From the Kennedy Krieger Institute, Baltimore, Maryland (AKM, RN, GV, DTJ, EH, NS, LAM); Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, Maryland (AKM, LAM); Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland (RN); and Department of Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland (LAM).
Am J Phys Med Rehabil. 2021 Dec 1;100(12):1140-1147. doi: 10.1097/PHM.0000000000001896.
The long-term sequelae after SARS-CoV-2 infections in children is unknown. Guidance is needed on helpful models of care for an emerging subset of pediatric patients with postacute/long COVID who continue to experience persistent symptoms after initial COVID-19 diagnosis. Here, we describe a pediatric multidisciplinary post-COVID-19 rehabilitation clinic model as well as a case series of the initial cohort of patients who presented to this clinic. A consecutive sample of nine patients (pediatric patients <21 yrs of age) who presented to our clinic are included. The most common presenting symptoms were fatigue (8 of 9 patients), headaches (6 of 9), difficulty with schoolwork (6 of 8), "brain fog" (4 of 9), and dizziness/lightheadedness (4 of 9). Most patients had decreased scores on self-reported quality-of-life measures compared with healthy controls. In the patients who participated in neuropsychological testing, a subset demonstrated difficulties with sustained auditory attention and divided attention; however, most of these patients had preexisting attention and/or mood concerns. There were also some who self-reported elevated depression and anxiety symptoms. Pediatric patients with postacute/long COVID may present with a variety of physical, cognitive, and mood symptoms. We present a model of care to address these symptoms through a multidisciplinary rehabilitation approach.
儿童感染 SARS-CoV-2 后的长期后遗症尚不清楚。对于在初始 COVID-19 诊断后持续出现持续症状的、患有急性后/长 COVID 的新兴亚组儿科患者,需要有关有益的护理模式的指导。在这里,我们描述了一种儿科多学科 COVID-19 后康复诊所模式,以及该诊所首批患者的病例系列。纳入了连续 9 名(年龄<21 岁的儿科患者)就诊于本诊所的患者。最常见的首发症状是疲劳(9 例中的 8 例)、头痛(9 例中的 6 例)、学业困难(8 例中的 6 例)、“脑雾”(9 例中的 4 例)和头晕/头晕(9 例中的 4 例)。与健康对照组相比,大多数患者的自我报告生活质量评分下降。在参加神经心理学测试的患者中,有一部分患者存在持续性听觉注意力和分散注意力方面的困难;然而,这些患者中大多数存在注意力和/或情绪方面的问题。也有一些患者自我报告抑郁和焦虑症状升高。患有急性后/长 COVID 的儿科患者可能出现多种身体、认知和情绪症状。我们提出了一种通过多学科康复方法来解决这些症状的护理模式。