Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 420 E 70th street LH 348, New York, NY, USA.
Division of Biostatistics, Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA.
BMC Pediatr. 2024 Oct 5;24(1):635. doi: 10.1186/s12887-024-04817-9.
Long COVID, characterized by persistent symptoms beyond the acute infection phase, remains poorly characterized in children. Our study aim is to determine if children who exhibit any symptoms/conditions associated with Long COVID after acute COVID-19 infection have higher Emergency Department (ED) utilization compared to those who do not exhibit these symptoms.
Data from the HealthJump ambulatory database from the COVID-19 Research Database Consortium was utilized to identify pediatric COVID-19 cases from March 2020 to May 2023. Long COVID cases were defined based on symptoms/conditions occurring 30-180 days after initial COVID diagnosis. Descriptive statistics and multivariable logistic regression models were used to model the relationship between Long COVID and child ED utilization.
Out of 130,010 children diagnosed with COVID-19, 43,645 (33.6%) exhibited at least one Long COVID symptom/condition. Children with Long COVID symptoms/conditions had 152% higher odds (OR: 2.52, CI: 2.32-2.73) of ED visits, while those with specific symptoms including "chest pain" had 255% higher odds (AOR: 3.55, CI: 2.73-4.54) and "fluid and electrolyte disturbances" had 229% higher odds (AOR: 3.29, CI: 2.23-4.73) compared to those without those symptoms/conditions.
This study reveals that children with Long COVID symptoms had notably higher odds of ED visits, with chest pain, fluid imbalances, and generalized pain being most closely linked to such visits. This study highlights the burden of Long COVID on ED providers and underscores the importance of improved guidance for managing Long COVID symptoms in children.
长新冠，即急性感染期过后持续存在的症状，在儿童中表现得并不明显。我们的研究目的是确定在急性 COVID-19 感染后出现任何与长新冠相关的症状/病症的儿童与未出现这些症状的儿童相比，他们是否更倾向于去急诊就诊。
本研究利用 COVID-19 研究数据库联盟的 HealthJump 门诊数据库，从 2020 年 3 月至 2023 年 5 月期间确定儿科 COVID-19 病例。长新冠病例的定义是在最初 COVID 诊断后 30-180 天出现症状/病症。使用描述性统计和多变量逻辑回归模型来模拟长新冠与儿童急诊就诊之间的关系。
在 130010 名确诊 COVID-19 的儿童中，43645 名（33.6%）出现了至少一种长新冠症状/病症。出现长新冠症状/病症的儿童急诊就诊的可能性是没有这些症状/病症的儿童的 152%（OR：2.52，95%CI：2.32-2.73），而出现特定症状的儿童（包括“胸痛”的儿童就诊可能性是没有这些症状/病症的儿童的 255%（AOR：3.55，95%CI：2.73-4.54），而出现“液体和电解质紊乱”的儿童就诊可能性是没有这些症状/病症的儿童的 229%（AOR：3.29，95%CI：2.23-4.73）。
本研究表明，出现长新冠症状的儿童去急诊就诊的可能性明显更高，胸痛、液体失衡和全身疼痛与急诊就诊关系最密切。本研究突出了长新冠对急诊提供者的负担，并强调了为管理儿童长新冠症状提供更好指导的重要性。
