학술논문
Persistent symptoms and decreased health-related quality of life after symptomatic pediatric COVID-19: A prospective study in a Latin American tertiary hospital
Document Type
article
Author
Fink, Thais T.; Marques, Heloisa H.S.; Gualano, Bruno; Lindoso, Livia; Bain, Vera; Astley, Camilla; Martins, Fernanda; Matheus, Denise; Matsuo, Olivia M.; Suguita, Priscila; Trindade, Vitor; Paula, Camila S.Y.; Farhat, Sylvia C.L.; Palmeira, Patricia; Leal, Gabriela N.; Suzuki, Lisa; Odone Filho, Vicente; Carneiro-Sampaio, Magda; Duarte, Alberto José S.; Antonangelo, Leila; Batisttella, Linamara R.; Polanczyk, Guilherme V.; Pereira, Rosa Maria R.; Carvalho, Carlos Roberto R.; Buchpiguel, Carlos A.; Latronico, Ana Claudia; Seelaender, Marilia; Silva, Clovis Artur; Pereira, Maria Fernanda B.; Sallum, Adriana M. E.; Brentani, Alexandra V. M.; Neto, Álvaro José S.; Ihara, Amanda; Santos, Andrea R.; Canton, Ana Pinheiro M.; Watanabe, Andreia; Santos, Angélica C. dos; Pastorino, Antonio C.; Franco, Bernadette D. G. M.; Caruzo, Bruna; Ceneviva, Carina; Martins, Carolina C. M. F.; Prado, Danilo; Abellan, Deipara M.; Benatti, Fabiana B.; Smaria, Fabiana; Gonçalves, Fernanda T.; Penteado, Fernando D.; Castro, Gabriela S. F. de; Gonçalves, Guilherme S.; Roschel, Hamilton; Disi, Ilana R.; Marques, Isabela G.; Castro, Inar A.; Buscatti, Izabel M.; Faiad, Jaline Z.; Fiamoncini, Jarlei; Rodrigues, Joaquim C.; Carneiro, Jorge D. A.; Paz, Jose A.; Ferreira, Juliana C.; Ferreira, Juliana C. O.; Silva, Katia R.; Bastos, Karina L. M.; Kozu, Katia; Cristofani, Lilian M.; Souza, Lucas V. B.; Campos, Lucia M. A.; Silva Filho, Luiz Vicente R. F.; Sapienza, Marcelo T.; Lima, Marcos S.; Garanito, Marlene P.; Santos, Márcia F. A.; Dorna, Mayra B.; Aikawa, Nadia E.; Litvinov, Nadia; Sakita, Neusa K.; Gaiolla, Paula V. V.; Pasqualucci, Paula; Toma, Ricardo K.; Correa-Silva, Simone; Sieczkowska, Sofia M.; Imamura, Marta; Forsait, Silvana; Santos, Vera A.; Zheng, Yingying
Source
Clinics. January 2021 76
Subject
Language
English
ISSN
1807-5932
Abstract
OBJECTIVES: To prospectively evaluate demographic, anthropometric and health-related quality of life (HRQoL) in pediatric patients with laboratory-confirmed coronavirus disease 2019 (COVID-19) METHODS: This was a longitudinal observational study of surviving pediatric post-COVID-19 patients (n=53) and pediatric subjects without laboratory-confirmed COVID-19 included as controls (n=52) was performed. RESULTS: The median duration between COVID-19 diagnosis (n=53) and follow-up was 4.4 months (0.8-10.7). Twenty-three of 53 (43%) patients reported at least one persistent symptom at the longitudinal follow-up visit and 12/53 (23%) had long COVID-19, with at least one symptom lasting for >12 weeks. The most frequently reported symptoms at the longitudinal follow-up visit were headache (19%), severe recurrent headache (9%), tiredness (9%), dyspnea (8%), and concentration difficulty (4%). At the longitudinal follow-up visit, the frequencies of anemia (11% versus 0%, p=0.030), lymphopenia (42% versus 18%, p=0.020), C-reactive protein level of >30 mg/L (35% versus 0%, p=0.0001), and D-dimer level of >1000 ng/mL (43% versus 6%, p=0.0004) significantly reduced compared with baseline values. Chest X-ray abnormalities (11% versus 2%, p=0.178) and cardiac alterations on echocardiogram (33% versus 22%, p=0.462) were similar at both visits. Comparison of characteristic data between patients with COVID-19 at the longitudinal follow-up visit and controls showed similar age (p=0.962), proportion of male sex (p=0.907), ethnicity (p=0.566), family minimum monthly wage (p=0.664), body mass index (p=0.601), and pediatric pre-existing chronic conditions (p=1.000). The Pediatric Quality of Live Inventory 4.0 scores, median physical score (69 [0-100] versus 81 [34-100], p=0.012), and school score (60 [15-100] versus 70 [15-95], p=0.028) were significantly lower in pediatric patients with COVID-19 at the longitudinal follow-up visit than in controls. CONCLUSIONS: Pediatric patients with COVID-19 showed a longitudinal impact on HRQoL parameters, particularly in physical/school domains, reinforcing the need for a prospective multidisciplinary approach for these patients. These data highlight the importance of closer monitoring of children and adolescents by the clinical team after COVID-19.