Persistent symptoms after COVID-19 in children and adolescents from Argentina

Abstract

Objectives: Although long COVID-19 is widely recognized in adults, less information is available about this condition in children, especially in developing countries. Here, we studied the long-term symptoms of SARS-CoV-2 infection beyond 3 months and the associated risk factors in a pediatric population.

Methods: This observational study included 639 Argentinian children and adolescents with previously confirmed COVID-19 from June 2020-June 2021 and 577 children without previous COVID-19. Parents completed a survey about symptoms that their child had for >3 months after the diagnosis of SARS-CoV-2 infection.

Results: At least one persistent symptom was observed more frequently in children with previous COVID-19 than in the non-COVID-19 group (34% vs 13%, P <0.0001). SARS-CoV-2 infection increased the risk of headache, dizziness, loss of taste, dyspnea, cough, fatigue, muscle pain, and loss of weight by three- to seven-fold. The loss of smell was only reported in infected children. After controlling for the other variables, older age, symptomatic COVID-19, and comorbidities were independent predictors of long-term symptoms.

Conclusions: One-third of children experienced persistent symptoms after COVID-19. Older age, symptomatic infection, and comorbidities were shown to be risk factors for long COVID-19. Pediatric long COVID-19 is a new condition that requires further investigation.

Keywords: Child; Comorbidity; Long COVID-19; SARS-CoV-2.

Figure 1

Forest plots showing the unadjusted and adjusted ORs of symptoms lasting at least 3 months. Unadjusted (a) and adjusted ORs (b) for cohort, age, sex, presence of any comorbidity, and presence of symptoms among COVID-19 and non-COVID-19 (n = 1216) is shown. Abbreviation: OR, odds ratio. Cohorts were coded as follows: 0 = non-COVID-19, 1 = COVID-19. The dots indicate the OR and the horizontal lines indicate the lower and upper limits of the 95% confidence interval. ^aHeadache, dizziness, loss of smell, and loss of taste were requested only in children ≥5 years (n = 835). ^bLogistic regression analysis was not possible for loss of smell, which was only reported among COVID-19 children.

Figure 2

Upset plot showing the coexistence of symptoms categories lasting at least 3 months in children with previous COVID-19 ≥5 years. Each bar (intersection size) shows the number of children who reported some particular category symptom or combination of categories (neurological, respiratory, sensory, fatigue, muscle pain, and loss of weight). Underneath it is a graphical table showing what those combinations are. The black dots and lines show the combination of symptoms that make up each cluster or subset of symptoms. The smaller bar chart (set size) to the left of the graphical table shows the overall size of each category. The top 20 intersections are shown.