Characterizing Long COVID in Children and Adolescents.

Autor:	Gross RS; Division of General Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine, New York., Thaweethai T; Department of Biostatistics, Massachusetts General Hospital, Boston.; Department of Medicine, Harvard Medical School, Boston, Massachusetts., Kleinman LC; Division of Population Health, Quality, and Implementation Sciences (PopQuIS), Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.; Bristol Myers Squibb Children's Hospital, New Brunswick, New Jersey., Snowden JN; Division of Infectious Diseases, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock., Rosenzweig EB; Division of Pediatric Cardiology, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York., Milner JD; Division of Pediatric Allergy, Immunology and Rheumatology, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York., Tantisira KG; Division of Respiratory Medicine, Department of Pediatrics, UC San Diego School of Medicine, Rady Children's Hospital, San Diego, California., Rhee KE; Division of Child and Community Health, Department of Pediatrics, UC San Diego School of Medicine, Rady Children's Hospital, San Diego, California., Jernigan TL; Departments of Cognitive Science, Psychiatry, and Radiology, UC San Diego School of Medicine, Rady Children's Hospital, San Diego, California., Kinser PA; School of Nursing, Virginia Commonwealth University, Richmond., Salisbury AL; School of Nursing, Virginia Commonwealth University, Richmond., Warburton D; Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles., Mohandas S; Division of Infectious Diseases, Department of Pediatrics, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles., Wood JC; Division of Cardiology, Department of Pediatrics, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles., Newburger JW; Department of Cardiology, Harvard Medical School, Boston, Massachusetts.; Boston Children's Hospital, Boston, Massachusetts., Truong DT; Division of Pediatric Cardiology, Department of Pediatrics, University of Utah, Primary Children's Hospital, Salt Lake City., Flaherman VJ; Division of General Pediatrics, Department of Pediatrics, University of California, San Francisco., Metz TD; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City., Karlson EW; Division of Rheumatology, Inflammation, and Immunity, Department of Medicine, Massachusetts General Hospital, Boston.; Brigham and Women's Hospital, Boston, Massachusetts., Chibnik LB; Division of Neurology, Department of Neurology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.; Massachusetts General Hospital, Boston., Pant DB; Department of Biostatistics, Massachusetts General Hospital, Boston., Krishnamoorthy A; Department of Biostatistics, Massachusetts General Hospital, Boston., Gallagher R; Division of Child Study Center, Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York., Lamendola-Essel MF; Department of Medicine, NYU Grossman School of Medicine, New York., Hasson DC; Division of Pediatric Critical Care Medicine, Department of Pediatrics, NYU Grossman School of Medicine, New York., Katz SD; Division of Cardiology, Department of Medicine, NYU Grossman School of Medicine, New York., Yin S; Division of General Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine, New York.; NYU Grossman School of Medicine, Bellevue Hospital Center, New York., Dreyer BP; Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine, New York., Carmilani M; RECOVER Patient, Caregiver, or Community Advocate Representative, New York, New York.; Long Covid Families, Charlotte, North Carolina., Coombs K; RECOVER Patient, Caregiver, or Community Advocate Representative, New York, New York.; Division of Long COVID, Department of Pandemic Equity, Vermont Center for Independent Living, Montpelier., Fitzgerald ML; RECOVER Patient, Caregiver, or Community Advocate Representative, New York, New York.; Patient Led Research Collaborative, Washington, DC., Güthe N; RECOVER Patient, Caregiver, or Community Advocate Representative, New York, New York., Hornig M; RECOVER Patient, Caregiver, or Community Advocate Representative, New York, New York.; CORe Community, Inc (COVID Recovery through Community, a 501c3), New York, New York., Letts RJ; RECOVER Patient, Caregiver, or Community Advocate Representative, New York, New York., Peddie AK; RECOVER Patient, Caregiver, or Community Advocate Representative, New York, New York., Taylor BD; RECOVER Patient, Caregiver, or Community Advocate Representative, New York, New York.; Division of Community Impact, Department of Health Strategies, American Heart Association, Atlanta, Georgia., Balaraman V; Department of Pediatrics, Kapi'olani Medical Center for Women and Children, University of Hawaii, John A. Burns School of Medicine, Honolulu, Hawaii., Bogie A; Department of Pediatrics, Oklahoma University Health Science Center, Oklahoma City., Bukulmez H; Division of Pediatric Rheumatology, Department of Pediatrics, MetroHealth System, Cleveland, Ohio., Dozor AJ; Division of Pediatric Pulmonology, Allergy, and Sleep Medicine, Department of Pediatrics, Boston Children's Health Physicians, New York Medical College, Valhalla., Eckrich D; Department of Biomedical Research Informatics Center, Nemours Children's Hospital Delaware, Wilmington., Elliott AJ; Avera Research Institute, Sioux Falls, South Dakota., Evans DN; Division of Research, Department of Research Administration, Arkansas Children's Hospital, Little Rock., Farkas JS; Department of Pediatrics, NYU Grossman School of Medicine, New York City Health and Hospitals Bellevue, New York., Faustino EVS; Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut., Fischer L; Pediatric Research Office, University of Nebraska Medical Center, Omaha., Gaur S; Division of Allergy, Immunology, and Infectious Diseases, Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey., Harahsheh AS; Division of Cardiology, Department of Pediatrics, Children's National Hospital, The George Washington University School of Medicine & Health Sciences, Washington, DC., Hasan UN; Division of Infectious Diseases, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, New Jersey., Hsia DS; Department of Clinical Trials Unit, Pennington Biomedical Research Center, Baton Rouge, Louisiana., Huerta-Montañez G; Division of Puerto Rico Testsite for Exploring Contamination Threats, Northeastern University, Boston, Massachusetts., Hummel KD; Division of Research, Department of Research Administration, Arkansas Children's Hospital, Little Rock., Kadish MP; Division of General Pediatrics, Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque., Kaelber DC; Departments of Pediatrics, Internal Medicine, and Population and Quantitative Health Sciences, MetroHealth System, Cleveland, Ohio., Krishnan S; Division of Pediatric Pulmonology, Allergy, and Sleep Medicine, Department of Pediatrics, Boston Children's Health Physicians, New York Medical College, Valhalla., Kosut JS; Department of Pediatrics, Kapi'olani Medical Center for Women and Children, University of Hawaii, John A. Burns School of Medicine, Honolulu, Hawaii., Larrabee J; Division of General Pediatrics, Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque., Lim PPC; Division of Infectious Diseases, Department of Pediatrics, University of South Dakota Sanford School of Medicine, Avera Research Institute, Sioux Falls., Michelow IC; Division of Infectious Diseases, Department of Pediatrics, Connecticut Children's Medical Center, University of Connecticut School of Medicine, Hartford., Oliveira CR; Division of Infectious Diseases, Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut., Raissy H; Division of Pulmonary, Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque., Rosario-Pabon Z; Division of Puerto Rico Testsite for Exploring Contamination Threats, Department of Civil and Environmental Engineering, Northeastern University, Boston, Massachusetts., Ross JL; Division of Pediatrics Administration, Department of Pediatrics, Thomas Jefferson University, Nemours Children's Hospital Delaware, Philadelphia, Pennsylvania., Sato AI; Division of Infectious Disease, Department of Pediatrics, University of Nebraska Medical Center, Omaha., Stevenson MD; Division of Norton Children's Emergency Medicine, Department of Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky., Talavera-Barber MM; Department of Pediatrics, University of South Dakota Sanford School of Medicine, Avera Research Institute, Sioux Falls., Teufel RJ; Department of Pediatrics, Medical University of South Carolina, Charleston., Weakley KE; Division of Norton Children's Infectious Diseases, Department of Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky., Zimmerman E; Division of Puerto Rico Testsite for Exploring Contamination Threats, Department of Communication Sciences & Disorders, Northeastern University, Boston, Massachusetts., Bind MC; Division of Biostatistics, Department of Medicine, Massachusetts General Hospital, Boston., Chan J; Department of Biostatistics, Massachusetts General Hospital, Boston., Guan Z; Department of Biostatistics, Massachusetts General Hospital, Boston., Morse RE; Department of Biostatistics, Massachusetts General Hospital, Boston., Reeder HT; Department of Biostatistics, Massachusetts General Hospital, Boston., Akshoomoff N; Department of Psychiatry, UC San Diego School of Medicine, Rady Children's Hospital, San Diego, California., Aschner JL; Center for Discovery and Innovation, Department of Pediatrics, Hackensack Meridian School of Medicine, Nutley, New Jersey., Bhattacharjee R; Division of Respiratory Medicine, Department of Pediatrics, UC San Diego School of Medicine, Rady Children's Hospital, San Diego, California., Cottrell LA; Department of Pediatrics, West Virginia University, Morgantown., Cowan K; Division of Pediatric Pulmonology, Department of Pediatrics, University of Vermont, Burlington., D'Sa VA; Department of Developmental Pediatrics, Rhode Island Hospital, Providence., Fiks AG; Division of General Pediatrics, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia., Gennaro ML; Public Health Research Institute, Departments of Medicine, Rutgers Robert Wood Johnson Medical School, Newark, New Jersey., Irby K; Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock., Khare M; Division of Hospital Medicine, Department of Pediatrics, UC San Diego School of Medicine, Rady Children's Hospital, San Diego, California., Guttierrez JL; Division of Respiratory Medicine, Department of Pediatrics, UC San Diego School of Medicine, Rady Children's Hospital, San Diego, California., McCulloh RJ; Division of Pediatric Hospital Medicine, Department of Pediatrics, University of Nebraska Medical Center, Omaha., Narang S; Cooperman Barnabas Medical Center, Livingston, New Jersey., Ness-Cochinwala M; Nicklaus Children's Hospital, Division of Population Health, Quality, and Implementation Sciences (PopQuIS), Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, Miami, Florida., Nolan S; Division of Infectious Diseases, Department of Pediatrics, Boston Children's Health Physicians, New York Medical College, Valhalla., Palumbo P; Divisions of Infectious Disease and International Health, Departments of Pediatrics and Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire., Ryu J; Division of Respiratory Medicine, Department of Pediatrics, UC San Diego School of Medicine, Rady Children's Hospital, San Diego, California., Salazar JC; Division of Infectious Diseases, Department of Pediatrics, Connecticut Children's Medical Center, University of Connecticut School of Medicine, Hartford., Selvarangan R; Department of Pediatrics, Children's Mercy Hospital and Clinics, Kansas City, Missouri., Stein CR; Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York., Werzberger A; Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, Best Healthcare Inc, Monroe, New York., Zempsky WT; Department of Pediatrics, Connecticut Children's Medical Center, University of Connecticut School of Medicine, Hartford., Aupperle R; Laureate Institute for Brain Research, Tulsa, Oklahoma., Baker FC; Center for Health Sciences, SRI International, Menlo Park, California., Banich MT; Institute of Cognitive Science and Department of Psychology and Neuroscience, University of Colorado Boulder., Barch DM; Departments of Psychological & Brain Sciences, Psychiatry, and Radiology, Washington University in St Louis, St Louis, Missouri., Baskin-Sommers A; Department of Psychology, Yale University, New Haven, Connecticut., Bjork JM; Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond., Bookheimer SY; Department of Psychiatry and Biobehavioral Sciences, University of Southern California, Children's Hospital Los Angeles., Brown SA; Department of Psychology and Psychiatry, UC San Diego School of Medicine, Rady Children's Hospital, San Diego, California., Casey BJ; Department of Psychology, Barnard College - Columbia University, New York, New York., Chang L; Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland Baltimore., Clark DB; Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania., Dale AM; Departments of Neurosciences, Radiology, and Psychiatry, UC San Diego School of Medicine, Rady Children's Hospital, San Diego, California., Dapretto M; Department of Psychiatry and Biobehavioral Sciences, University of Southern California, Children's Hospital Los Angeles., Ernst TM; Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland Baltimore., Fair DA; Institute of Child Development, Department of Pediatrics, Masonic Institute for the Developing Brain, University of Minnesota, Oregon Health & Science University, Minneapolis., Feldstein Ewing SW; Department of Psychology, University of Rhode Island, Kingston., Foxe JJ; Deptartment of Neuroscience, Del Monte Institute for Neuroscience, University of Rochester School of Medicine, Rochester, New York., Freedman EG; Deptartment of Neuroscience, Del Monte Institute for Neuroscience, University of Rochester School of Medicine, Rochester, New York., Friedman NP; Institute for Behavioral Genetics and Department of Psychology and Neuroscience, University of Colorado Boulder., Garavan H; Department of Psychiatry, University of Vermont, Burlington., Gee DG; Department of Psychology, Yale University, New Haven, Connecticut., Gonzalez R; Department of Psychology, Florida International University, Miami., Gray KM; Division of Addiction Sciences, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston., Heitzeg MM; Department of Psychiatry, University of Michigan, Ann Arbor., Herting MM; Department of Population and Public Health Sciences, University of Southern California, Children's Hospital Los Angeles., Jacobus J; Department of Psychiatry, UC San Diego School of Medicine, Rady Children's Hospital, San Diego, California., Laird AR; Department of Physics, Florida International University, Miami., Larson CL; Department of Psychology, University of Wisconsin-Milwaukee., Lisdahl KM; Department of Psychology, University of Wisconsin-Milwaukee., Luciana M; Department of Psychology, University of Minnesota, Minneapolis., Luna B; Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania., Madden PAF; Department of Psychiatry, Washington University in St Louis, St Louis, Missouri., McGlade EC; Departments of Psychiatry and Veteran Affairs, MIRECC, University of Utah School of Medicine, Salt Lake City., Müller-Oehring EM; Center for Health Sciences, SRI International, Menlo Park, California., Nagel BJ; Department of Psychiatry, Oregon Health & Science University, Portland., Neale MC; Virginia Institute for Psychiatric & Behavioral Genetics, Virginia Commonwealth University, Richmond., Paulus MP; Laureate Institute for Brain Research, Tulsa, Oklahoma., Potter AS; Division of Clinical Neuroscience Research Unit, Department of Psychiatry, University of Vermont, Burlington., Renshaw PF; Departments of Psychiatry and Veteran Affairs, MIRECC, University of Utah School of Medicine, Salt Lake City., Sowell ER; Department of Pediatrics, University of Southern California, Children's Hospital Los Angeles., Squeglia LM; Division of Addiction Sciences, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston., Tapert S; Department of Psychiatry, UC San Diego School of Medicine, Rady Children's Hospital, San Diego, California., Uddin LQ; Department of Psychiatry and Biobehavioral Sciences, University of Southern California, Children's Hospital Los Angeles., Wilson S; Institute of Child Development, University of Minnesota, Minneapolis., Yurgelun-Todd DA; Departments of Psychiatry and Veteran Affairs, MIRECC, University of Utah School of Medicine, Salt Lake City., Foulkes AS; Division of Biostatistics, Department of Medicine, Massachusetts General Hospital, Boston., Stockwell MS; Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York.; Department of Population and Family Health, Mailman School of Public Health, New York-Presbyterian Hospital, New York.
Jazyk:	angličtina
Zdroj:	JAMA [JAMA] 2024 Aug 21. Date of Electronic Publication: 2024 Aug 21.
DOI:	10.1001/jama.2024.12747
Abstrakt:	Importance: Most research to understand postacute sequelae of SARS-CoV-2 infection (PASC), or long COVID, has focused on adults, with less known about this complex condition in children. Research is needed to characterize pediatric PASC to enable studies of underlying mechanisms that will guide future treatment. Objective: To identify the most common prolonged symptoms experienced by children (aged 6 to 17 years) after SARS-CoV-2 infection, how these symptoms differ by age (school-age [6-11 years] vs adolescents [12-17 years]), how they cluster into distinct phenotypes, and what symptoms in combination could be used as an empirically derived index to assist researchers to study the likely presence of PASC. Design, Setting, and Participants: Multicenter longitudinal observational cohort study with participants recruited from more than 60 US health care and community settings between March 2022 and December 2023, including school-age children and adolescents with and without SARS-CoV-2 infection history. Exposure: SARS-CoV-2 infection. Main Outcomes and Measures: PASC and 89 prolonged symptoms across 9 symptom domains. Results: A total of 898 school-age children (751 with previous SARS-CoV-2 infection [referred to as infected] and 147 without [referred to as uninfected]; mean age, 8.6 years; 49% female; 11% were Black or African American, 34% were Hispanic, Latino, or Spanish, and 60% were White) and 4469 adolescents (3109 infected and 1360 uninfected; mean age, 14.8 years; 48% female; 13% were Black or African American, 21% were Hispanic, Latino, or Spanish, and 73% were White) were included. Median time between first infection and symptom survey was 506 days for school-age children and 556 days for adolescents. In models adjusted for sex and race and ethnicity, 14 symptoms in both school-age children and adolescents were more common in those with SARS-CoV-2 infection history compared with those without infection history, with 4 additional symptoms in school-age children only and 3 in adolescents only. These symptoms affected almost every organ system. Combinations of symptoms most associated with infection history were identified to form a PASC research index for each age group; these indices correlated with poorer overall health and quality of life. The index emphasizes neurocognitive, pain, and gastrointestinal symptoms in school-age children but change or loss in smell or taste, pain, and fatigue/malaise-related symptoms in adolescents. Clustering analyses identified 4 PASC symptom phenotypes in school-age children and 3 in adolescents. Conclusions and Relevance: This study developed research indices for characterizing PASC in children and adolescents. Symptom patterns were similar but distinguishable between the 2 groups, highlighting the importance of characterizing PASC separately for these age ranges.
Databáze:	MEDLINE
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