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. 2023 Feb 20;15(2):579.
doi: 10.3390/v15020579.

High Prevalence of Alternative Diagnoses in Children and Adolescents with Suspected Long COVID-A Single Center Cohort Study

Sarah C Goretzki  1   2   3 , Maire Brasseler  1   2   3 , Burcin Dogan  1   3 , Tom Hühne  1 , Daniel Bernard  1 , Anne Schönecker  4 , Mathis Steindor  4 , Andrea Gangfuß  1   2 , Adela Della Marina  1   2 , Ursula Felderhoff-Müser  1   2 , Christian Dohna-Schwake  1   2   3 , Nora Bruns  1   2
Affiliations

High Prevalence of Alternative Diagnoses in Children and Adolescents with Suspected Long COVID-A Single Center Cohort Study

Sarah C Goretzki et al. Viruses. .

Abstract

Background: Long COVID (LC) is a diagnosis that requires exclusion of alternative somatic and mental diseases. The aim of this study was to examine the prevalence of differential diagnoses in suspected pediatric LC patients and assess whether adult LC symptom clusters are applicable to pediatric patients.

Materials and methods: Pediatric presentations at the Pediatric Infectious Diseases Department of the University Hospital Essen (Germany) were assessed retrospectively. The correlation of initial symptoms and final diagnoses (LC versus other diseases or unclarified) was assessed. The sensitivity, specificity, negative and positive predictive values of adult LC symptom clusters were calculated.

Results: Of 110 patients, 32 (29%) suffered from LC, 52 (47%) were diagnosed with alternative somatic/mental diseases, and 26 (23%) remained unclarified. Combined neurological and respiratory clusters displayed a sensitivity of 0.97 (95% CI 0.91-1.00) and a negative predictive value of 0.97 (0.92-1.00) for LC.

Discussion/conclusions: The prevalence of alternative somatic and mental diseases in pediatric patients with suspected LC is high. The range of underlying diseases is wide, including chronic and potentially life-threatening conditions. Neurological and respiratory symptom clusters may help to identify patients that are unlikely to be suffering from LC.

Keywords: differential diagnoses; pediatric Long COVID; post COVID; post-acute sequelae SARS-CoV-2 infection; symptom cluster.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure A1
Figure A1
Checklist for the survey of symptom clusters in suspected Long COVID in children and adolescents.
Figure A2
Figure A2
Questionnaire in the context of the initial presentation in case of suspicion of pediatric Long-COVID.
Figure A2
Figure A2
Questionnaire in the context of the initial presentation in case of suspicion of pediatric Long-COVID.
Figure A2
Figure A2
Questionnaire in the context of the initial presentation in case of suspicion of pediatric Long-COVID.
Figure 1
Figure 1
Referral and diagnostic procedure at the Long COVID Outpatient Department at the University Hospital Essen (see Appendix B, Figure A2 for the referral request form).
Figure 2
Figure 2
Flow chart of children and adolescents who attended the Long COVID Outpatient Department at the University Hospital Essen between January 2021 and September 2022 with suspected long COVID.
Figure 3
Figure 3
Heat map of referral areas of children and adolescents attended at the Long COVID Outpatient Department of the University Hospital Essen between January 2021 and September 2022 with suspected Long COVID.
Figure 4
Figure 4
Relative risk of being diagnosed with Long COVID versus an alternative disease in children and adolescents with suspected Long COVID depending on symptoms at presentation.
See this image and copyright information in PMC

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