tetano
Editor, Senior Moderator
Pediatr Pulmonol
. 2025 Dec;60(12):e71426.
doi: 10.1002/ppul.71426. Pulmonary Sequelae of Severe Acute COVID-19 and Multisystem Inflammatory Syndrome (MIS-C) in Dutch Children
Lieke C E Noij[SUP] 1 [/SUP], Caroline L H Brackel[SUP] 2 [/SUP], Mariëlle W Pijnenburg[SUP] 3 [/SUP], Michiel A G E Bannier[SUP] 4 [/SUP], Sanne F Kloosterman[SUP] 3 [/SUP], Joost G van den Aardweg[SUP] 5 [/SUP], Arjen Pelgröm[SUP] 5 [/SUP], Irene Kuipers[SUP] 6 [/SUP], Erik G J von Asmuth[SUP] 7 [/SUP], Emilie P Buddingh[SUP] 7 [/SUP], Miriam G Mooij[SUP] 8 [/SUP], Angelique M A M Winkel[SUP] 9 [/SUP], Lotte Haverman[SUP] 10 [/SUP], Lorynn Teela[SUP] 10 [/SUP], Anke H Maitland van der Zee[SUP] 5 [/SUP], Johannes B van Goudoever[SUP] 11 [/SUP], Simone Hashimoto[SUP] 1 [/SUP], Suzanne W J Terheggen-Lagro[SUP] 1 [/SUP]
Affiliations
Background: Although rare, COVID-19 in children may lead to hospitalization due to severe respiratory symptoms, or a hyperinflammatory state called Multisystem Inflammatory Syndrome in Children (MIS-C). This study examined respiratory morbidity in children 5 to 12 months after hospitalization for MIS-C or COVID-19.
Methods: In this multi-center, prospective cohort study, children (0-17 years) with a history of hospitalization for MIS-C or COVID-19 in Dutch hospitals were invited for follow-up. Visits were scheduled in one of three academic hospitals, to evaluate current clinical status and health-related quality of life (HRQoL), and perform lung function tests and cardiopulmonary exercise testing (CPET).
Results: 72 children were included (43 MIS-C, 29 COVID-19), of whom 19% (5% and 41%, respectively) reported long-term respiratory symptoms including dyspnea and cough, a median of 8 months after hospitalization. Fatigue was the most common non-respiratory symptom. HRQoL was more frequently (60%) impaired in the COVID-19 group than the MIS-C group (14%). Spirometry (n = 48) and CPET (n = 40) were conducted in children aged > 4 and > 6 years, respectively. Spirometry was abnormal in 15% of the MIS-C group and 44% of COVID-19 group, CPET in 41% and 75%, respectively. Deconditioning patterns were the most common reason (30%) for abnormal CPET results.
Conclusion: Long-term respiratory sequelae and fatigue occurred after both MIS-C and severe COVID-19, but respiratory symptoms and impaired HRQoL were more frequent after COVID-19. Lung function and CPET abnormalities in children with COVID-19 often corresponded with symptoms. Children with MIS-C often showed CPET abnormalities without respiratory complaints or lung function changes.
Keywords: MIS‐C; Pulmonary sequelae; acute COVID‐19; children, cardiopulmonary exercise test (CPET).
. 2025 Dec;60(12):e71426.
doi: 10.1002/ppul.71426. Pulmonary Sequelae of Severe Acute COVID-19 and Multisystem Inflammatory Syndrome (MIS-C) in Dutch Children
Lieke C E Noij[SUP] 1 [/SUP], Caroline L H Brackel[SUP] 2 [/SUP], Mariëlle W Pijnenburg[SUP] 3 [/SUP], Michiel A G E Bannier[SUP] 4 [/SUP], Sanne F Kloosterman[SUP] 3 [/SUP], Joost G van den Aardweg[SUP] 5 [/SUP], Arjen Pelgröm[SUP] 5 [/SUP], Irene Kuipers[SUP] 6 [/SUP], Erik G J von Asmuth[SUP] 7 [/SUP], Emilie P Buddingh[SUP] 7 [/SUP], Miriam G Mooij[SUP] 8 [/SUP], Angelique M A M Winkel[SUP] 9 [/SUP], Lotte Haverman[SUP] 10 [/SUP], Lorynn Teela[SUP] 10 [/SUP], Anke H Maitland van der Zee[SUP] 5 [/SUP], Johannes B van Goudoever[SUP] 11 [/SUP], Simone Hashimoto[SUP] 1 [/SUP], Suzanne W J Terheggen-Lagro[SUP] 1 [/SUP]
Affiliations
- PMID: 41399030
- PMCID: PMC12706180
- DOI: 10.1002/ppul.71426
Background: Although rare, COVID-19 in children may lead to hospitalization due to severe respiratory symptoms, or a hyperinflammatory state called Multisystem Inflammatory Syndrome in Children (MIS-C). This study examined respiratory morbidity in children 5 to 12 months after hospitalization for MIS-C or COVID-19.
Methods: In this multi-center, prospective cohort study, children (0-17 years) with a history of hospitalization for MIS-C or COVID-19 in Dutch hospitals were invited for follow-up. Visits were scheduled in one of three academic hospitals, to evaluate current clinical status and health-related quality of life (HRQoL), and perform lung function tests and cardiopulmonary exercise testing (CPET).
Results: 72 children were included (43 MIS-C, 29 COVID-19), of whom 19% (5% and 41%, respectively) reported long-term respiratory symptoms including dyspnea and cough, a median of 8 months after hospitalization. Fatigue was the most common non-respiratory symptom. HRQoL was more frequently (60%) impaired in the COVID-19 group than the MIS-C group (14%). Spirometry (n = 48) and CPET (n = 40) were conducted in children aged > 4 and > 6 years, respectively. Spirometry was abnormal in 15% of the MIS-C group and 44% of COVID-19 group, CPET in 41% and 75%, respectively. Deconditioning patterns were the most common reason (30%) for abnormal CPET results.
Conclusion: Long-term respiratory sequelae and fatigue occurred after both MIS-C and severe COVID-19, but respiratory symptoms and impaired HRQoL were more frequent after COVID-19. Lung function and CPET abnormalities in children with COVID-19 often corresponded with symptoms. Children with MIS-C often showed CPET abnormalities without respiratory complaints or lung function changes.
Keywords: MIS‐C; Pulmonary sequelae; acute COVID‐19; children, cardiopulmonary exercise test (CPET).