Risk factors for long covid in previously hospitalised children using the ISARIC Global follow-up protocol: A prospective cohort study

Osmanov, Ismail M; Spiridonova, Ekaterina; Bobkova, Polina; Gamirova, Aysylu; Shikhaleva, Anastasia; Andreeva, Margarita; Blyuss, Oleg; El-Taravi, Yasmin; DunnGalvin, Audrey; Comberiati, Pasquale; Peroni, Diego G; Apfelbacher, Christian; Genuneit, Jon; Mazankova, Lyudmila; Miroshina, Alexandra; Chistyakova, Evgeniya; Samitova, Elmira; Borzakova, Svetlana; Bondarenko, Elena; Korsunskiy, Anatoliy A; Konova, Irina; Hanson, Sarah Wulf; Carson, Gail; Sigfrid, Louise; Scott, Janet T; Greenhawt, Matthew; Whittaker, Elizabeth A; Garralda, Elena; Swann, Olivia; Buonsenso, Danilo; Nicholls, Dasha E; Simpson, Frances; Jones, Christina; Semple, Malcolm G; Warner, John O; Vos, Theo; Olliaro, Piero; Munblit, Daniel

BACKGROUND: The long-term sequelae of coronavirus disease 2019 (Covid-19) in children remain poorly characterised. This study aimed to assess long-term outcomes in children previously hospitalised with Covid-19 and associated risk factors. METHODS: This is a prospective cohort study of children (≤18†years old) admitted with confirmed Covid-19. Children admitted to the hospital between April 2, 2020 and August 26, 2020, were included. Telephone interview using the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) Covid-19 Health and Wellbeing paediatric follow-up survey. Persistent symptoms (>5†months) were further categorised by system(s) involved. FINDINGS: 518 of 853 (61%) of eligible children were available for the follow-up assessment and included in the study. Median age was 10.4†years (IQR, 3-15.2) and 270 (52.1%) were girls; median follow-up since hospital discharge was 256 (223-271) days. At the time of the follow-up interview 126 (24.3%) participants reported persistent symptoms among which fatigue (53, 10.7%), sleep disturbance (36, 6.9%,) and sensory problems (29, 5.6%) were the most common. Multiple symptoms were experienced by 44 (8.4%) participants. Risk factors for persistent symptoms were: older age "6-11 years" (odds ratio 2.74 (95% confidence interval 1.37 to 5.75) and "12-18 years" (2.68, 1.41 to 5.4); and a history of allergic diseases (1.67, 1.04 to 2.67). INTERPRETATION: A quarter of children experienced persistent symptoms months after hospitalization with acute covid-19 infection, with almost one in ten experiencing multi-system involvement. Older age and allergic diseases were associated with higher risk of persistent symptoms at follow-up.