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November 2, 2022

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Post-COVID in the Pediatric Population: 1 in 4 With Persistent Symptoms Months After Hospitalization

Reviewed by Terri Stillwell, MD

As we near the end of the pandemic’s third year, there is much to be learned regarding the long-term effects of COVID-19. Prolonged post-COVID symptoms have been described in adult patients, but there is limited research on comparable symptoms in the pediatric population. In a recent study, published in Pediatrics, authors characterized the recovery of pediatric patients with severe COVID-19 or multisystem inflammatory syndrome in children (MIS-C) and looked to identify factors associated with prolonged symptomatology.

In this multicenter, prospective study, authors evaluated outcomes in pediatric patients previously hospitalized with severe COVID-19 or MIS-C. The study identified persistent symptoms or activity intolerance at 2-to-4 months post-hospitalization. Outcomes were reported for 279 patients (119 with acute COVID-19; 160 had MIS-C).

Median length of hospitalization was 4 days (COVID-19) and 6 days (MIS-C), respectively. For those with acute COVID-19, 32 of 119 (26.9%) had persistent symptoms or activity impairment at the 2-to-4-month mark, the most common symptoms being fatigue and weakness, followed by cough and shortness of breath. In those with MIS-C, 48 (30%) had ongoing symptomatology, including fatigue, weakness, and headache; pre-existing asthma diagnosis was associated with persistent symptoms, while obesity was associated with impaired activity. For both groups, longer hospitalization was associated with ongoing symptomatology.

This study is a great start to understanding prolonged post-COVID symptoms in the pediatric population, but we have a long way to go. Given that the study was conducted early in the pandemic, these data may not hold true for current circulating variants. Additionally, this study looked at hospitalized patients, but the bulk of pediatric COVID infections have been managed as outpatient; the outpatient population’s outcomes may look entirely different. Though the pandemic may be on its way out, its effects will likely continue for years. Ongoing research will be needed to fully understand these impacts.

(Maddux et al. Pediatrics. 2022;150(3):e2022057798.)

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