Health Impairments in Children and Adolescents After Hospitalization for Acute COVID-19 or MIS-C.

Autor:	Maddux AB; Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado., Berbert L; Biostatistics and Research Design Center, Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, Massachusetts., Young CC; Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts., Feldstein LR; COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia., Zambrano LD; COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia., Kucukak S; Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts., Newhams MM; Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts., Miller K; Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado., FitzGerald MM; Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts., He J; Biostatistics and Research Design Center, Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, Massachusetts., Halasa NB; Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee., Cvijanovich NZ; Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland, California., Loftis LL; Section of Critical Care Medicine, Department of Pediatrics, Texas Children's Hospital, Houston, Texas., Walker TC; Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill, North Carolina., Schwartz SP; Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill, North Carolina., Gertz SJ; Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, New Jersey., Tarquinio KM; Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia., Fitzgerald JC; Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania., Kong M; Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama., Schuster JE; Division of Pediatric Infectious Disease, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri., Mack EH; Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston, South Carolina., Hobbs CV; Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, Mississippi., Rowan CM; Division of Pediatric Critical Care Medicine, Department of Pediatrics, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Indiana., Staat MA; Department of Pediatrics, University of Cincinnati, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio., Zinter MS; Department of Pediatrics, Division of Critical Care, University of California San Francisco, San Francisco, California., Irby K; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock, Arkansas., Crandall H; Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah., Flori H; Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor, Michigan., Cullimore ML; Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, Nebraska., Nofziger RA; Division of Critical Care Medicine, Akron Children's Hospital, Akron, Ohio., Shein SL; Division of Pediatric Critical Care Medicine, Rainbow Babies and Children's Hospital, Cleveland, Ohio., Gaspers MG; University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson, Arizona., Hume JR; Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota., Levy ER; Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado., Chen SR; Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts., Patel MM; COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia., Tenforde MW; COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia., Weller E; Biostatistics and Research Design Center, Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, Massachusetts.; Departments of Pediatrics, Harvard Medical School, Boston, Massachusetts., Campbell AP; COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia., Randolph AG; Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts.; Departments of Pediatrics, Harvard Medical School, Boston, Massachusetts.; Department of Anaesthesia, Harvard Medical School, Boston, Massachusetts.
Jazyk:	angličtina
Zdroj:	Pediatrics [Pediatrics] 2022 Sep 01; Vol. 150 (3).
DOI:	10.1542/peds.2022-057798
Abstrakt:	Objectives: To evaluate risk factors for postdischarge sequelae in children and adolescents hospitalized for acute coronavirus disease 2019 (COVID-19) or multisystem inflammatory syndrome in children (MIS-C). Methods: Multicenter prospective cohort study conducted in 25 United States pediatric hospitals. Patients <21-years-old, hospitalized May 2020 to May 2021 for acute COVID-19 or MIS-C with follow-up 2 to 4 months after admission. We assessed readmissions, persistent symptoms or activity impairment, and new morbidities. Multivariable regression was used to calculate adjusted risk ratios (aRR) and 95% confidence intervals (CI). Results: Of 358 eligible patients, 2 to 4 month survey data were available for 119 of 155 (76.8%) with acute COVID-19 and 160 of 203 (78.8%) with MIS-C. Thirteen (11%) patients with acute COVID-19 and 12 (8%) with MIS-C had a readmission. Thirty-two (26.9%) patients with acute COVID-19 had persistent symptoms (22.7%) or activity impairment (14.3%) and 48 (30.0%) with MIS-C had persistent symptoms (20.0%) or activity impairment (21.3%). For patients with acute COVID-19, persistent symptoms (aRR, 1.29 [95% CI, 1.04-1.59]) and activity impairment (aRR, 1.37 [95% CI, 1.06-1.78]) were associated with more organ systems involved. Patients with MIS-C and pre-existing respiratory conditions more frequently had persistent symptoms (aRR, 3.09 [95% CI, 1.55-6.14]) and those with obesity more frequently had activity impairment (aRR, 2.52 [95% CI, 1.35-4.69]). New morbidities were infrequent (9% COVID-19, 1% MIS-C). Conclusions: Over 1 in 4 children hospitalized with acute COVID-19 or MIS-C experienced persistent symptoms or activity impairment for at least 2 months. Patients with MIS-C and respiratory conditions or obesity are at higher risk of prolonged recovery.
Databáze:	MEDLINE
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