Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Section of Pediatric Emergency Medicine, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
JAMA Netw Open. 2023 Dec 1;6(12):e2349613. doi: 10.1001/jamanetworkopen.2023.49613.
There is a need to understand the long-term outcomes among children infected with SARS-CoV-2.
To quantify the prevalence of post-COVID-19 condition (PCC) among children tested for SARS-CoV-2 infection in pediatric emergency departments (EDs).
DESIGN, SETTING, AND PARTICIPANTS: Multicenter, prospective cohort study at 14 Canadian tertiary pediatric EDs that are members of the Pediatric Emergency Research Canada network with 90-day, 6-month, and 12-month follow-up. Participants were children younger than 18 years who were tested for SARS-CoV-2 infection between August 2020 and February 2022. Data were analyzed from May to November 2023.
The presence of SARS-CoV-2 infection at or within 14 days of the index ED visit.
Presence of symptoms and QoL reductions that meet the PCC definition. This includes any symptom with onset within 3 months of infection that is ongoing at the time of follow-up and affects everyday functioning. The outcome was quantified at 6 and 12 months following the index ED visit.
Among the 5147 children at 6 months (1152 with SARS-CoV-2 positive tests and 3995 with negative tests) and 5563 children at 12 months (1192 with SARS-CoV-2 positive tests and 4371 with negative tests) who had sufficient data regarding the primary outcome to enable PCC classification, the median (IQR) age was 2.0 (0.9-5.0) years, and 2956 of 5563 (53.1%) were male. At 6-month follow-up, symptoms and QoL changes consistent with the PCC definition were present in 6 of 1152 children with positive SARS-CoV-2 tests (0.52%) and 4 of 3995 children with negative SARS-CoV-2 tests (0.10%; absolute risk difference, 0.42%; 95% CI, 0.02% to 0.94%). The PCC definition was met at 12 months by 8 of 1192 children with positive SARS-CoV-2 tests (0.67%) and 7 of 4371 children with negative SARS-CoV-2 tests (0.16%; absolute risk difference, 0.51%; 95% CI, 0.06 to 1.08%). At 12 months, the median (IQR) PedsQL Generic Core Scale scores were 98.4 (90.0-100) among children with positive SARS-CoV-2 tests and 98.8 (91.7-100) among children with negative SARS-CoV-2 tests (difference, -0.3; 95% CI, -1.5 to 0.8; P = .56). Among the 8 children with SARS-CoV-2 positive tests and PCC at 12-month follow-up, children reported respiratory (7 of 8 patients [88%]), systemic (3 of 8 patients [38%]), and neurologic (1 of 8 patients [13%]) symptoms.
In this cohort study of children tested for SARS-CoV-2 infection in Canadian pediatric EDs, although children infected with SARS-CoV-2 reported increased chronic symptoms, few of these children developed PCC, and overall QoL did not differ from children with negative SARS-CoV-2 tests.
需要了解感染 SARS-CoV-2 的儿童的长期结果。
量化在儿科急诊部 (ED) 检测 SARS-CoV-2 感染的儿童中新冠后疾病 (PCC) 的患病率。
设计、地点和参与者：在加拿大 14 个儿科急诊部进行的多中心前瞻性队列研究，这些急诊部是加拿大儿科急诊研究网络的成员，具有 90 天、6 个月和 12 个月的随访。参与者是年龄在 18 岁以下的儿童，他们在 2020 年 8 月至 2022 年 2 月期间接受了 SARS-CoV-2 感染检测。数据于 2023 年 5 月至 11 月进行分析。
在指数 ED 就诊时或就诊后 14 天内存在 SARS-CoV-2 感染。
出现符合 PCC 定义的症状和生活质量下降。这包括感染后 3 个月内出现且在随访时仍在持续并影响日常生活功能的任何症状。在指数 ED 就诊后 6 个月和 12 个月时对该结果进行量化。
在 6 个月（1152 例 SARS-CoV-2 阳性检测和 3995 例阴性检测）和 12 个月（1192 例 SARS-CoV-2 阳性检测和 4371 例阴性检测）的 5563 例儿童中有足够数据进行主要结局分类，中位数（IQR）年龄为 2.0（0.9-5.0）岁，5563 例儿童中有 2956 例（53.1%）为男性。在 6 个月的随访中，1152 例 SARS-CoV-2 阳性检测儿童中有 6 例（0.52%）和 3995 例 SARS-CoV-2 阴性检测儿童中有 4 例（0.10%；绝对风险差异，0.42%；95%CI，0.02%至 0.94%）出现符合 PCC 定义的症状和生活质量变化。在 12 个月时，1192 例 SARS-CoV-2 阳性检测儿童中有 8 例（0.67%）和 4371 例 SARS-CoV-2 阴性检测儿童中有 7 例（0.16%）符合 PCC 定义（绝对风险差异，0.51%；95%CI，0.06%至 1.08%）。在 12 个月时，SARS-CoV-2 阳性检测儿童的 PedsQL 通用核心量表评分中位数（IQR）为 98.4（90.0-100），SARS-CoV-2 阴性检测儿童的评分中位数（IQR）为 98.8（91.7-100）（差值，-0.3；95%CI，-1.5 至 0.8；P=0.56）。在 12 个月时随访中 SARS-CoV-2 阳性检测且符合 PCC 的 8 例儿童中，儿童报告有呼吸系统（8 例患者中的 7 例 [88%]）、全身（8 例患者中的 3 例 [38%]）和神经系统（8 例患者中的 1 例 [13%]）症状。
在这项对加拿大儿科急诊部检测 SARS-CoV-2 感染的儿童进行的队列研究中，尽管感染 SARS-CoV-2 的儿童报告有慢性症状增加，但很少有儿童出现 PCC，总体生活质量与 SARS-CoV-2 阴性检测儿童没有差异。
