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

被引：7

作者：

Maddux, Aline B. ^{[1
,2
]}

Young, Cameron C. ^{[3
]}

Kucukak, Suden ^{[3
]}

Zambrano, Laura D. ^{[4
]}

Newhams, Margaret M. ^{[3
]}

Rollins, Caitlin K. ^{[5
,6
]}

Halasa, Natasha B. ^{[7
]}

Gertz, Shira J. ^{[8
]}

Mack, Elizabeth H. ^{[9
]}

Schwartz, Stephanie ^{[10
]}

Kong, Michele ^{[11
]}

Loftis, Laura L. ^{[12
]}

Irby, Katherine ^{[13
]}

Rowan, Courtney M. ^{[14
]}

Tarquinio, Keiko M. ^{[15
]}

Zinter, Matt S. ^{[16
]}

Crandall, Hillary ^{[17
]}

Cvijanovich, Natalie Z. ^{[18
]}

Schuster, Jennifer E. ^{[19
]}

Fitzgerald, Julie C. ^{[20
]}

Staat, Mary A. ^{[21
]}

Hobbs, Charlotte V. ^{[22
]}

Nofziger, Ryan A. ^{[23
]}

Shein, Steven ^{[24
]}

Flori, Heidi ^{[25
,26
]}

Cullimore, Melissa L. ^{[27
]}

Chatani, Brandon M. ^{[28
]}

Levy, Emily R. ^{[29
]}

Typpo, Katri V. ^{[30
]}

Hume, Janet R. ^{[31
]}

Campbell, Angela P.

Randolph, Adrienne G. ^{[32
]}

机构：

[1] Univ Colorado, Sch Med, Dept Pediat, Sect Crit Care Med, Aurora, CO 80045 USA

[2] Childrens Hosp Colorado, Aurora, CO 80045 USA

[3] Boston Childrens Hosp, Dept Anesthesiol, Crit Care & Pain Med, Boston, MA USA

[4] CDCP, COVID 19 Response, Atlanta, GA USA

[5] Boston Childrens Hosp, Dept Neurol, Boston, MA USA

[6] Harvard Med Sch, Boston, MA 02115 USA

[7] Vanderbilt Univ, Med Ctr, Dept Pediat, Div Pediat Infect Dis, Nashville, TN 37232 USA

[8] Cooperman Barnabas Med Ctr, Div Pediat Crit Care, Dept Pediat, Livingston, NJ USA

[9] Med Univ South Carolina, Div Pediat Crit Care Med, Charleston, SC USA

[10] Univ North Carolina Chapel Hill, Dept Pediat, Chapel Hill, NC USA

[11] Univ Alabama Birmingham, Dept Pediat, Div Pediat Crit Care Med, Birmingham, AL USA

[12] Texas Childrens Hosp, Dept Pediat, Sect Crit Care Med, Houston, TX USA

[13] Arkansas Childrens Hosp, Dept Pediat, Sect Pediat Crit Care, Little Rock, AR USA

[14] Indiana Univ Sch Med, Riley Hosp Children, Dept Pediat, Div Pediat Crit Care Med, Indianapolis, IN USA

[15] Emory Univ, Dept Pediat, Div Crit Care Med, Childrens Healthcare Atlanta,Sch Med, Atlanta, GA USA

[16] Univ Calif San Francisco, Dept Pediat, Div Crit Care, San Francisco, CA USA

[17] Univ Utah, Dept Pediat, Div Pediat Crit Care, Primary Childrens Hosp, Salt Lake City, UT USA

[18] UCSF Benioff Childrens Hosp, Div Crit Care Med, Oakland, CA USA

[19] Childrens Mercy Kansas City, Dept Pediat, Div Pediat Infect Dis, Kansas City, MO USA

[20] Univ Penn, Childrens Hosp Philadelphia, Perelman Sch Med, Dept Anesthesiol & Crit Care, Philadelphia, PA USA

[21] Univ Cincinnati, Cincinnati Childrens Hosp Med Ctr, Dept Pediat, Div Infect Dis, Cincinnati, OH USA

[22] Univ Mississippi, Med Ctr, Dept Pediat, Div Infect Dis, Jackson, MS 39216 USA

[23] Akron Childrens Hosp, Div Crit Care Med, Akron, OH USA

[24] Rainbow Babies & Childrens Hosp, Div Pediat Crit Care Med, Cleveland, OH USA

[25] CS Mott Childrens Hosp, Dept Pediat, Div Pediat Crit Care Med, Ann Arbor, MI USA

[26] Univ Michigan, Ann Arbor, MI 48109 USA

[27] Childrens Hosp & Med Ctr, Dept Pediat, Div Pediat Crit Care, Omaha, NE USA

[28] AdventHlth Children, Dept Pediat, Div Pediat Infect Dis, Orlando, FL USA

[29] Mayo Clin, Dept Pediat & Adolescent Med, Div Pediat Infect Dis, Div Pediat Crit Care Med, Rochester, MN USA

[30] Univ Arizona, Diamond Childrens Banner Childrens Med Ctr, Tucson, AZ USA

[31] Univ Minnesota, Masonic Childrens Hosp, Div Pediat Crit Care, Minneapolis, MN USA

[32] Boston Childrens Hosp, Dept Anesthesiol Crit Care & Pain Med, Boston, MA USA

来源：

FRONTIERS IN PEDIATRICS | 2023年 / 11卷

关键词：

post-acute COVID-19 syndrome; COVID-19 post-intensive care syndrome; critical care outcomes; SARS-CoV-2; multisystem inflammatory syndrome in children; MIS-C; COVID-19; pediatrics; OUTCOMES; CARE; PEDSQL(TM)-4.0; RELIABILITY;

D O I：

10.3389/fped.2023.1260372

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

Objective: To identify risk factors for persistent impairments after pediatric hospitalization for acute coronavirus disease 2019 (COVID-19) or multisystem inflammatory syndrome in children (MIS-C) during the SARS-CoV-2 pandemic.Methods: Across 25 U.S. Overcoming COVID-19 Network hospitals, we conducted a prospective cohort study of patients <21-years-old hospitalized for acute COVID-19 or MIS-C (May 2020 to March 2022) surveyed 2- to 4-months post-admission. Multivariable regression was used to calculate adjusted risk ratios (aRR) and 95% confidence intervals (CI).Results: Of 232 children with acute COVID-19, 71 (30.6%) had persistent symptoms and 50 (21.6%) had activity impairments at follow-up; for MIS-C (n = 241), 56 (23.2%) had persistent symptoms and 58 (24.1%) had activity impairments. In adjusted analyses of patients with acute COVID-19, receipt of mechanical ventilation was associated with persistent symptoms [aRR 1.83 (95% CI: 1.07, 3.13)] whereas obesity [aRR 2.18 (95% CI: 1.05, 4.51)] and greater organ system involvement [aRR 1.35 (95% CI: 1.13, 1.61)] were associated with activity impairment. For patients with MIS-C, having a pre-existing respiratory condition was associated with persistent symptoms [aRR 3.04 (95% CI: 1.70, 5.41)] whereas obesity [aRR 1.86 (95% CI: 1.09, 3.15)] and greater organ system involvement [aRR 1.26 (1.00, 1.58)] were associated with activity impairments.Discussion: Among patients hospitalized, nearly one in three hospitalized with acute COVID-19 and one in four hospitalized with MIS-C had persistent impairments for >= 2 months post-hospitalization. Persistent impairments were associated with more severe illness and underlying health conditions, identifying populations to target for follow-up.

引用

页数：11

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