Health Impairments in Children and Adolescents After Hospitalization for Acute COVID-19 or MIS-C

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Creator
  • Maddux A.B.
    • Other Affiliation: University of Colorado School of Medicine
  • Berbert L.
    • Other Affiliation: Boston Children's Hospital
  • Young C.C.
    • Other Affiliation: Boston Children's Hospital
  • Feldstein L.R.
    • Other Affiliation: Centers for Disease Control and Prevention
  • Zambrano L.D.
    • Other Affiliation: Centers for Disease Control and Prevention
  • Kucukak S.
    • Other Affiliation: Boston Children's Hospital
  • Newhams M.M.
    • Other Affiliation: Boston Children's Hospital
  • Miller K.
    • Other Affiliation: University of Colorado
  • FitzGerald M.M.
    • Other Affiliation: Boston Children's Hospital
  • He J.
    • Other Affiliation: Boston Children's Hospital
  • Halasa N.B.
    • Other Affiliation: Vanderbilt University Medical Center
  • Cvijanovich N.Z.
    • Other Affiliation: UCSF Benioff Children's Hospital
  • Loftis L.L.
    • Other Affiliation: Texas Children's Hospital
  • Walker T.C.
    • Affiliation: School of Medicine, Department of Pediatrics
  • Schwartz S.P.
    • Affiliation: School of Medicine, Department of Pediatrics
  • Gertz S.J.
    • Other Affiliation: Cooperman Barnabas Medical Center
  • Tarquinio K.M.
    • Other Affiliation: Children's Healthcare of Atlanta
  • Fitzgerald J.C.
    • Other Affiliation: University of Pennsylvania
  • Kong M.
    • Other Affiliation: University of Alabama at Birmingham
  • Schuster J.E.
    • Other Affiliation: Children's Mercy Kansas City
  • Mack E.H.
    • Other Affiliation: Medical University of South Carolina
  • Hobbs C.V.
    • Other Affiliation: University of Mississippi Medical Center
  • Rowan C.M.
    • Other Affiliation: Indiana University School of Medicine
  • Staat M.A.
    • Other Affiliation: Cincinnati Children's Hospital Medical Center
  • Zinter M.S.
    • Other Affiliation: University of California San Francisco
  • Irby K.
    • Other Affiliation: Arkansas Children's Hospital
  • Crandall H.
    • Other Affiliation: University of Utah
  • Flori H.
    • Other Affiliation: Mott Children's Hospital and University of Michigan
  • Cullimore M.L.
    • Other Affiliation: Children's Hospital and Medical Center
  • Nofziger R.A.
    • Other Affiliation: Akron Children's Hospital
  • Shein S.L.
    • Other Affiliation: Rainbow Babies and Children's Hospital
  • Gaspers M.G.
    • Other Affiliation: University of Arizona
  • Hume J.R.
    • Other Affiliation: University of Minnesota Masonic Children's Hospital
  • Levy E.R.
    • Other Affiliation: University of Colorado School of Medicine and Children's Hospital Colorado
  • Chen S.R.
    • Other Affiliation: Boston Children’s Hospital
  • Patel M.M.
    • Other Affiliation: Centers for Disease Control and Prevention
  • Tenforde M.W.
    • Other Affiliation: Centers for Disease Control and Prevention
  • Weller E.
    • Other Affiliation: Harvard Medical School
  • Campbell A.P.
    • Other Affiliation: Centers for Disease Control and Prevention
  • Randolph A.G.
    • Other Affiliation: Boston Children's Hospital
Abstract
  • OBJECTIVES: To evaluate risk factors for postdischarge sequelae in children and adolescents hospitalized for acute coronavirus disease 2019 (COVID-19) or multisystem inflammatory syndrome in children (MIS-C). METHODS: Multicenter prospective cohort study conducted in 25 United States pediatric hospitals. Patients <21-years-old, hospitalized May 2020 to May 2021 for acute COVID-19 or MIS-C with follow-up 2 to 4 months after admission. We assessed readmissions, persistent symptoms or activity impairment, and new morbidities. Multivariable regression was used to calculate adjusted risk ratios (aRR) and 95% confidence intervals (CI). RESULTS: Of 358 eligible patients, 2 to 4 month survey data were available for 119 of 155 (76.8%) with acute COVID-19 and 160 of 203 (78.8%) with MIS-C. Thirteen (11%) patients with acute COVID-19 and 12 (8%) with MIS-C had a readmission. Thirty-two (26.9%) patients with acute COVID-19 had persistent symptoms (22.7%) or activity impairment (14.3%) and 48 (30.0%) with MIS-C had persistent symptoms (20.0%) or activity impairment (21.3%). For patients with acute COVID-19, persistent symptoms (aRR, 1.29 [95% CI, 1.04-1.59]) and activity impairment (aRR, 1.37 [95% CI, 1.06-1.78]) were associated with more organ systems involved. Patients with MIS-C and pre-existing respiratory conditions more frequently had persistent symptoms (aRR, 3.09 [95% CI, 1.55-6.14]) and those with obesity more frequently had activity impairment (aRR, 2.52 [95% CI, 1.35-4.69]). New morbidities were infrequent (9% COVID-19, 1% MIS-C). CONCLUSIONS: Over 1 in 4 children hospitalized with acute COVID-19 or MIS-C experienced persistent symptoms or activity impairment for at least 2 months. Patients with MIS-C and respiratory conditions or obesity are at higher risk of prolonged recovery.
Date of publication
DOI
Identifier
Resource type
  • Article
License
  • Attribution-NonCommercial-NoDerivs 4.0 International
Journal title
  • Pediatrics
Journal volume
  • 150
Journal issue
  • 3
Language
  • English
Version
  • Publisher
ISSN
  • 1098-4275

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