Department of Pediatrics, Department of Pediatric Endocrinology, University of Health and Sciences, Ankara Atatürk Sanatorium Training and Research Hospital, Ankara, Turkey.
Eur Rev Med Pharmacol Sci. 2022 Oct;26(20):7695-7704. doi: 10.26355/eurrev_202210_30046.
The majority of children experience a mild course of acute Coronavirus Disease 2019 (COVID-19). Only few studies have looked at long-term recovery from COVID-19 infection in children. The purpose of this study was to identify the predictors of long-COVID by performing a thorough analysis of the clinical, laboratory, and demographic characteristics of children with COVID-19.
Between August and October 2021, data were obtained retrospectively from the medical records of 251 children diagnosed with COVID-19 at a tertiary single-center hospital. The prognostic effects of admission-related factors were compared between patients who experienced long-lasting symptoms and those who did not.
Long-COVID symptoms were noted in 12.4% of patients. Joint pain (7.6%), lumbago (4.8%), and headache (3.2%) were the most common symptoms. The mean onset of long-COVID symptoms was 1.35±0.49 months. The onset of long-COVID symptoms was 4 weeks after initial diagnosis in 64.5% of patients and 4-8 weeks later in 35.5% of the patients. The mean duration of long-COVID symptoms was 5.32±2.51 months. Children with long-COVID had higher leukocytes, neutrophils, monocytes, basophils, platelets, and D-dimer when compared with patients without long-COVID (p < 0.001). Leukocytes, neutrophils, monocytes, platelets, and D-dimer had the highest AUC in the ROC analysis (0.694, 0.658, 0.681, 0.667, and 0.612, respectively) and were statistically significant.
Despite the majority of children with COVID-19 having mild or asymptomatic acute disease, the majority of long-COVID symptoms were associated with functional impairment between 1 and 9 months after the start of the infection. Increased leukocytes, monocytes, neutrophils, platelets, and D-dimer appear to be the most powerful laboratory predictors for long-COVID and monitoring these predictors may assist clinicians to identify and follow-up patients with higher risk for long-COVID.
大多数儿童患急性 2019 年冠状病毒病（COVID-19）的病情较轻。只有少数研究关注儿童 COVID-19 感染后的长期康复情况。本研究的目的是通过对 COVID-19 患儿的临床、实验室和人口统计学特征进行全面分析，确定长 COVID 的预测因素。
2021 年 8 月至 10 月，我们回顾性地从一家三级单中心医院的 251 名确诊 COVID-19 的患儿的病历中获取数据。比较了有长期症状和无长期症状患者的入院相关因素的预后影响。
12.4%的患者出现长 COVID 症状。最常见的症状是关节痛（7.6%）、腰痛（4.8%）和头痛（3.2%）。长 COVID 症状的平均发病时间为 1.35±0.49 个月。64.5%的患者在初次诊断后 4 周出现长 COVID 症状，35.5%的患者在 4-8 周后出现长 COVID 症状。长 COVID 症状的平均持续时间为 5.32±2.51 个月。与无长 COVID 症状的患者相比，长 COVID 症状患者的白细胞、中性粒细胞、单核细胞、嗜碱性粒细胞、血小板和 D-二聚体更高（p<0.001）。白细胞、中性粒细胞、单核细胞、血小板和 D-二聚体在 ROC 分析中 AUC 最高（分别为 0.694、0.658、0.681、0.667 和 0.612），且具有统计学意义。
尽管大多数 COVID-19 患儿的急性疾病为轻症或无症状，但在感染开始后 1-9 个月，大多数长 COVID 症状与功能障碍相关。白细胞、单核细胞、中性粒细胞、血小板和 D-二聚体升高似乎是长 COVID 的最强有力的实验室预测因素，监测这些预测因素可能有助于临床医生识别和随访有更高长 COVID 风险的患者。
