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Multicenter Study
. 2022 Sep 1;150(3):e2022057798.
doi: 10.1542/peds.2022-057798.

Health Impairments in Children and Adolescents After Hospitalization for Acute COVID-19 or MIS-C

Aline B Maddux  1 , Laura Berbert  2 , Cameron C Young  3 , Leora R Feldstein  4 , Laura D Zambrano  4 , Suden Kucukak  3 , Margaret M Newhams  3 , Kristen Miller  1 , Madyson M FitzGerald  3 , Jie He  2 , Natasha B Halasa  5 , Natalie Z Cvijanovich  6 , Laura L Loftis  7 , Tracie C Walker  8 , Stephanie P Schwartz  8 , Shira J Gertz  9 , Keiko M Tarquinio  10 , Julie C Fitzgerald  11 , Michele Kong  12 , Jennifer E Schuster  13 , Elizabeth H Mack  14 , Charlotte V Hobbs  15 , Courtney M Rowan  16 , Mary A Staat  17 , Matt S Zinter  18 , Katherine Irby  19 , Hillary Crandall  20 , Heidi Flori  21 , Melissa L Cullimore  22 , Ryan A Nofziger  23 , Steven L Shein  24 , Mary Glas Gaspers  25 , Janet R Hume  26 , Emily R Levy  1 , Sabrina R Chen  3 , Manish M Patel  4 , Mark W Tenforde  4 , Edie Weller  2   27 , Angela P Campbell  4 , Adrienne G Randolph  3   27   28 ; Overcoming COVID-19 Investigators
Affiliations
Multicenter Study

Health Impairments in Children and Adolescents After Hospitalization for Acute COVID-19 or MIS-C

Aline B Maddux et al. Pediatrics. .

Abstract

Objectives: To evaluate risk factors for postdischarge sequelae in children and adolescents hospitalized for acute coronavirus disease 2019 (COVID-19) or multisystem inflammatory syndrome in children (MIS-C).

Methods: Multicenter prospective cohort study conducted in 25 United States pediatric hospitals. Patients <21-years-old, hospitalized May 2020 to May 2021 for acute COVID-19 or MIS-C with follow-up 2 to 4 months after admission. We assessed readmissions, persistent symptoms or activity impairment, and new morbidities. Multivariable regression was used to calculate adjusted risk ratios (aRR) and 95% confidence intervals (CI).

Results: Of 358 eligible patients, 2 to 4 month survey data were available for 119 of 155 (76.8%) with acute COVID-19 and 160 of 203 (78.8%) with MIS-C. Thirteen (11%) patients with acute COVID-19 and 12 (8%) with MIS-C had a readmission. Thirty-two (26.9%) patients with acute COVID-19 had persistent symptoms (22.7%) or activity impairment (14.3%) and 48 (30.0%) with MIS-C had persistent symptoms (20.0%) or activity impairment (21.3%). For patients with acute COVID-19, persistent symptoms (aRR, 1.29 [95% CI, 1.04-1.59]) and activity impairment (aRR, 1.37 [95% CI, 1.06-1.78]) were associated with more organ systems involved. Patients with MIS-C and pre-existing respiratory conditions more frequently had persistent symptoms (aRR, 3.09 [95% CI, 1.55-6.14]) and those with obesity more frequently had activity impairment (aRR, 2.52 [95% CI, 1.35-4.69]). New morbidities were infrequent (9% COVID-19, 1% MIS-C).

Conclusions: Over 1 in 4 children hospitalized with acute COVID-19 or MIS-C experienced persistent symptoms or activity impairment for at least 2 months. Patients with MIS-C and respiratory conditions or obesity are at higher risk of prolonged recovery.

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Conflict of interest statement

Conflict of Interest Disclosure: The authors have no conflicts of interest relevant to this article to disclose.

Figures

Figure 1.
Figure 1.. Enrollment and follow-up of patients hospitalized for acute COVID-19 or MIS-C across 25 U.S. sites in the Overcoming COVID-19 network.
COVID-19: acute coronavirus 19 disease; MIS-C: multisystem inflammatory syndrome in children.
Figure 2.
Figure 2.. Outcomes of patients hospitalized for acute COVID-19 or MIS-C with A.) Persistent Symptoms and B.) Ongoing Activity Impairment 2–4 months after hospitalization.
*Denotes significant difference (p<0.05) between patients with acute COVID-19 and MIS-C. COVID-19: acute coronavirus 19 disease; MIS-C: multisystem inflammatory syndrome in children.
Figure 3.
Figure 3.. Multivariable models evaluating factors associated with persistent symptoms or impaired activity 2–4 months after hospitalization for COVID-19 or MIS-C.
aVariable versus Reference Group corresponds to proportion of subjects with the outcome in “No” versus “Yes” for each variable. Organ system involvement is a continuous variable. COVID-19: acute coronavirus 19 disease; MIS-C: multisystem inflammatory syndrome in children.
See this image and copyright information in PMC

References

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