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Persistent symptoms and decreased health-related quality of life after symptomatic pediatric COVID-19: A prospective study in a Latin American tertiary hospital

Overview of attention for article published in Clinics, November 2021
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Persistent symptoms and decreased health-related quality of life after symptomatic pediatric COVID-19: A prospective study in a Latin American tertiary hospital
Published in
Clinics, November 2021
DOI 10.6061/clinics/2021/e3511
Pubmed ID

Thais T. Fink, Heloisa H.S. Marques, Bruno Gualano, Livia Lindoso, Vera Bain, Camilla Astley, Fernanda Martins, Denise Matheus, Olivia M. Matsuo, Priscila Suguita, Vitor Trindade, Camila S.Y. Paula, Sylvia C.L. Farhat, Patricia Palmeira, Gabriela N. Leal, Lisa Suzuki, Vicente Odone, Magda Carneiro-Sampaio, Alberto José S. Duarte, Leila Antonangelo, Linamara R. Batisttella, Guilherme V. Polanczyk, Rosa Maria R. Pereira, Carlos Roberto R. Carvalho, Carlos A. Buchpiguel, Ana Claudia L. Xavier, Marilia Seelaender, Clovis Artur Silva, Maria Fernanda B. Pereira, Adriana M. E. Sallum, Alexandra V. M. Brentani, Álvaro José S. Neto, Amanda Ihara, Andrea R. Santos, Ana Pinheiro M. Canton, Andreia Watanabe, Angélica C. dos Santos, Antonio C. Pastorino, Bernadette D. G. M. Franco, Bruna Caruzo, Carina Ceneviva, Carolina C. M. F. Martins, Danilo Prado, Deipara M. Abellan, Fabiana B. Benatti, Fabiana Smaria, Fernanda T. Gonçalves, Fernando D. Penteado, Gabriela S. F. de Castro, Guilherme S. Gonçalves, Hamilton Roschel, Ilana R. Disi, Isabela G. Marques, Inar A. Castro, Izabel M. Buscatti, Jaline Z. Faiad, Jarlei Fiamoncini, Joaquim C. Rodrigues, Jorge D. A. Carneiro, Jose A. Paz, Juliana C. Ferreira, Juliana C. O. Ferreira, Katia R. Silva, Karina L. M. Bastos, Katia Kozu, Lilian M. Cristofani, Lucas V. B. Souza, Lucia M. A. Campos, Luiz Vicente R. F. Silva, Marcelo T. Sapienza, Marcos S. Lima, Marlene P. Garanito, Márcia F. A. Santos, Mayra B. Dorna, Nadia E. Aikawa, Nadia Litvinov, Neusa K. Sakita, Paula V. V. Gaiolla, Paula Pasqualucci, Ricardo K. Toma, Simone Correa-Silva, Sofia M. Sieczkowska, Marta Imamura, Silvana Forsait, Vera A. Santos, Yingying Zheng


To prospectively evaluate demographic, anthropometric and health-related quality of life (HRQoL) in pediatric patients with laboratory-confirmed coronavirus disease 2019 (COVID-19). 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. 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. 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.

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Geographical breakdown

Country Count As %
Unknown 5 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 2 40%
Student > Master 2 40%
Unknown 1 20%
Readers by discipline Count As %
Medicine and Dentistry 3 60%
Nursing and Health Professions 1 20%
Environmental Science 1 20%