Persistent symptoms and decreased health-related quality of life after symptomatic pediatric COVID-19: A prospective study in a Latin American tertiary hospital

To prospectively evaluate demographic, anthropometric and health-related quality of life (HRQoL) in pediatric patients with laboratory-confirmed coronavirus disease 2019 (COVID-19) This was a longitudinal observational study of surviving pediatric post-COVID-19 patients (n=53) and pediatric subjects...

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Published in:	Clinics (São Paulo, Brazil) Vol. 76; p. e3511
Main Authors:	Fink, Thais T., Marques, Heloisa H.S., Gualano, Bruno, Lindoso, Livia, Bain, Vera, Astley, Camilla, Martins, Fernanda, Matheus, Denise, Matsuo, Olivia M., Suguita, Priscila, Trindade, Vitor, Paula, Camila S.Y., Farhat, Sylvia C.L., Palmeira, Patricia, Leal, Gabriela N., Suzuki, Lisa, Odone, Vicente, Carneiro-Sampaio, Magda, Duarte, Alberto José S., Antonangelo, Leila, Batisttella, Linamara R., Polanczyk, Guilherme V., Pereira, Rosa Maria R., Carvalho, Carlos Roberto R., Buchpiguel, Carlos A., Xavier, Ana Claudia L., Seelaender, Marilia, Silva, Clovis Artur, Pereira, Maria Fernanda B., Sallum, Adriana M.E., Brentani, Alexandra V.M., Neto, Álvaro José S., Ihara, Amanda, Santos, Andrea R., Canton, Ana Pinheiro M., Watanabe, Andreia, Santos, Angélica C. dos, Pastorino, Antonio C., Franco, Bernadette D.G.M., Caruzo, Bruna, Ceneviva, Carina, Martins, Carolina C.M.F., Prado, Danilo, Abellan, Deipara M., Benatti, Fabiana B., Smaria, Fabiana, Gonçalves, Fernanda T., Penteado, Fernando D., Castro, Gabriela S. F. de, Gonçalves, Guilherme S., Roschel, Hamilton, Disi, Ilana R., Marques, Isabela G., Castro, Inar A., Buscatti, Izabel M., Faiad, Jaline Z., Fiamoncini, Jarlei, Rodrigues, Joaquim C., Carneiro, Jorge D.A., Paz, Jose A., Ferreira, Juliana C., Ferreira, Juliana C.O., Silva, Katia R., Bastos, Karina L.M., Kozu, Katia, Cristofani, Lilian M., Souza, Lucas V.B., Campos, Lucia M.A., Silva, Luiz Vicente R.F., Sapienza, Marcelo T., Lima, Marcos S., Garanito, Marlene P., Santos, Márcia F.A., Dorna, Mayra B., Aikawa, Nadia E., Litvinov, Nadia, Sakita, Neusa K., Gaiolla, Paula V.V., Pasqualucci, Paula, Toma, Ricardo K., Correa-Silva, Simone, Sieczkowska, Sofia M., Imamura, Marta, Forsait, Silvana, Santos, Vera A., Zheng, Yingying
Format:	Journal Article
Language:	English
Published:	United States Elsevier España, S.L.U 2021 Faculdade de Medicina / USP Elsevier España
Subjects:	Adolescent Child COVID-19 - complications COVID-19 Testing Humans Latin America Long Coronavirus Disease 2019 Male MEDICINE, GENERAL & INTERNAL Multisystem Inflammatory Syndrome in Children Original Post-Acute COVID-19 Syndrome Prospective Studies Quality of Life SARS-CoV-2 Sequelae Tertiary Care Centers Latin America Sequelae Multisystem Inflammatory Syndrome in Children Child Adolescent Long Coronavirus Disease 2019
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Summary:	To prospectively evaluate demographic, anthropometric and health-related quality of life (HRQoL) in pediatric patients with laboratory-confirmed coronavirus disease 2019 (COVID-19) 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. 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. 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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3 Both authors contributed equally with this paper
ISSN:	1807-5932 1980-5322 1980-5322
DOI:	10.6061/clinics/2021/e3511