key: cord-0897857-qkwm76x6
authors: Matteudi, Tatiana; Luciani, Léa; Fabre, Alexandre; Minodier, Philippe; Boucekine, Mohammed; Bosdure, Emmanuelle; Dubus, Jean‐Christophe; Colson, Philippe; Chabrol, Brigitte; Morand, Aurélie
title: Clinical characteristics of paediatric COVID‐19 patients followed for up to 13 months
date: 2021-08-22
journal: Acta Paediatr
DOI: 10.1111/apa.16071
sha: 325e09d04671edb8ccd0fef60afe51fb776572f4
doc_id: 897857
cord_uid: qkwm76x6

Children are less affected by COVID-19 than adults1 . But, a small proportion of children develop paediatric inflammatory multisystem syndrome2 , with potentially lethal consequences. Studies have also described persistent long COVID symptoms that last more than four weeks from the onset of illness, including fatigue, muscle weakness, dyspnoea, chest pain, cough and anosmia2-5 . However, information on paediatric long COVID remains scarce and studies often describe hospitalised populations2,3 . We report the first 201 paediatric patients under 16 years old that were tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Marseille public hospitals during the first wave of the COVID-19 pandemic in France. We described the acute symptoms and long-term consequences of COVID-19 in the children, who were mostly outpatients.

Clinical characteristics of paediatric COVID-19 patients followed for up to 13 months 1 | INTRODUC TI ON Children are less affected by COVID-19 than adults. 1 But, a small proportion of children develop paediatric inflammatory multisystem syndrome, 2 with potentially lethal consequences. Studies have also described persistent long COVID symptoms that last more than 4 weeks from the onset of illness, including fatigue, muscle weakness, dyspnoea, chest pain, cough and anosmia. [2] [3] [4] [5] However, information on paediatric long COVID remains scarce and studies often describe hospitalised populations. 2, 3 We report the first 201 paediatric patients under 16 years old that were tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Marseille public hospitals during the first wave of the COVID-19 pandemic in France. We described the acute symptoms and long-term consequences of COVID-19 in the children, who were mostly outpatients.

Polymerase chain reaction assays were performed on nasopharyngeal swabs from 27 February to 15 May 2020, and the data were collected by Marseille university hospital.

Virus positive children were followed by the paediatric team via phone call 1, 2, 7, 14 and 30 days after the 1 st positive sample and 10-13 months after the acute phase.

We assessed their age, sex, risk factors including chronic diseases and obesity, household exposure, symptoms and evolution, laboratory findings, chest X-rays, hospitalisation rates, paediatric intensive care unit admissions and mortality. The severity of the disease was assessed using the classification described by Dong et al. Table 1 ). The most common long COVID-19 symptoms were asthenia (9.5%), learning difficulties (8.0%) and headache (5.8%). One had favourable outcomes with no viral fatalities. About a sixth had persistent and/or recurrent symptoms after COVID-19, 2-5 but had no inflammatory complications. 2 Asthenia was the most common persisting symptom. Children with symptomatic acute COVID-19 were significatively more susceptible to develop long-term symptoms.

In conclusion, open screening helped to detect asymptomatic carriers and moderately ill paediatric patients, especially when there were family clusters. This approach is enabling us to provide better clinical follow-up, including appropriate counselling and household isolation, especially if children have inflammatory complications or long COVID. 

Epidemiology of COVID-19 among children in China

Preliminary evidence on long COVID in children

& Sechenov StopCOVID Research Team. Risk factors for long covid in previously hospitalised children using the ISARIC Global follow-up protocol: a prospective cohort study

Evidence of lung perfusion defects and ongoing inflammation in an adolescent with postacute sequelae of SARS-CoV-2 infection

Similar patterns of 18F-FDG brain PET hypometabolism in paediatric and adult patients with long COVID: a paediatric case series

Additional supporting information may be found online in the Supporting Information section