Infections Posters SESSION TYPE Original Investigation Posters PRESENTED ON 10/18/2022 0130 pm - 0230 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