Risk factors for health impairments in children after hospitalization for acute COVID-19 or MIS-C

oleh: Aline B. Maddux, Cameron C. Young, Suden Kucukak, Laura D. Zambrano, Margaret M. Newhams, Caitlin K. Rollins, Natasha B. Halasa, Shira J. Gertz, Elizabeth H. Mack, Stephanie Schwartz, Michele Kong, Laura L. Loftis, Katherine Irby, Courtney M. Rowan, Keiko M. Tarquinio, Matt S. Zinter, Hillary Crandall, Natalie Z. Cvijanovich, Jennifer E. Schuster, Julie C. Fitzgerald, Mary A. Staat, Charlotte V. Hobbs, Ryan A. Nofziger, Steven Shein, Heidi Flori, Melissa L. Cullimore, Brandon M. Chatani, Emily R. Levy, Katri V. Typpo, Janet R. Hume, Angela P. Campbell, Adrienne G. Randolph, the Overcoming COVID-19 Investigators, Michele Kong, Meghan Murdock, Heather Kelley, Candice Colston, Mary Glas Gaspers, Katri V. Typpo, Ronald C. Sanders, Katherine Irby, Natalie Z. Cvijanovich, Matt S. Zinter, Aline B. Maddux, Emily Port, Rachel Mansour, Sara Shankman, Brandon M. Chatani, Keiko M. Tarquinio, Kaitlin Jones, Courtney M. Rowan, Adrienne G. Randolph, Margaret M. Newhams, Cameron C. Young, Suden Kucukak, Caitlin Rollins, Tanya Novak, Janet Chou, Mary Beth Son, Julia Clarke, Brooke Sens, Eve Listerud, Sabrina Chen, Kasey Stewart, Heidi R. Flori, Mary K. Dahmer, Janet R. Hume, Emily R. Levy, Supriya Behl, Noelle M. Drapeau, Charlotte V. Hobbs, Lora Martin, Lacy Malloch, Maygan Martin, Kayla Patterson, Cameron Sanders, Kengo Inagaki, Sarah McGraw, Anita Dhanrajani, Jennifer E. Schuster, Abigail Kietzman, Shannon Hill, Melissa L. Cullimore, Russell J. McCulloh, Shira J. Gertz, Stephanie P. Schwartz, Tracie C. Walker, Ryan A. Nofziger, Mary Allen Staat, Steven Shein, Rajashri Rasal, Julie C. Fitzgerald, Ryan Burnett, Jenny Bush, Elizabeth H. Mack, Natasha B. Halasa, Meena Golcha, Laura Stewart, Laura L. Loftis, Hillary Crandall, Krow Ampofo, Manish M. Patel, Leora R. Feldstein, Mark W. Tenforde, Ashley M. Jackson, Angela Campbell, Laura D. Zambrano

Format: Article
Diterbitkan: Frontiers Media S.A. 2023-10-01

Deskripsi

ObjectiveTo identify risk factors for persistent impairments after pediatric hospitalization for acute coronavirus disease 2019 (COVID-19) or multisystem inflammatory syndrome in children (MIS-C) during the SARS-CoV-2 pandemic.MethodsAcross 25 U.S. Overcoming COVID-19 Network hospitals, we conducted a prospective cohort study of patients <21-years-old hospitalized for acute COVID-19 or MIS-C (May 2020 to March 2022) surveyed 2- to 4-months post-admission. Multivariable regression was used to calculate adjusted risk ratios (aRR) and 95% confidence intervals (CI).ResultsOf 232 children with acute COVID-19, 71 (30.6%) had persistent symptoms and 50 (21.6%) had activity impairments at follow-up; for MIS-C (nā€‰=ā€‰241), 56 (23.2%) had persistent symptoms and 58 (24.1%) had activity impairments. In adjusted analyses of patients with acute COVID-19, receipt of mechanical ventilation was associated with persistent symptoms [aRR 1.83 (95% CI: 1.07, 3.13)] whereas obesity [aRR 2.18 (95% CI: 1.05, 4.51)] and greater organ system involvement [aRR 1.35 (95% CI: 1.13, 1.61)] were associated with activity impairment. For patients with MIS-C, having a pre-existing respiratory condition was associated with persistent symptoms [aRR 3.04 (95% CI: 1.70, 5.41)] whereas obesity [aRR 1.86 (95% CI: 1.09, 3.15)] and greater organ system involvement [aRR 1.26 (1.00, 1.58)] were associated with activity impairments.DiscussionAmong patients hospitalized, nearly one in three hospitalized with acute COVID-19 and one in four hospitalized with MIS-C had persistent impairments for ā‰„2 months post-hospitalization. Persistent impairments were associated with more severe illness and underlying health conditions, identifying populations to target for follow-up.