Age differences in prevalence and symptoms of post-COVID-19 condition among children: a prospective cohort study, 2025, Wu et al

Age differences in prevalence and symptoms of post-COVID-19 condition among children: a prospective cohort study

Yixin Wu, Xiangrong Sun, Jingyun Yang, Hailin Fan, Ouxuan Jin, Liwei Tang, Meixian Zhang, Lizhen Wang

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Abstract
Some individuals experience unexplained, persistent, or newly developed symptoms after coronavirus disease 2019 (COVID-19), known as post-COVID-19 condition (PCC).

We explored the age-related prevalence, symptoms, and associated factors for PCC in children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This prospective cohort study enrolled children with SARS-CoV-2 infection between December 7, 2022, and January 31, 2023. The participants were assessed via telephone 6 months post-SARS-CoV-2 diagnosis. PCC in children was diagnosed according to the World Health Organization definition.

In total, 1084 patients were eligible for matching and follow-up. Eventually, 785 patients (follow-up rate, 72.4%) completed the follow-up.

The incidence of PCC among pediatric patients with COVID-19 was 8%. The most common symptom reported by children diagnosed with PCC in all age groups was fatigue.

For patients aged 0–2 years, the presence of gastrointestinal symptoms (OR,6.323; 95% CI, 1.549–25.818) and neurological symptoms (OR, 3.816; 95% CI, 1.075–13.545) at the onset of COVID-19 were associated factors for PCC.

For patients aged 3–6 years, no associated factors associated with PCC were identified.

For patients aged 7–12 years, preexisting comorbidities (OR, 6.869; 95% CI, 2.209–21.360) were associated factors for PCC.

For patients aged 13–17 years, female sex (OR, 3.635; 95% CI, 1.164–11.355) and preexisting comorbidities (OR, 6.295; 95% CI, 2.052–19.316) were associated factors for PCC.

Conclusion: The incidence of PCC among pediatric patients with COVID-19 was 8%, with fatigue being the most commonly reported symptom across all age groups. The associated factors for PCC varied according to age groups.

What is Known:
• Post-COVID-19 condition (PCC) can significantly affect the psychological and physiological health of children.

•The characteristics of persistent symptoms and the incidence of PCC varied among children of different age groups.

What is New:
• Fatigue is the most common symptom of PCC in children of all age groups.

• The associated factors for PCC varied according to age group.

Link (European Journal of Pediatrics) [Paywall]