Written by Kimiko Dunbar
Spoon Feed
Compared with those who have never been infected with SARS-CoV-2, children with a history of COVID-19 infection report more symptoms of fatigue, respiratory, and GI illness as well as lower overall health.
The gift that keeps on giving…
This cross-sectional analysis of the Pediatric SARS-CoV-2 Long-Term Outcomes Study (PECOS) examined post-infection sequelae in 654 children (541 infected, 113 controls). Infected children reported more symptoms (e.g., fatigue, shortness of breath, non-specific GI), with odds ratios up to 4.35. Those with a history of infection also had significantly lower global health, physical functioning and mobility, cognitive function, sleep disturbance, and fatigue scores on parent-reported outcome scores, and children reported worse pain interference and fatigue scores. Aside from increased incidence of perihilar and peribronchial thickening on chest radiograph and worse performance on the 6-minute walk test among infected adolescents, there were no differences in abnormalities on cardiopulmonary evaluation, including chest CT and echocardiogram. Both groups described an increase in anxiety and depression, likely related to experiences living through the pandemic. This study is limited by the potential for significant selection bias – participants were able to self-refer, which could have led to recruitment of individuals more likely to be symptomatic after COVID-19 infection. Further, the range of time between infection and the study was highly varied among participants.
How will this change my practice?
Signs and symptoms of long-COVID are pretty nonspecific, and in my personal (pediatric) practice has been a diagnosis of exclusion. Given the lack of objective data used to diagnose long COVID, it’s difficult to diagnose even when alternatives have been ruled out. I still don’t plan to attribute non-specific symptoms to prior COVID-19 infection without conducting a reasonable work-up. That said, I feel more confident in suggesting long COVID as a possibility if no other cause can be identified. I’m looking forward to future work on both diagnosis and management.
Source
Pediatric SARS-CoV-2 long term outcomes study (PECOS): cross sectional analysis at baseline. Pediatr Res. 2024 Dec 18. doi: 10.1038/s41390-024-03777-1. Epub ahead of print. PMID: 39695262
