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Clinics (Sao Paulo)
. 2021 Nov 26;76:e3511.
doi: 10.6061/clinics/2021/e3511. eCollection 2021.
Persistent symptoms and decreased health-related quality of life after symptomatic pediatric COVID-19: A prospective study in a Latin American tertiary hospital
Thais T Fink 1 , Heloisa H S Marques 1 , Bruno Gualano 1 , Livia Lindoso 1 , Vera Bain 1 , Camilla Astley 1 , Fernanda Martins 1 , Denise Matheus 1 , Olivia M Matsuo 1 , Priscila Suguita 1 , Vitor Trindade 1 , Camila S Y Paula 1 , Sylvia C L Farhat 1 , Patricia Palmeira 1 , Gabriela N Leal 1 , Lisa Suzuki 1 , Vicente Odone Filho 1 , Magda Carneiro-Sampaio 1 , Alberto José S Duarte 1 , Leila Antonangelo 1 , Linamara R Batisttella 1 , Guilherme V Polanczyk 1 , Rosa Maria R Pereira 1 , Carlos Roberto R Carvalho 1 , Carlos A Buchpiguel 1 , Ana Claudia L Xavier 1 , Marilia Seelaender 1 , Clovis Artur Silva 1 , Maria Fernanda B Pereira 1 , HC-FMUSP Pediatric Post-COVID-19 Study Group; Adriana M E Sallum 2 , Alexandra V M Brentani 2 , Álvaro José S Neto 2 , Amanda Ihara 2 , Andrea R Santos 2 , Ana Pinheiro M Canton 2 , Andreia Watanabe 2 , Angélica C Dos Santos 2 , Antonio C Pastorino 2 , Bernadette D G M Franco 2 , Bruna Caruzo 2 , Carina Ceneviva 2 , Carolina C M F Martins 2 , Danilo Prado 2 , Deipara M Abellan 2 , Fabiana B Benatti 2 , Fabiana Smaria 2 , Fernanda T Gonçalves 2 , Fernando D Penteado 2 , Gabriela S F de Castro 2 , Guilherme S Gonçalves 2 , Hamilton Roschel 2 , Ilana R Disi 2 , Isabela G Marques 2 , Inar A Castro 2 , Izabel M Buscatti 2 , Jaline Z Faiad 2 , Jarlei Fiamoncini 2 , Joaquim C Rodrigues 2 , Jorge D A Carneiro 2 , Jose A Paz 2 , Juliana C Ferreira 2 , Juliana C O Ferreira 2 , Katia R Silva 2 , Karina L M Bastos 2 , Katia Kozu 2 , Lilian M Cristofani 2 , Lucas V B Souza 2 , Lucia M A Campos 2 , Luiz Vicente R F Silva Filho 2 , Marcelo T Sapienza 2 , Marcos S Lima 2 , Marlene P Garanito 2 , Márcia F A Santos 2 , Mayra B Dorna 2 , Nadia E Aikawa 2 , Nadia Litvinov 2 , Neusa K Sakita 2 , Paula V V Gaiolla 2 , Paula Pasqualucci 2 , Ricardo K Toma 2 , Simone Correa-Silva 2 , Sofia M Sieczkowska 2 , Marta Imamura 2 , Silvana Forsait 2 , Vera A Santos 2 , Yingying Zheng 2
Affiliations
- PMID: 34852145
- DOI: 10.6061/clinics/2021/e3511
Abstract
Objectives: To prospectively evaluate demographic, anthropometric and health-related quality of life (HRQoL) in pediatric patients with laboratory-confirmed coronavirus disease 2019 (COVID-19).
Methods: This was a longitudinal observational study of surviving pediatric post-COVID-19 patients (n=53) and pediatric subjects without laboratory-confirmed COVID-19 included as controls (n=52) was performed.
Results: The median duration between COVID-19 diagnosis (n=53) and follow-up was 4.4 months (0.8-10.7). Twenty-three of 53 (43%) patients reported at least one persistent symptom at the longitudinal follow-up visit and 12/53 (23%) had long COVID-19, with at least one symptom lasting for >12 weeks. The most frequently reported symptoms at the longitudinal follow-up visit were headache (19%), severe recurrent headache (9%), tiredness (9%), dyspnea (8%), and concentration difficulty (4%). At the longitudinal follow-up visit, the frequencies of anemia (11% versus 0%, p=0.030), lymphopenia (42% versus 18%, p=0.020), C-reactive protein level of >30 mg/L (35% versus 0%, p=0.0001), and D-dimer level of >1000 ng/mL (43% versus 6%, p=0.0004) significantly reduced compared with baseline values. Chest X-ray abnormalities (11% versus 2%, p=0.178) and cardiac alterations on echocardiogram (33% versus 22%, p=0.462) were similar at both visits. Comparison of characteristic data between patients with COVID-19 at the longitudinal follow-up visit and controls showed similar age (p=0.962), proportion of male sex (p=0.907), ethnicity (p=0.566), family minimum monthly wage (p=0.664), body mass index (p=0.601), and pediatric pre-existing chronic conditions (p=1.000). The Pediatric Quality of Live Inventory 4.0 scores, median physical score (69 [0-100] versus 81 [34-100], p=0.012), and school score (60 [15-100] versus 70 [15-95], p=0.028) were significantly lower in pediatric patients with COVID-19 at the longitudinal follow-up visit than in controls.
Conclusions: Pediatric patients with COVID-19 showed a longitudinal impact on HRQoL parameters, particularly in physical/school domains, reinforcing the need for a prospective multidisciplinary approach for these patients. These data highlight the importance of closer monitoring of children and adolescents by the clinical team after COVID-19.