Event rates and incidence of post-COVID-19 condition in hospitalised SARS-CoV-2 positive children and young people and controls across different pandemic waves: exposure-stratified prospective cohort study in Moscow (StopCOVID).
COVID-19
COVID-19 sequelae
Children
Controlled study
Incidence
Long COVID
PASC
Post COVID-19 condition
Post-acute sequelae of SARS-CoV-2 infection
Journal
BMC medicine
ISSN: 1741-7015
Titre abrégé: BMC Med
Pays: England
ID NLM: 101190723
Informations de publication
Date de publication:
01 Feb 2024
01 Feb 2024
Historique:
received:
06
07
2023
accepted:
07
12
2023
medline:
2
2
2024
pubmed:
2
2
2024
entrez:
2
2
2024
Statut:
epublish
Résumé
Long-term health outcomes in children and young people (CYP) after COVID-19 infection are not well understood and studies with control groups exposed to other infections are lacking. This study aimed to investigate the incidence of post-COVID-19 condition (PCC) and incomplete recovery in CYP after hospital discharge and compare outcomes between different SARS-CoV-2 variants and non-SARS-CoV-2 infections. A prospective exposure-stratified cohort study of individuals under 18 years old in Moscow, Russia. Exposed cohorts were paediatric patients admitted with laboratory-confirmed COVID-19 infection between April 2 and December 11, 2020 (Wuhan variant cohort) and between January 12 and February 19, 2022 (Omicron variant cohort). CYP admitted with respiratory and intestinal infections, but negative lateral flow rapid diagnostic test and PCR-test results for SARS-CoV-2, between January 12 and February 19, 2022, served as unexposed reference cohort. Comparison between the 'exposed cohorts' and 'reference cohort' was conducted using 1:1 matching by age and sex. Follow-up data were collected via telephone interviews with parents, utilising the long COVID paediatric protocol and survey developed by the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC). The WHO case definition was used to categorise PCC. Of 2595 CYP with confirmed COVID-19, 1707 (65.7%) participated in follow-up interviews, with 1183/1707 (69%) included in the final 'matched' analysis. The median follow-up time post-discharge was 6.7 months. The incidence of PCC was significantly higher in the Wuhan variant cohort (89.7 cases per 1000 person-months, 95% CI 64.3-120.3) compared to post-infection sequalae in the reference cohort (12.2 cases per 1000 person-months, 95% CI 4.9-21.9), whereas the difference with the Omicron variant cohort and reference cohort was not significant. The Wuhan cohort had higher incidence rates of dermatological, fatigue, gastrointestinal, sensory, and sleep manifestations, as well as behavioural and emotional problems than the reference cohort. The only significant difference between Omicron variant cohort and reference cohort was decreased school attendance. When comparing the Wuhan and Omicron variant cohorts, higher incidence of PCC and event rates of fatigue, decreased physical activity, and deterioration of relationships was observed. The rate of incomplete recovery was also significantly higher in the Wuhan variant cohort than in both the reference and the Omicron variant cohorts. Wuhan variant exhibited a propensity for inducing a broad spectrum of physical symptoms and emotional behavioural changes, suggesting a pronounced impact on long-term health outcomes. Conversely, the Omicron variant resulted in fewer post-infection effects no different from common seasonal viral illnesses. This may mean that the Omicron variant and subsequent variants might not lead to the same level of long-term health consequences as earlier variants.
Sections du résumé
BACKGROUND
BACKGROUND
Long-term health outcomes in children and young people (CYP) after COVID-19 infection are not well understood and studies with control groups exposed to other infections are lacking. This study aimed to investigate the incidence of post-COVID-19 condition (PCC) and incomplete recovery in CYP after hospital discharge and compare outcomes between different SARS-CoV-2 variants and non-SARS-CoV-2 infections.
METHODS
METHODS
A prospective exposure-stratified cohort study of individuals under 18 years old in Moscow, Russia. Exposed cohorts were paediatric patients admitted with laboratory-confirmed COVID-19 infection between April 2 and December 11, 2020 (Wuhan variant cohort) and between January 12 and February 19, 2022 (Omicron variant cohort). CYP admitted with respiratory and intestinal infections, but negative lateral flow rapid diagnostic test and PCR-test results for SARS-CoV-2, between January 12 and February 19, 2022, served as unexposed reference cohort. Comparison between the 'exposed cohorts' and 'reference cohort' was conducted using 1:1 matching by age and sex. Follow-up data were collected via telephone interviews with parents, utilising the long COVID paediatric protocol and survey developed by the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC). The WHO case definition was used to categorise PCC.
RESULTS
RESULTS
Of 2595 CYP with confirmed COVID-19, 1707 (65.7%) participated in follow-up interviews, with 1183/1707 (69%) included in the final 'matched' analysis. The median follow-up time post-discharge was 6.7 months. The incidence of PCC was significantly higher in the Wuhan variant cohort (89.7 cases per 1000 person-months, 95% CI 64.3-120.3) compared to post-infection sequalae in the reference cohort (12.2 cases per 1000 person-months, 95% CI 4.9-21.9), whereas the difference with the Omicron variant cohort and reference cohort was not significant. The Wuhan cohort had higher incidence rates of dermatological, fatigue, gastrointestinal, sensory, and sleep manifestations, as well as behavioural and emotional problems than the reference cohort. The only significant difference between Omicron variant cohort and reference cohort was decreased school attendance. When comparing the Wuhan and Omicron variant cohorts, higher incidence of PCC and event rates of fatigue, decreased physical activity, and deterioration of relationships was observed. The rate of incomplete recovery was also significantly higher in the Wuhan variant cohort than in both the reference and the Omicron variant cohorts.
CONCLUSIONS
CONCLUSIONS
Wuhan variant exhibited a propensity for inducing a broad spectrum of physical symptoms and emotional behavioural changes, suggesting a pronounced impact on long-term health outcomes. Conversely, the Omicron variant resulted in fewer post-infection effects no different from common seasonal viral illnesses. This may mean that the Omicron variant and subsequent variants might not lead to the same level of long-term health consequences as earlier variants.
Identifiants
pubmed: 38302974
doi: 10.1186/s12916-023-03221-x
pii: 10.1186/s12916-023-03221-x
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
48Investigateurs
Khazhar Aktulaeva
(K)
Islamudin Aldanov
(I)
Nikol Alekseeva
(N)
Ramina Assanova
(R)
Asmik Avagyan
(A)
Irina Babkova
(I)
Lusine Baziyants
(L)
Anna Berbenyuk
(A)
Tatiana Bezbabicheva
(T)
Julia Chayka
(J)
Iuliia Cherdantseva
(I)
Yana Chervyakova
(Y)
Tamara Chitanava
(T)
Alexander Chubukov
(A)
Natalia Degtiareva
(N)
Gleb Demyanov
(G)
Semen Demyanov
(S)
Salima Deunezhewa
(S)
Aleksandr Dubinin
(A)
Anastasia Dymchishina
(A)
Murad Dzhavadov
(M)
Leila Edilgireeva
(L)
Veronika Filippova
(V)
Yuliia Frumkina
(Y)
Anastasia Gorina
(A)
Cyrill Gorlenko
(C)
Marat Gripp
(M)
Mariia Grosheva
(M)
Eliza Gudratova
(E)
Elena Iakimenko
(E)
Margarita Kalinina
(M)
Ekaterina Kharchenko
(E)
Anna Kholstinina
(A)
Bogdan Kirillov
(B)
Herman Kiseljow
(H)
Natalya Kogut
(N)
Polina Kondrashova
(P)
Irina Konova
(I)
Mariia Korgunova
(M)
Anastasia Kotelnikova
(A)
Alexandra Krupina
(A)
Anna Kuznetsova
(A)
Anastasia Kuznetsova
(A)
Anna S Kuznetsova
(AS)
Anastasia Laevskaya
(A)
Veronika Laukhina
(V)
Baina Lavginova
(B)
Yulia Levina
(Y)
Elza Lidjieva
(E)
Anastasia Butorina
(A)
Juliya Lyaginskaya
(J)
Ekaterina Lyubimova
(E)
Shamil Magomedov
(S)
Daria Mamchich
(D)
Rezeda Minazetdinova
(R)
Artemii Mingazov
(A)
Aigun Mursalova
(A)
Daria Nikolaeva
(D)
Alexandra Nikolenko
(A)
Viacheslav Novikov
(V)
Georgiy Novoselov
(G)
Ulyana Ovchinnikova
(U)
Veronika Palchikova
(V)
Kira Papko
(K)
Mariia Pavlova
(M)
Alexandra Pecherkina
(A)
Sofya Permyakova
(S)
Erika Porubayeva
(E)
Kristina Presnyakova
(K)
Maksim Privalov
(M)
Alesia Prutkogliadova
(A)
Anna Pushkareva
(A)
Arina Redya
(A)
Anastasia Romanenko
(A)
Filipp Roshchin
(F)
Diana Salakhova
(D)
Maria Sankova
(M)
Ilona Sarukhanyan
(I)
Viktoriia Savina
(V)
Ekaterina Semeniako
(E)
Valeriia Seregina
(V)
Anna Shapovalova
(A)
Khivit Sharbetova
(K)
Nataliya Shishkina
(N)
Anastasia Shvedova
(A)
Valeriia Stener
(V)
Valeria Ustyan
(V)
Yana Valieva
(Y)
Maria Varaksina
(M)
Katerina Varaksina
(K)
Ekaterina Varlamova
(E)
Natalia Vlasova
(N)
Margarita Yegiyan
(M)
Nadezhda Ziskina
(N)
Daniella Zolochevskaya
(D)
Elena Zuykova
(E)
Informations de copyright
© 2024. The Author(s).
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