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Pediatr Pulmonol . Protracted respiratory findings in children post-SARS-CoV-2 infection

tetano

Editor, Senior Moderator
Pediatr Pulmonol


. 2021 Sep 17.
doi: 10.1002/ppul.25671. Online ahead of print.
Protracted respiratory findings in children post-SARS-CoV-2 infection


Shoshana C Leftin Dobkin[SUP] 1 [/SUP], Joseph M Collaco[SUP] 2 [/SUP], Sharon A McGrath-Morrow[SUP] 3 [/SUP]



Affiliations

Abstract

Introduction: Although prolonged respiratory symptoms following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have been described in adults, data are emerging that children also experience long-term sequelae of coronavirus disease 2019 (COVID-19). The respiratory sequelae of COVID-19 in children remain poorly characterized. In this study we describe health data and respiratory findings in pediatric patients presenting with persistent respiratory symptoms following COVID-19.
Methods: This study included patients referred to Pulmonary Clinic at the Children's Hospital of Philadelphia between December 2020 and April 2021 (n = 29). Inclusion criteria included a history of SARS-CoV-2 RNA positivity or confirmed close household contact and suggestive symptoms. A retrospective chart review was performed and demographic, clinical, imaging, and functional test data were collected.
Results: The mean age at presentation to clinic was 13.1 years (range: 4-19 years). Patients had persistent respiratory symptoms ranging from 1.3 to 6.7 months postacute infection. Persistent dyspnea and/or exertional dyspnea were present in nearly all (96.6%) patients at the time of clinic presentation. Other reported chronic symptoms included cough (51.7%) and exercise intolerance (48.3%). Fatigue was reported in 13.8% of subjects. Many subjects were overweight or obese (62.1%) and 11 subjects (37.9%) had a prior history of asthma. Spirometry and plethysmography were normal in most patients. The six-minute walk test (6MWT) revealed exercise intolerance and significant tachycardia in two-thirds of the nine children tested.
Conclusion: Exertional dyspnea, cough and exercise intolerance were the most common respiratory symptoms in children with postacute COVID-19 respiratory symptoms seen in an outpatient pulmonary clinic. Spirometry (and plethysmography when available), however, was mostly normal, and exertional intolerance was frequently demonstrated using the 6MWT.

Keywords: breathlessness; exercise; functional capacity; postcovid syndrome; pulmonary function.
 
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