Risk factors for health impairments in children after hospitalization for acute COVID-19 or MIS-C

Maddux, Aline B.; Young, Cameron C.; Kucukak, Suden; Zambrano, Laura D.; Newhams, Margaret M.; Rollins, Caitlin K.; Halasa, Natasha B.; Gertz, Shira J.; Mack, Elizabeth H.; Schwartz, Stephanie; Kong, Michele; Loftis, Laura L.; Irby, Katherine; Rowan, Courtney M.; Tarquinio, Keiko M.; Zinter, Matt S.; Crandall, Hillary; Cvijanovich, Natalie Z.; Schuster, Jennifer E.; Fitzgerald, Julie C.; Staat, Mary A.; Hobbs, Charlotte V.; Nofziger, Ryan A.; Shein, Steven; Flori, Heidi; Cullimore, Melissa L.; Chatani, Brandon M.; Levy, Emily R.; Typpo, Katri V.; Hume, Janet R.; Campbell, Angela P.; Randolph, Adrienne G.; ,

doi:10.3389/fped.2023.1260372

Cited by 3 publications

(1 citation statement)

References 33 publications

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“…Children with myocarditis due to MIS-C or with myocarditis related to COVID-19 vaccination had faster resolution of cardiac dysfunction compared to a historical cohort of children with viral myocarditis diagnosed prior to the COVID-19 pandemic, with 93% and 100% having normal left ventricular ejection fraction at the time of discharge respectively, compared to 70% in the viral myocarditis cohort [39]. Children with chronic medical conditions prior to hospitalization for MIS-C and greater organ involvement were more likely to report persistent symptoms 2 to 4 months after initial hospitalization and may require more frequent follow-ups [40].…”

Section: Multisystem Inflammatory Syndrome In Children (Mis-c)mentioning

confidence: 97%

Overview of COVID-19 Infection, Treatment, and Prevention in Children

Kao

2024

JCM

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Coronavirus disease 2019 (COVID-19), caused by the novel respiratory virus—severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)—was declared a global pandemic by the World Health Organization on 11 March 2020. Since then, substantial gains have been made in our understanding of COVID-19 epidemiology, disease presentation, and management. While children tend to have less severe disease courses compared to adults, children can still develop severe COVID-19 infections, particularly in those with underlying medical conditions such as obesity, chronic lung disease, or prematurity. In addition, children are at risk of severe complications of COVID-19 infection, such as multisystem inflammatory syndrome in children (MIS-C) or long COVID. The case definitions of MIS-C and long COVID have continued to evolve with the increased understanding of these new entities; however, improved methods of diagnosis and determination of the optimal management are still needed. Furthermore, with the continued circulation of SARS-CoV-2 variants, there remains a need for clinicians to remain up-to-date on the latest treatment and prevention options. The purpose of this review is to provide an evidence-based review of what we have learned about COVID-19 in children since the start of the pandemic and how best to counsel children and their families on the best methods of prevention.

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Section: Multisystem Inflammatory Syndrome In Children (Mis-c)mentioning

confidence: 97%

Overview of COVID-19 Infection, Treatment, and Prevention in Children

Kao

2024

JCM

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One- and Two-Year Multidisciplinary Follow-Up of MIS-C at a Tertiary Hospital: A Retrospective Cohort Study

Johnson,

Penner,

Issitt

et al. 2024

Pediatric Infectious Disease Journal

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Background: Although 6-month follow-up of patients with multisystem inflammatory syndrome in children (MIS-C) was reassuring, there is scant data on long-term sequelae, including whether changing variants affect clinical severity and outcomes. Methods: Children (<18 years of age) admitted to Great Ormond Street Hospital between April 4, 2020, and January 2023, meeting diagnostic criteria for MIS-C were included. Admission and follow-up data were categorized by the predominant SARS-CoV-2 circulating variant in the United Kingdom. Results: One hundred and sixty children [median age, 10.1 (interquartile range, 7.9-12.6) years] were included. There was no difference in the time of symptom onset to diagnosis between waves (P=0.23) or hospitalization days across all waves (P=0.32). Inflammatory markers were normal for up to 2 years in all patients except one. Eleven patients (6.9%) remain in follow-up: cardiology (n=5), gastroenterology (n=5) and nephrology (n=1). The main self-reported symptoms at 2 years were abdominal pain (n=5) and myalgia (n=2). Fatigue was present in approximately a quarter of patients at admission; this reduced to 14 (9%), (2%) and 1 (2%) at 6-month, 1-year and 2-year follow-ups, respectively. Chronic fatigue or long-COVID symptomatology was rare (n=1) even with high rates of concurrent Epstein–Barr virus positivity (49/134). All patients had sustained neurological recovery with no new neurological pathology observed. Conclusions: Patients with MIS-C have a sustained recovery, which is reassuring for positive long-term outcomes. Across waves, time from symptom onset to diagnosis and treatment, symptomatology and length of stay were similar. Sustained recovery is reassuring for clinicians and parents alike. Differentiating long-COVID symptomatology from that of MIS-C is important in formulating an individualized treatment plan.

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Long-term Health Outcomes After Hospital Discharge Among Children Hospitalized for MIS-C or COVID-19, September 29, 2021, to June 21, 2022

Godfred-Cato,

Kunkel,

Abrams

et al. 2024

Pediatric Infectious Disease Journal

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Background: The long-term effects of children hospitalized with multisystem inflammatory syndrome in children (MIS-C) or acute COVID-19 are not well known. Our objective was to determine long-term outcomes. Methods: Children hospitalized with MIS-C or COVID-19 at 3 US hospitals from March 2020, through February 2021 were followed to assess health through 2 years post-hospitalization using medical records and patient surveys. Results: Medical record abstraction was performed for 183 patients hospitalized with MIS-C, 53 of whom participated in surveys, and 97 patients hospitalized with COVID-19, 35 of whom participated in surveys. Patients with MIS-C were younger (median, 9 vs. 14 years of age for COVID-19 patients; P = 0.004), more frequently male (62% vs. 39%; P < 0.001) and had more cardiac (14% vs. 2%; P = 0.001) and neurologic sequelae (8% vs. 1%; P = 0.023). Children with COVID-19 more often had other comorbidities (59% vs. 19%; P < 0.001). Full mental recovery at the time of survey 2 (median, 16 months post-hospitalization for patients with MIS-C and 20 months for patients with COVID-19) was 85% and 88%, respectively; full physical recovery was 87% and 81%, respectively; and nearly all had resumption of normal activities. Patients with MIS-C reported more frequent headache at 1 month (45% vs. 20%; P = 0.037). Patients with COVID-19 were more likely to report cough at 1 month (37% vs. 17%; P = 0.045). Fatigue persisted >1 year in 15%–20% of patients in both groups. Conclusions: Approximately 20% of children with MIS-C and COVID-19 continued to have symptoms including fatigue and headache >1 year after hospital discharge. The duration of these findings emphasizes the importance of providers following patients until sequelae have resolved.

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Risk factors for health impairments in children after hospitalization for acute COVID-19 or MIS-C

Cited by 3 publications

References 33 publications

Overview of COVID-19 Infection, Treatment, and Prevention in Children

Overview of COVID-19 Infection, Treatment, and Prevention in Children

One- and Two-Year Multidisciplinary Follow-Up of MIS-C at a Tertiary Hospital: A Retrospective Cohort Study

Long-term Health Outcomes After Hospital Discharge Among Children Hospitalized for MIS-C or COVID-19, September 29, 2021, to June 21, 2022

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