Children, once mistakenly believed to be protected from the worst of COVID-19, face more serious illness with the rise of the Omicron variant. A study, published in JAMA, looked at the proportion of children who contracted COVID-19 and reported post-COVID-19 conditions (PCC) 90 days after an emergency department visit. This prospective cohort study was conducted from 7 March 2020 to 20 January 2021, based on indexing data from 36 emergency departments (EDs) in 8 countries. The study enrolled 8642 children and this was limited to 1884 children who contracted COVID-19, had ED index data available, and completed a 90-day follow-up. The cohort was 52.8% male and the mean age was 3 years. The researchers defined post-COVID-19 conditions as any persistent, new, or recurrent relevant health problems reported at the 90-day follow-up survey. At ED indexing, the most common symptoms were fever (65.9%), cough (48.7%), and rhinorrhea or congestion (47.4%). After 90 days, a total of 5.8% (n = 110) reported PCC, including children who were both hospitalized and not hospitalized during acute illness. Among children who tested positive for COVID-19, the most common symptom was fatigue or weakness. Factors most indicative of long-term COVID included hospitalization for at least 48 hours (compared to children never hospitalized), having 4 or more symptoms reported at the index ED visit (compared to 1-3 symptoms at indexing); and are 14 years of age or older (compared to children under 1 year of age). Children who were still positive for COVID-19 were more likely to report prolonged COVID symptoms at 90 days than children who were negative. The researchers noted that guidance and follow-up are especially important for hospitalized children who are older and have multiple acute symptoms. “The reported rates of long-term COVID in adults are significantly higher than what we found in children,” said Nathan Kuppermann, MD, MPH, principal investigator from the University of California, Davis School of Medicine. “Our findings can inform public health policy decisions about COVID-19 mitigation strategies for children and screening approaches for long-term COVID-19 among those with severe infections.”
