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. 2024 Feb 12:12:1340385.
doi: 10.3389/fped.2024.1340385. eCollection 2024.

Post-discharge outcomes of hospitalized children diagnosed with acute SARS-CoV-2 or MIS-C

Ericka L Fink  1   2 , Alicia M Alcamo  3 , Marlina Lovett  4 , Mary Hartman  5 , Cydni Williams  6 , Angela Garcia  7 , Lindsey Rasmussen  8 , Ria Pal  9 , Kurt Drury  6   10 , Elizabeth MackDiaz  11 , Peter A Ferrazzano  12 , Leslie Dervan  13 , Brian Appavu  14 , Kellie Snooks  15 , Casey Stulce  16 , Pamela Rubin  1 , Bianca Pate  1 , Nicole Toney  1 , Courtney L Robertson  17 , Mark S Wainwright  18 , Juan D Roa  19 , Michelle E Schober  20 , Beth S Slomine  21
Affiliations

Post-discharge outcomes of hospitalized children diagnosed with acute SARS-CoV-2 or MIS-C

Ericka L Fink et al. Front Pediatr. .

Erratum in

Abstract

Introduction: Hospitalized children diagnosed with SARS-CoV-2-related conditions are at risk for new or persistent symptoms and functional impairments. Our objective was to analyze post-hospital symptoms, healthcare utilization, and outcomes of children previously hospitalized and diagnosed with acute SARS-CoV-2 infection or Multisystem Inflammatory Syndrome in Children (MIS-C).

Methods: Prospective, multicenter electronic survey of parents of children <18 years of age surviving hospitalization from 12 U.S. centers between January 2020 and July 2021. The primary outcome was a parent report of child recovery status at the time of the survey (recovered vs. not recovered). Secondary outcomes included new or persistent symptoms, readmissions, and health-related quality of life. Multivariable backward stepwise logistic regression was performed for the association of patient, disease, laboratory, and treatment variables with recovered status.

Results: The children [n = 79; 30 (38.0%) female] with acute SARS-CoV-2 (75.7%) or MIS-C (24.3%) had a median age of 6.5 years (interquartile range 2.0-13.0) and 51 (64.6%) had a preexisting condition. Fifty children (63.3%) required critical care. One-third [23/79 (29.1%)] were not recovered at follow-up [43 (31, 54) months post-discharge]. Admission C-reactive protein levels were higher in children not recovered vs. recovered [5.7 (1.3, 25.1) vs. 1.3 (0.4, 6.3) mg/dl, p = 0.02]. At follow-up, 67% overall had new or persistent symptoms. The most common symptoms were fatigue (37%), weakness (25%), and headache (24%), all with frequencies higher in children not recovered. Forty percent had at least one return emergency visit and 24% had a hospital readmission. Recovered status was associated with better total HRQOL [87 (77, 95) vs. 77 (51, 83), p = 0.01]. In multivariable analysis, lower admission C-reactive protein [odds ratio 0.90 (95% confidence interval 0.82, 0.99)] and higher admission lymphocyte count [1.001 (1.0002, 1.002)] were associated with recovered status.

Conclusions: Children considered recovered by their parents following hospitalization with SARS-CoV-2-related conditions had less symptom frequency and better HRQOL than those reported as not recovered. Increased inflammation and lower lymphocyte count on hospital admission may help to identify children needing longitudinal, multidisciplinary care.

Clinical trial registration: ClinicalTrials.gov (NCT04379089).

Keywords: SARS-CoV-2; child development; patient outcome assessment; pediatrics; post-acute COVID-19 syndrome.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer MP-E declared a past co-authorship with the author LD to the handling editor.

Figures

Figure 1
Figure 1
CONSORT diagram.
See this image and copyright information in PMC

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