Persistent symptoms and decreased health-related quality of life after symptomatic pediatric COVID-19: A prospective study in a Latin American tertiary hospital Thais

Author(s):Show less -

Fink, Thais T. ^[1] ; Marques, Heloisa H. S. ^[1] ; Gualano, Bruno ^[1] ; Lindoso, Livia ^[1] ; Bain, Vera ^[1] ; Astley, Camilla ^[1] ; Martins, Fernanda ^[1] ; Matheus, Denise ^[1] ; Matsuo, Olivia M. ^[1] ; Suguita, Priscila ^[1] ; Trindade, Vitor ^[1] ; Paula, Camila S. Y. ^[1] ; Farhat, Sylvia C. L. ^[1] ; Palmeira, Patricia ^[1] ; Leal, Gabriela N. ^[1] ; Suzuki, Lisa ^[1] ; Odone Filho, Vicente ^[1] ; Carneiro-Sampaio, Magda ^[1] ; Duarte, Alberto Jose S. ^[1] ; Antonangelo, Leila ^[1] ; Batisttella, Linamara R. ^[1] ; Polanczyk, V, Guilherme ; Pereira, Rosa Maria R. ^[2] ; Carvalho, Carlos Roberto R. ^[2] ; Buchpiguel, Carlos A. ^[2] ; Xavier, Ana Claudia L. ^[2] ; Seelaender, Marilia ^[2] ; Silva, Clovis Artur ^[2] ; Pereira, Maria Fernanda B. ^[2] ; Stud, HC-FMUSP Pediat Post-COVID-19

Affiliation

^[1] Hosp Clin HCFMUSP, Fac Med, Sao Paulo, SP - Brazil

^[2] Polanczyk, Guilherme, V, Hosp Clin HCFMUSP, Fac Med, Sao Paulo, SP - Brazil

• Document type: Journal article
• Source: Clinics; v. 76, 2021.
• Web of Science Citations: 1

Abstract

OBJECTIVES: To prospectively evaluate demographic, anthropometric and health-related quality of life (HRQoL) in pediatric patients with laboratory-confirmed coronavirus disease 2019 (COVID-19) METHODS: This was a longitudinal observational study of surviving pediatric post-COVID-19 patients (n=53) and pediatric subjects without laboratory-confirmed COVID-19 included as controls (n=52) was performed. RESULTS: The median duration between COVID-19 diagnosis (n=53) and follow-up was 4.4 months (0.8-10.7). Twenty-three of 53 (43%) patients reported at least one persistent symptom at the longitudinal follow-up visit and 12/53 (23%) had long COVID-19, with at least one symptom lasting for >12 weeks. The most frequently reported symptoms at the longitudinal follow-up visit were headache (19%), severe recurrent headache (9%), tiredness (9%), dyspnea (8%), and concentration difficulty (4%). At the longitudinal follow-up visit, the frequencies of anemia (11% versus 0%, p=0.030), lymphopenia (42% versus 18%, p=0.020), C-reactive protein level of >30 mg/L (35% versus 0%, p=0.0001), and D-dimer level of >1000 ng/mL (43% versus 6%, p=0.0004) significantly reduced compared with baseline values. Chest X-ray abnormalities (11% versus 2%, p=0.178) and cardiac alterations on echocardiogram (33% versus 22%, p=0.462) were similar at both visits. Comparison of characteristic data between patients with COVID-19 at the longitudinal follow-up visit and controls showed similar age (p=0.962), proportion of male sex (p=0.907), ethnicity (p=0.566), family minimum monthly wage (p=0.664), body mass index (p=0.601), and pediatric pre-existing chronic conditions (p=1.000). The Pediatric Quality of Live Inventory 4.0 scores, median physical score (69 {[}0-100] versus 81 {[}34-100], p=0.012), and school score (60 {[}15-100] versus 70 {[}15-95], p=0.028) were significantly lower in pediatric patients with COVID-19 at the longitudinal follow-up visit than in controls. CONCLUSIONS: Pediatric patients with COVID-19 showed a longitudinal impact on HRQoL parameters, particularly in physical/school domains, reinforcing the need for a prospective multidisciplinary approach for these patients. These data highlight the importance of closer monitoring of children and adolescents by the clinical team after COVID-19. (AU)

• FAPESP's process: 15/03756-4 - Assessment of relevance of blood levels of drugs in the monitoring rheumatic autoimmune diseases: safety, effectiveness and adherence to therapy
• Grantee: Eloisa Silva Dutra de Oliveira Bonfá
• Support Opportunities: Research Projects - Thematic Grants