Long/post-COVID in children and adolescents: symptom onset and recovery after one year based on healthcare records in Germany.
COVID-19
Electronic health records
Epidemiology
Pediatrics
Post-COVID
Journal
Infection
ISSN: 1439-0973
Titre abrégé: Infection
Pays: Germany
ID NLM: 0365307
Informations de publication
Date de publication:
16 Sep 2024
16 Sep 2024
Historique:
received:
05
04
2024
accepted:
09
09
2024
medline:
17
9
2024
pubmed:
17
9
2024
entrez:
16
9
2024
Statut:
aheadofprint
Résumé
Evidence on the incidence and persistence of post-acute sequelae of COVID-19 (PASC) among children and adolescents is still limited. In this retrospective cohort study, 59,339 children and adolescents with laboratory-confirmed COVID-19 in 2020 and 170,940 matched controls were followed until 2021-09-30 using German routine healthcare data. Incidence rate differences (ΔIR) and ratios (IRR) of 96 potential PASC were estimated using Poisson regression. Analyses were stratified according to age (0-11, 12-17 years), and sex. At the individual level, persistence of diagnoses in patients with onset symptoms was tracked starting from the first quarter post-infection. At 0-3 month follow-up, children and adolescents with a previous SARS-CoV-2 infection showed a 34% increased risk of adverse health outcome, and approximately 6% suffered from PASC in association with COVID-19. The attributable risk was higher among adolescents (≥ 12 years) than among children. For most common symptoms, IRRs largely persisted at 9-12 month follow-up. IRR were highest for rare conditions strongly associated with COVID-19, particularly inflammatory conditions among children 0-11 years, and chronic fatigue and respiratory insufficiency among adolescents. Tracking of diagnoses at the individual level revealed similar rates in the decline of symptoms among COVID-19 and control cohorts, generally leaving less than 10% of the patients with persistent diagnoses after 12 months. Although very few patients presented symptoms for longer than 12 months, excess morbidity among children and, particularly, adolescents with a history of COVID-19 means a relevant burden for pediatric care.
Identifiants
pubmed: 39285063
doi: 10.1007/s15010-024-02394-8
pii: 10.1007/s15010-024-02394-8
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Bundesministerium für Gesundheit
ID : 2521NIK705
Organisme : Bundesministerium für Gesundheit
ID : 2521NIK705
Organisme : Bundesministerium für Gesundheit
ID : 2521NIK705
Organisme : Bundesministerium für Gesundheit
ID : 2521NIK705
Organisme : Bundesministerium für Gesundheit
ID : 2521NIK705
Organisme : Bundesministerium für Gesundheit
ID : 2521NIK705
Organisme : Bundesministerium für Gesundheit
ID : 2521NIK705
Organisme : Bundesministerium für Gesundheit
ID : 2521NIK705
Organisme : Bundesministerium für Gesundheit
ID : 2521NIK705
Informations de copyright
© 2024. The Author(s).
Références
Zimmermann P, Pittet LF, Curtis N. How common is long COVID in children and adolescents? Pediatr Infect Dis J. 2021;40: e482. https://doi.org/10.1097/INF.0000000000003328 .
doi: 10.1097/INF.0000000000003328
pubmed: 34870392
pmcid: 8575095
Pellegrino R, Chiappini E, Licari A, Galli L, Marseglia GL. Prevalence and clinical presentation of long COVID in children: a systematic review. Eur J Pediatr. 2022;181:3995–4009. https://doi.org/10.1007/s00431-022-04600-x .
doi: 10.1007/s00431-022-04600-x
pubmed: 36107254
pmcid: 9476461
Organization WH (2023) A clinical case definition for post COVID-19 condition in children and adolescents by expert consensus, 16 February 2023
National Institute for Health and Care Excellence (NICE) (2020) COVID-19 rapid guideline: managing the long-term effects of COVID-19, NICE guideline [NG188]. 2020. Last updated: 11 November 2021. https://www.nice.org.uk/guidance/ ng188
Nalbandian A, Sehgal K, Gupta A, Madhavan MV, McGroder C, Stevens JS, et al. Post-acute COVID-19 syndrome. Nat Med. 2021;27:601–15. https://doi.org/10.1038/s41591-021-01283-z .
doi: 10.1038/s41591-021-01283-z
pubmed: 33753937
pmcid: 8893149
Groff D, Sun A, Ssentongo AE, Ba DM, Parsons N, Poudel GR, et al. Short-term and long-term rates of postacute sequelae of SARS-CoV-2 infection: a systematic review. JAMA Network Open. 2021;4:e2128568.
doi: 10.1001/jamanetworkopen.2021.28568
pubmed: 34643720
pmcid: 8515212
Koczulla A, Ankermann T, Behrends U, Berlit P, Berner R, Böing S, et al. S1-leitlinie long-/Post-COVID. Pneumologie. 2022;76:855–907. https://doi.org/10.1055/a-1946-3230 .
doi: 10.1055/a-1946-3230
pubmed: 36479679
Toepfner N, Brinkmann F, Augustin S, Stojanov S, Behrends U. Long COVID in pediatrics—epidemiology, diagnosis, and management. Eur J Pediatr. 2024. https://doi.org/10.1007/s00431-023-05360-y .
doi: 10.1007/s00431-023-05360-y
pubmed: 38279014
pmcid: 11001657
United States, Department of Health and Human Services, Centers for Disease Control and Prevention (CDC) (2024) Long COVID Basics. Centers for Disease Control and Prevention. Last accessed: 12 June 2024. https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/
Gentilotti E, Górska A, Tami A, et al. Clinical phenotypes and quality of life to define post-COVID-19 syndrome: a cluster analysis of the multinational, prospective ORCHESTRA cohort. EClinicalMedicine. 2023;62:102107. https://doi.org/10.1016/j.eclinm.2023.102107 .
doi: 10.1016/j.eclinm.2023.102107
pubmed: 37654668
pmcid: 10466236
Nittas V, Gao M, West EA, Ballouz T, Menges D, Wulf Hanson S, Puhan MA. Long COVID through a public health lens: an umbrella review. Public Health Rev. 2022;43:1604501. https://doi.org/10.3389/phrs.2022.1604501 .
doi: 10.3389/phrs.2022.1604501
pubmed: 35359614
pmcid: 8963488
Stephenson T, Shafran R, Ladhani SN. Long COVID in children and adolescents. Curr Opin Infect Dis. 2022;35:461. https://doi.org/10.1097/QCO.0000000000000854 .
doi: 10.1097/QCO.0000000000000854
pubmed: 36098262
pmcid: 9553244
Molteni E, Sudre CH, Canas LS, Bhopal SS, Hughes RC, Antonelli M, et al. Illness duration and symptom profile in symptomatic UK school-aged children tested for SARS-CoV-2. Lancet Child Adolesc Health. 2021;5:708–18. https://doi.org/10.1016/S2352-4642(21)00198-X .
doi: 10.1016/S2352-4642(21)00198-X
pubmed: 34358472
pmcid: 8443448
Berg SK, Nielsen SD, Nygaard U, Bundgaard H, Palm P, Rotvig C, Christensen AV. Long COVID symptoms in SARS-CoV-2-positive adolescents and matched controls (LongCOVIDKidsDK): a national, cross-sectional study. lancet Child Adolesc Health. 2022;6:240–8. https://doi.org/10.1016/s2352-4642(22)00004-9 .
doi: 10.1016/s2352-4642(22)00004-9
Stephenson T, Pereira SMP, Shafran R, De Stavola BL, Rojas N, McOwat K, et al. Physical and mental health 3 months after SARS-CoV-2 infection (long COVID) among adolescents in England (CLoCk): a national matched cohort study. Lancet Child Adolesc Health. 2022;6:230–9. https://doi.org/10.1016/S2352-4642(22)00022-0 .
doi: 10.1016/S2352-4642(22)00022-0
pubmed: 35143770
pmcid: 8820961
Lopez-Leon S, Wegman-Ostrosky T, Ayuzo del Valle NC, Perelman C, Sepulveda R, Rebolledo PA, et al. Long-COVID in children and adolescents: a systematic review and meta-analyses. Scientific Reports. 2022;12:9950.
doi: 10.1038/s41598-022-13495-5
pubmed: 35739136
pmcid: 9226045
Behnood S, Newlands F, O’Mahoney L, Haghighat Ghahfarokhi M, Muhid MZ, Dudley J, et al. Persistent symptoms are associated with long term effects of COVID-19 among children and young people: Results from a systematic review and meta-analysis of controlled studies. PLoS One. 2023;18: e0293600. https://doi.org/10.1371/journal.pone.0293600 .
doi: 10.1371/journal.pone.0293600
pubmed: 38153928
pmcid: 10754445
Franco JVA, Garegnani LI, Oltra GV, Metzendorf M-I, Trivisonno LF, Sgarbossa N, Ducks D, Heldt K, Mumm R, Barnes B, et al. Short and long-term wellbeing of children following SARS-CoV-2 infection: a systematic review. Int J Environ Res Public Health. 2022;19:14392. https://doi.org/10.3390/ijerph192114392 .
doi: 10.3390/ijerph192114392
pubmed: 36361269
pmcid: 9657555
Seylanova N, Aiyegbusi OL, Hughes S, Munblit D. Core outcome measurement set for research and clinical practice in post COVID-19 condition (Long COVID) in children and young people: an international delphi consensus study ‘PC-COS Children.’ Eur Respir J. 2023. https://doi.org/10.1183/13993003.01761-2023 .
doi: 10.1183/13993003.01761-2023
Albanji MH, Baghafar AA, Alghanmi YA, Shaaban MM, Alkashlan EA, Sende HH, et al. Clinical presentation and management of multisystem inflammatory syndrome in children with COVID-19: a systematic review. Cureus. 2023. https://doi.org/10.7759/cureus.46918 .
doi: 10.7759/cureus.46918
pubmed: 37954764
pmcid: 10639140
Rotulo GA, Palma P. Understanding COVID-19 in children: immune determinants and post-infection conditions. Pediatric Res. 2023. https://doi.org/10.1038/s41390-023-02549-7 .
doi: 10.1038/s41390-023-02549-7
Stephenson T, Pinto Pereira SM, Nugawela MD, McOwat K, Simmons R, Chalder T, et al. Long COVID—six months of prospective follow-up of changes in symptom profiles of non-hospitalised children and young people after SARS-CoV-2 testing: a national matched cohort study (the clock) study. PLoS One. 2023;18: e0277704. https://doi.org/10.1371/journal.pone.0277704 .
doi: 10.1371/journal.pone.0277704
pubmed: 36877677
pmcid: 9987792
Pereira SMP, Shafran R, Nugawela MD, Panagi L, Hargreaves D, Ladhani SN, et al. Natural course of health and well-being in non-hospitalised children and young people after testing for SARS-CoV-2: a prospective follow-up study over 12 months. Lancet Reg Health-Europe. 2023. https://doi.org/10.1016/j.lanepe.2022.100554 .
doi: 10.1016/j.lanepe.2022.100554
Magnusson K, Skyrud KD, Suren P, Greve-Isdahl M, Størdal K, Kristoffersen DT, Telle K. Healthcare use in 700 000 children and adolescents for six months after covid-19: before and after register based cohort study. BMJ. 2022. https://doi.org/10.1136/bmj-2021-066809 .
doi: 10.1136/bmj-2021-066809
pubmed: 35264329
Chen C, Haupert SR, Zimmermann L, Shi X, Fritsche LG, Mukherjee B. Global prevalence of post-coronavirus disease 2019 (COVID-19) condition or long COVID: a meta-analysis and systematic review. J Infect Dis. 2022;226:1593–607. https://doi.org/10.1093/infdis/jiac136 .
doi: 10.1093/infdis/jiac136
pubmed: 35429399
Roessler M, Tesch F, Batram M, Jacob J, Loser F, Weidinger O, et al. Post-COVID-19-associated morbidity in children, adolescents, and adults: a matched cohort study including more than 157,000 individuals with COVID-19 in Germany. PLoS Med. 2022;19: e1004122. https://doi.org/10.1371/journal.pmed.1004122 .
doi: 10.1371/journal.pmed.1004122
pubmed: 36355754
pmcid: 9648706
Benchimol EI, Smeeth L, Guttmann A, Harron K, Moher D, Petersen I, et al. The REporting of studies conducted using observational routinely-collected health data (RECORD) statement. PLoS Med. 2015;12: e1001885. https://doi.org/10.1371/journal.pmed.1001885 .
doi: 10.1371/journal.pmed.1001885
pubmed: 26440803
pmcid: 4595218
Tesch F, Ehm F, Vivirito A, Wende D, Batram M, Loser F, et al. Incident autoimmune diseases in association with SARS-CoV-2 infection: a matched cohort study. Clin Rheumatol. 2023. https://doi.org/10.1007/s10067-023-06670-0 .
doi: 10.1007/s10067-023-06670-0
pubmed: 37405528
pmcid: 10497701
Syed U, Subramanian A, Wraith DC, Lord JM, McGee K, Ghokale K, et al. Incidence of immune-mediated inflammatory diseases following COVID-19: a matched cohort study in UK primary care. BMC Med. 2023;21:363. https://doi.org/10.1186/s12916-023-03049-5 .
doi: 10.1186/s12916-023-03049-5
pubmed: 37735654
pmcid: 10512476
Morrow AK, Malone LA, Kokorelis C, Petracek LS, Eastin EF, Lobner KL, et al. Long-term COVID 19 sequelae in adolescents: the overlap with orthostatic intolerance and ME/CFS. Curr Pediatrics Reports. 2022;10:31–44. https://doi.org/10.1007/s40124-022-00261-4 .
doi: 10.1007/s40124-022-00261-4
Borch L, Holm M, Knudsen M, Ellermann-Eriksen S, Hagstroem S. Long COVID symptoms and duration in SARS-CoV-2 positive children—a nationwide cohort study. Eur J Pediatr. 2022;181:1597–607. https://doi.org/10.1007/s00431-021-04345-z .
doi: 10.1007/s00431-021-04345-z
pubmed: 35000003
pmcid: 8742700
Bilu Y, Flaks-Manov N, Goldshtein I, Bivas-Benita M, Akiva P, Bodenheimer G, Greenfeld S. Youth mental health outcomes up to two years after SARS-CoV-2 infection long-COVID or long-pandemic syndrome: a retrospective cohort study. J Adolesc Health. 2023;73:701–6. https://doi.org/10.1016/j.jadohealth.2023.05.022 .
doi: 10.1016/j.jadohealth.2023.05.022
pubmed: 37389526