Study highlights need for clear international definition of pediatric long COVID
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SAN FRANCISCO — A new study presented at the American Thoracic Society International Conference highlights inconsistent definitions and management of pediatric long COVID across various centers and countries.
Caroline L.H. Brackel, MD, pediatric pulmonologist at Emma Children’s Hospital at Amsterdam University Medical Center, and colleagues conducted a study to evaluate currently available pediatric long COVID care programs worldwide and patient characteristics of those in the programs. The researchers created an international network and performed a cross-section analysis using data aggregated from survey responses on topics including definitions of pediatric long COVID, organization of pediatric long COVID clinics and characteristics of pediatric patients with long COVID. In total, the researchers analyzed data from participants working in 10 pediatric post-COVID condition care cohorts and six acute COVID-19 follow-up cohorts, and patient characteristics from 549 pediatric post-COVID condition patients in nine cohorts.
Various definitions for long COVID were used worldwide, mainly surrounding symptom duration and the requirement for microbiologically proven SARS-CoV-2 infection.
In the pediatric long COVID cohorts, 66.6% to 100% of patients experienced symptoms for more than 12 weeks and 49.5% to 97.3% of patients had positive serology for SARS-CoV-2. Most patients reported experiencing asymptomatic or mild acute COVID-19. Five percent to 37.3% of pediatric post-COVID condition patients reported severe daily life limitations.
Most of the long COVID care programs featured in-person visits with multidisciplinary health care teams that included general pediatricians, pediatric lung specialists, cardiologists, infectiologists, a physiotherapist and psychologist. At long COVID clinics, investigations ranged from medical history assessment in 100% of visits and standardized questionnaires in 91% of visits to in-depth organ functioning evaluation.
Among the pediatric patients with long COVID, mean age ranged from 6.5 to 16.4 years and females comprised 20% to 65%.
Overall, 28% to 81.8% of patients had a positive medical history, with atopic syndrome, asthma and prematurity being the most common. Asymptomatic or mild acute COVID-19 was observed among most patients. The most frequent long COVID symptoms were fatigue, headache, concentration difficulty, dyspnea and sleep disturbance.
“This is the first study to describe the organization of pediatric long COVID care. It demonstrates that pediatric long COVID is recognized worldwide as a multisystemic disease, but its definition and care programs for pediatric long COVID patients differ between cohorts,” Brackel and colleagues wrote in the abstract. “A clear definition of pediatric long COVID is needed to improve international scientific collaboration and patient care. Our international network will facilitate further collaboration in investigation pathophysiology and therapeutic investigations in order to provide evidence-based medical care for these patients.”