tetano
Editor, Senior Moderator
Front Pediatr
. 2023 Oct 18:11:1260372.
doi: 10.3389/fped.2023.1260372. eCollection 2023. Risk factors for health impairments in children after hospitalization for acute COVID-19 or MIS-C
Aline B Maddux[SUP] 1 [/SUP], Cameron C Young[SUP] 2 [/SUP], Suden Kucukak[SUP] 2 [/SUP], Laura D Zambrano[SUP] 3 [/SUP], Margaret M Newhams[SUP] 2 [/SUP], Caitlin K Rollins[SUP] 4 [/SUP], Natasha B Halasa[SUP] 5 [/SUP], Shira J Gertz[SUP] 6 [/SUP], Elizabeth H Mack[SUP] 7 [/SUP], Stephanie Schwartz[SUP] 8 [/SUP], Michele Kong[SUP] 9 [/SUP], Laura L Loftis[SUP] 10 [/SUP], Katherine Irby[SUP] 11 [/SUP], Courtney M Rowan[SUP] 12 [/SUP], Keiko M Tarquinio[SUP] 13 [/SUP], Matt S Zinter[SUP] 14 [/SUP], Hillary Crandall[SUP] 15 [/SUP], Natalie Z Cvijanovich[SUP] 16 [/SUP], Jennifer E Schuster[SUP] 17 [/SUP], Julie C Fitzgerald[SUP] 18 [/SUP], Mary A Staat[SUP] 19 [/SUP], Charlotte V Hobbs[SUP] 20 [/SUP], Ryan A Nofziger[SUP] 21 [/SUP], Steven Shein[SUP] 22 [/SUP], Heidi Flori[SUP] 23 [/SUP], Melissa L Cullimore[SUP] 24 [/SUP], Brandon M Chatani[SUP] 25 [/SUP], Emily R Levy[SUP] 26 [/SUP], Katri V Typpo[SUP] 27 [/SUP], Janet R Hume[SUP] 28 [/SUP], Angela P Campbell[SUP] 3 [/SUP], Adrienne G Randolph[SUP] 29 [/SUP]; Overcoming COVID-19 Investigators
Collaborators, Affiliations
Objective: To identify risk factors for persistent impairments after pediatric hospitalization for acute coronavirus disease 2019 (COVID-19) or multisystem inflammatory syndrome in children (MIS-C) during the SARS-CoV-2 pandemic.
Methods: Across 25 U.S. Overcoming COVID-19 Network hospitals, we conducted a prospective cohort study of patients <21-years-old hospitalized for acute COVID-19 or MIS-C (May 2020 to March 2022) surveyed 2- to 4-months post-admission. Multivariable regression was used to calculate adjusted risk ratios (aRR) and 95% confidence intervals (CI).
Results: Of 232 children with acute COVID-19, 71 (30.6%) had persistent symptoms and 50 (21.6%) had activity impairments at follow-up; for MIS-C (n = 241), 56 (23.2%) had persistent symptoms and 58 (24.1%) had activity impairments. In adjusted analyses of patients with acute COVID-19, receipt of mechanical ventilation was associated with persistent symptoms [aRR 1.83 (95% CI: 1.07, 3.13)] whereas obesity [aRR 2.18 (95% CI: 1.05, 4.51)] and greater organ system involvement [aRR 1.35 (95% CI: 1.13, 1.61)] were associated with activity impairment. For patients with MIS-C, having a pre-existing respiratory condition was associated with persistent symptoms [aRR 3.04 (95% CI: 1.70, 5.41)] whereas obesity [aRR 1.86 (95% CI: 1.09, 3.15)] and greater organ system involvement [aRR 1.26 (1.00, 1.58)] were associated with activity impairments.
Discussion: Among patients hospitalized, nearly one in three hospitalized with acute COVID-19 and one in four hospitalized with MIS-C had persistent impairments for ≥2 months post-hospitalization. Persistent impairments were associated with more severe illness and underlying health conditions, identifying populations to target for follow-up.
Keywords: COVID-19; COVID-19 post-intensive care syndrome; MIS-C; SARS-CoV-2; critical care outcomes; multisystem inflammatory syndrome in children; pediatrics; post-acute COVID-19 syndrome.
. 2023 Oct 18:11:1260372.
doi: 10.3389/fped.2023.1260372. eCollection 2023. Risk factors for health impairments in children after hospitalization for acute COVID-19 or MIS-C
Aline B Maddux[SUP] 1 [/SUP], Cameron C Young[SUP] 2 [/SUP], Suden Kucukak[SUP] 2 [/SUP], Laura D Zambrano[SUP] 3 [/SUP], Margaret M Newhams[SUP] 2 [/SUP], Caitlin K Rollins[SUP] 4 [/SUP], Natasha B Halasa[SUP] 5 [/SUP], Shira J Gertz[SUP] 6 [/SUP], Elizabeth H Mack[SUP] 7 [/SUP], Stephanie Schwartz[SUP] 8 [/SUP], Michele Kong[SUP] 9 [/SUP], Laura L Loftis[SUP] 10 [/SUP], Katherine Irby[SUP] 11 [/SUP], Courtney M Rowan[SUP] 12 [/SUP], Keiko M Tarquinio[SUP] 13 [/SUP], Matt S Zinter[SUP] 14 [/SUP], Hillary Crandall[SUP] 15 [/SUP], Natalie Z Cvijanovich[SUP] 16 [/SUP], Jennifer E Schuster[SUP] 17 [/SUP], Julie C Fitzgerald[SUP] 18 [/SUP], Mary A Staat[SUP] 19 [/SUP], Charlotte V Hobbs[SUP] 20 [/SUP], Ryan A Nofziger[SUP] 21 [/SUP], Steven Shein[SUP] 22 [/SUP], Heidi Flori[SUP] 23 [/SUP], Melissa L Cullimore[SUP] 24 [/SUP], Brandon M Chatani[SUP] 25 [/SUP], Emily R Levy[SUP] 26 [/SUP], Katri V Typpo[SUP] 27 [/SUP], Janet R Hume[SUP] 28 [/SUP], Angela P Campbell[SUP] 3 [/SUP], Adrienne G Randolph[SUP] 29 [/SUP]; Overcoming COVID-19 Investigators
Collaborators, Affiliations
- PMID: 37920792
- PMCID: PMC10619659
- DOI: 10.3389/fped.2023.1260372
Objective: To identify risk factors for persistent impairments after pediatric hospitalization for acute coronavirus disease 2019 (COVID-19) or multisystem inflammatory syndrome in children (MIS-C) during the SARS-CoV-2 pandemic.
Methods: Across 25 U.S. Overcoming COVID-19 Network hospitals, we conducted a prospective cohort study of patients <21-years-old hospitalized for acute COVID-19 or MIS-C (May 2020 to March 2022) surveyed 2- to 4-months post-admission. Multivariable regression was used to calculate adjusted risk ratios (aRR) and 95% confidence intervals (CI).
Results: Of 232 children with acute COVID-19, 71 (30.6%) had persistent symptoms and 50 (21.6%) had activity impairments at follow-up; for MIS-C (n = 241), 56 (23.2%) had persistent symptoms and 58 (24.1%) had activity impairments. In adjusted analyses of patients with acute COVID-19, receipt of mechanical ventilation was associated with persistent symptoms [aRR 1.83 (95% CI: 1.07, 3.13)] whereas obesity [aRR 2.18 (95% CI: 1.05, 4.51)] and greater organ system involvement [aRR 1.35 (95% CI: 1.13, 1.61)] were associated with activity impairment. For patients with MIS-C, having a pre-existing respiratory condition was associated with persistent symptoms [aRR 3.04 (95% CI: 1.70, 5.41)] whereas obesity [aRR 1.86 (95% CI: 1.09, 3.15)] and greater organ system involvement [aRR 1.26 (1.00, 1.58)] were associated with activity impairments.
Discussion: Among patients hospitalized, nearly one in three hospitalized with acute COVID-19 and one in four hospitalized with MIS-C had persistent impairments for ≥2 months post-hospitalization. Persistent impairments were associated with more severe illness and underlying health conditions, identifying populations to target for follow-up.
Keywords: COVID-19; COVID-19 post-intensive care syndrome; MIS-C; SARS-CoV-2; critical care outcomes; multisystem inflammatory syndrome in children; pediatrics; post-acute COVID-19 syndrome.