Godfred-Cato Shana, Kunkel Amber, Abrams Joseph Y, Shah Ami B, Yousaf Anna, Hammett Teresa A, Choi Jong-Ha, Perez Maria A, Hsiao Hui-Mien, Rostad Christina A, Laham Federico R, Kao Carol M, Hunstad David A, Oster Matthew E, Campbell Angela P, Belay Ermias D
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia.
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.
Pediatr Infect Dis J. 2024 Nov 1;43(11):1074-1082. doi: 10.1097/INF.0000000000004477. Epub 2024 Aug 15.
The long-term effects of children hospitalized with multisystem inflammatory syndrome in children (MIS-C) or acute COVID-19 are not well known. Our objective was to determine long-term outcomes.
Children hospitalized with MIS-C or COVID-19 at 3 US hospitals from March 2020, through February 2021 were followed to assess health through 2 years post-hospitalization using medical records and patient surveys.
Medical record abstraction was performed for 183 patients hospitalized with MIS-C, 53 of whom participated in surveys, and 97 patients hospitalized with COVID-19, 35 of whom participated in surveys. Patients with MIS-C were younger (median, 9 vs. 14 years of age for COVID-19 patients; P = 0.004), more frequently male (62% vs. 39%; P < 0.001) and had more cardiac (14% vs. 2%; P = 0.001) and neurologic sequelae (8% vs. 1%; P = 0.023). Children with COVID-19 more often had other comorbidities (59% vs. 19%; P < 0.001). Full mental recovery at the time of survey 2 (median, 16 months post-hospitalization for patients with MIS-C and 20 months for patients with COVID-19) was 85% and 88%, respectively; full physical recovery was 87% and 81%, respectively; and nearly all had resumption of normal activities. Patients with MIS-C reported more frequent headache at 1 month (45% vs. 20%; P = 0.037). Patients with COVID-19 were more likely to report cough at 1 month (37% vs. 17%; P = 0.045). Fatigue persisted >1 year in 15%-20% of patients in both groups.
Approximately 20% of children with MIS-C and COVID-19 continued to have symptoms including fatigue and headache >1 year after hospital discharge. The duration of these findings emphasizes the importance of providers following patients until sequelae have resolved.
儿童多系统炎症综合征（MIS-C）或急性新冠病毒病（COVID-19）住院患儿的长期影响尚不清楚。我们的目的是确定长期预后情况。
对2020年3月至2021年2月期间在美国3家医院因MIS-C或COVID-19住院的患儿进行随访，通过病历和患者调查评估出院后2年的健康状况。
对183例因MIS-C住院的患者进行了病历摘要分析，其中53例参与了调查；对97例因COVID-19住院的患者进行了分析，其中35例参与了调查。MIS-C患者更年幼（中位数，MIS-C患者为9岁，COVID-19患者为14岁；P = 0.004），男性比例更高（62%对39%；P < 0.001），心脏后遗症（14%对2%；P = 0.001）和神经后遗症（8%对1%；P = 0.023）更多见。COVID-19患儿更常伴有其他合并症（59%对19%；P < 0.001）。在调查2时（MIS-C患者出院后中位数为16个月，COVID-19患者为20个月），完全精神恢复的比例分别为85%和88%；完全身体恢复的比例分别为87%和81%；几乎所有患儿都恢复了正常活动。MIS-C患者在1个月时头痛更频繁（45%对20%；P = 0.037）。COVID-19患者在1个月时更易出现咳嗽（37%对17%；P = 0.045）。两组中15%-20%的患者疲劳持续时间超过1年。
约20%的MIS-C和COVID-19患儿出院1年后仍有包括疲劳和头痛在内的症状。这些发现的持续时间强调了医疗服务提供者对患者进行随访直至后遗症消失的重要性。
