Post-COVID syndrome in children: the results of a retrospective multicenter cross-sectional study

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Abstract

Background. Currently, there are no multicenter studies to determine the prevalence and incidence of symptoms of post-COVID syndrome (PCS) in children in different age groups, to develop consistent observation algorithms, and to identify therapy options.

Aim. To establish the risk factors for PCS in children and its CSs in the Russian Federation.

Materials and methods. A retrospective multicenter cross-sectional study was conducted. The initial stage of the study included 565 children at 7.6±0.17 months after the new coronavirus infection (NCVI) who were on outpatient or inpatient observation in different regions of Russia from November 2022 to May 2023. Patients were selected from 9 regions of the Russian Federation, such as Izhevsk, Kemerovo, Moscow, Omsk and Omsk region, Yekaterinburg and Sverdlovsk region, Ufa, Tyumen, Samara, Naberezhnye Chelny. All patients were offered a questionnaire. The questionnaire was developed and adapted based on the British and American consensus on the PCS, which included an assessment of the history, severity of the disease, clinical form of acute NCVI, therapy in the acute period of NCVI, and the presence of comorbidities. In addition, the course of acute NCVI and symptoms 3 months after the disease were evaluated by the following groups of CS: asthenia, respiratory disorders (RD), gastrointestinal disorders (GI), neurocognitive disorders (NCD), skin/adnexal lesions, olfactory/taste disorders, autonomic dysfunction (AD), anxiety. Of the 565 questionnaires received, 435 (76.9%) met the inclusion criteria and were available for subsequent analysis. The mean age was 9.0±0.25 years.

Results. During the acute period of the NCVI, asthenic syndrome (AS), RD and NCD, anxiety symptoms, olfactory/taste disorders, manifestations of AD, GI and skin/adnexal lesions were most often detected. Our study showed that after 3 months or more after NKVI, AS, NCD, and RD recurred in almost half of the observed children (53.1, 49.0 and 47.8%, respectively), anxiety was detected in 42,5% of cases, in more than 1/5 of children, AD, olfactory/taste and gastrointestinal disorders, in 14.3% skin/appendage lesions. Even 90 days after recovery from NCVI, more than half of patients reported impaired functionality, and most children had multiple complaints, which significantly impaired their quality of life. The risk of developing certain manifestations of PCS was increased in patients with comorbidities.

Conclusion. The study found that PCS developed in patients with severe, moderate, and mild acute COVID-19. The presence of comorbidities (allergic, neurological diseases, ENT disorders) statistically significantly increased the risk of PCS. The study's results further confirm the importance of continuous monitoring of NKVI sequelae in children and adolescents and the need for follow-up in children recovered from NKVI for 3-12 months.

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About the authors

Sofya A. Tsarkova

Ural State Medical University

Author for correspondence.
Email: tsarkova_ugma@bk.ru
ORCID iD: 0000-0003-4588-5909

Sci. (Med.), Prof., Ural State Medical University

 

Russian Federation, Ekaterinburg

Olga V. Zaytseva

Russian University of Medicine

Email: tsarkova_ugma@bk.ru
ORCID iD: 0000-0003-3426-3426

Sci. (Med.), Prof., Russian University of Medicine

Russian Federation, Moscow

Evelina E. Lokshina

Russian University of Medicine

Email: tsarkova_ugma@bk.ru
ORCID iD: 0000-0001-6006-7846

Cand. Sci. (Med.), Russian University of Medicine

Russian Federation, Moscow

Svetlana V. Zaytseva

Russian University of Medicine; Federal Research and Clinical Center for Children and Adolescents

Email: tsarkova_ugma@bk.ru
ORCID iD: 0000-0003-1685-234X

Cand. Sci. (Med.), Russian University of Medicine

Russian Federation, Moscow; Moscow

Elena P. Isaeva

Russian University of Medicine; Federal Research and Clinical Center for Children and Adolescents

Email: tsarkova_ugma@bk.ru
ORCID iD: 0000-0003-0927-0288

Cand. Sci. (Med.), Russian University of Medicine

Russian Federation, Moscow; Moscow

Olga A. Murtazaeva

Russian University of Medicine

Email: tsarkova_ugma@bk.ru
ORCID iD: 0000-0001-6533-099X

Cand. Sci. (Med.), Russian University of Medicine

Russian Federation, Moscow

Margarita K. Ermakova

Izhevsk State Medical Academy

Email: tsarkova_ugma@bk.ru
ORCID iD: 0000-0001-8780-2994

Sci. (Med.), Prof., Izhevsk State Medical Academy

Russian Federation, Izhevsk

Elena B. Pavlinova

Omsk State Medical University

Email: tsarkova_ugma@bk.ru
ORCID iD: 0000-0002-6444-1871

Sci. (Med.), Prof., Omsk State Medical University

Russian Federation, Omsk

Vera P. Vavilova

Kemerovo State Medical University

Email: tsarkova_ugma@bk.ru
ORCID iD: 0000-0001-8056-7274

Sci. (Med.), Kemerovo State Medical University

Russian Federation, Kemerovo

Antonina D. Petrushina

Tyumen State Medical University

Email: tsarkova_ugma@bk.ru
ORCID iD: 0000-0003-1567-3710

Sci. Prof., (Med.), Prof., Tyumen State Medical University

Russian Federation, Tymen

Reseda M. Faizullina

Bashkir State Medical University

Email: tsarkova_ugma@bk.ru

Sci. (Med.), Bashkir State Medical University.

Russian Federation, Ufa

Ziliya A. Shangareeva

Bashkir State Medical University

Email: tsarkova_ugma@bk.ru
ORCID iD: 0000-0001-8745-9989

Cand. Sci. (Med.), Assoc. Prof., Bashkir State Medical University

Russian Federation, Ufa

Nataliya M. Bochkareva

Samara State Medical University

Email: tsarkova_ugma@bk.ru
ORCID iD: 0000-0002-2890-2116

Cand. Sci. (Med.), Assoc. Prof., Samara State Medical University

Russian Federation, Samara

Olga N. Yashkina

Samara State Medical University

Email: tsarkova_ugma@bk.ru
ORCID iD: 0000-0002-8234-9809

Assistant, Samara State Medical University

Russian Federation, Samara

Kristina Iu. Peterson

Ural State Medical University

Email: tsarkova_ugma@bk.ru
ORCID iD: 0009-0002-4053-101X

Student, Ural State Medical University

Russian Federation, Ekaterinburg

Artem A. Selivanov

Ural State Medical University

Email: tsarkova_ugma@bk.ru
ORCID iD: 0009-0000-6992-8198

Student, Ural State Medical University

Russian Federation, Ekaterinburg

Elizaveta A. Shikina

Ural State Medical University

Email: tsarkova_ugma@bk.ru
ORCID iD: 0009-0001-6539-5272

Student, Ural State Medical University

Russian Federation, Ekaterinburg

Irina D. Kaib

Tyumen State Medical University

Email: tsarkova_ugma@bk.ru
ORCID iD: 0009-0009-8009-7052

Cand. Sci. (Med.)

Russian Federation, Tymen

Marija P. Kulichenko

Tyumen State Medical University

Email: tsarkova_ugma@bk.ru
ORCID iD: 0009-0001-8670-9066

Cand. Sci. (Med.)

Russian Federation, Tymen

Oksana Iu. Khalidullina

Tyumen State Medical University

Email: tsarkova_ugma@bk.ru
ORCID iD: 0000-0002-1004-3253

Cand. Sci. (Med.), Assoc. Prof.

Russian Federation, Tymen

Svetlana A. Ushakova

Tyumen State Medical University

Email: tsarkova_ugma@bk.ru
ORCID iD: 0000-0002-1667-3221

Sci. (Med.), Assoc. Prof., Tyumen State Medical University

 

Russian Federation, Tymen

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Supplementary files

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1. JATS XML
2. Fig. 1. PCS CSs in children (n=435).

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3. Fig. 2. Evaluation of odds ratio (OR) with 95% CI for factors that may affect the development of PCS CSs in children (start).

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4. Fig. 3. Estimation of OR with 95% CI for factors that may influence the development of PCS CSs in children (continued).

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5. Fig. 4. History of allergic diseases as a statistically significant risk factor that can affect the development of 5 out of 8 reported PCS CSs.

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6. Fig. 5. History of diseases of the ENT diseases as a statistically significant risk factor that can affect the development of 5 out of 8 reported PCS CSs.

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7. Fig. 6. History of obesity as a statistically significant risk factor that can affect the development of PCS CSs.

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8. Fig. 7. History of central nervous system disorders as a statistically significant risk factor that can affect the development of PCS CSs.

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9. Fig. 8. Age over 7 years in children as a statistically significant risk factor that can affect the development of 6 out of 8 reported PCS CSs.

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