The risk of post-acute sequelae of SARS-CoV-2 infection (PASC), or long COVID, in children appears to be lower than what has been reported in adults, according to a recent study by the National Institutes of Health (NIH) RECOVER Pediatric Electronic Health Records (EHR) Cohort and written by Suchitra Rao, MD, an infectious disease specialist at Children's Hospital Colorado. In contrast to children who are hospitalized for acute COVID-19, more children have long COVID. A review of the findings appears in JAMA Pediatrics.

We came to the conclusion that while many of the symptoms children experience post-COVID-19 are similar to those reported in adults, some symptoms, like myocarditis, abnormal liver enzymes, hair loss, skin rashes, and diarrhea, are more specific to children. Understanding the short- and long-term effects of COVID-19 in children has become increasingly important. This is one of the largest studies we are aware of that looks at the post-acute consequences in children. Studies employing information from electronic health records are a wonderful tool to investigate theories that need to be confirmed in longer-term prospective studies.

While there are some similarities in the presentation between children and adults, there are also some differences. Children under the age of five, those with complicated medical conditions, and those hospitalized to the intensive care unit with their initial COVID-19 infection appear to be at higher risk for PASC.

59,893 children who tested positive for SARS-CoV-2 were compared to 59,286 children who tested negative in the exploratory study, "Syndromic, Systemic and Medication Features of Post-acute Sequelae of SARS-CoV-2 Infection in Children and Adolescents: EHR-based Cohort Study from the RECOVER Program," which used electronic health record data from PEDS net member institutions.

 

Using EHR data from children and adults under the age of 21 who underwent testing for SARS-CoV-2 at one of eight pediatric health systems nationwide between March 1, 2020, and October 31, 2021, the NIH RECOVER Pediatric EHR Cohort scientists conducted a multistate study. In the one to six months after testing, clinicians discovered ailments, symptoms, and drugs connected to PASC. 9 percent of the 660,000 kids who received testing were positive, and the majority of those were tested as outpatients.

The changes in loss of taste and smell, hair loss, chest discomfort, abnormal liver enzymes, skin rashes, fever and chills, exhaustion, and malaise were the symptoms most closely linked to infection. Myocarditis, severe respiratory distress, and myositis were the conditions most significantly linked to infection. Children who tested positive for PASC tended to receive mental health care more frequently than those who tested negative.