Risk factors for health impairments in children after hospitalization for acute COVID-19 or MIS-C

Aline B. Maddux; Cameron C. Young; Suden Kucukak; Laura D. Zambrano; Margaret M. Newhams; Caitlin K. Rollins; Natasha B. Halasa; Shira J. Gertz; Elizabeth H. Mack; Stephanie Schwartz; Michele Kong; Laura L. Loftis; Katherine Irby; Courtney M. Rowan; Keiko M. Tarquinio; Matt S. Zinter; Hillary Crandall; Natalie Z. Cvijanovich; Jennifer E. Schuster; Julie C. Fitzgerald; Mary A. Staat; Charlotte V. Hobbs; Ryan A. Nofziger; Steven Shein; Heidi Flori; Melissa L. Cullimore; Brandon M. Chatani; Emily R. Levy; Katri V. Typpo; Janet R. Hume; Angela P. Campbell; Adrienne G. Randolph

doi:10.3389/fped.2023.1260372

Risk factors for health impairments in children after hospitalization for acute COVID-19 or MIS-C

Aline B. Maddux, Cameron C. Young, Suden Kucukak, Laura D. Zambrano, Margaret M. Newhams, Caitlin K. Rollins, Natasha B. Halasa, Shira J. Gertz, Elizabeth H. Mack, Stephanie Schwartz, Michele Kong, Laura L. Loftis, Katherine Irby, Courtney M. Rowan, Keiko M. Tarquinio, Matt S. Zinter, Hillary Crandall, Natalie Z. Cvijanovich, Jennifer E. Schuster, Julie C. FitzgeraldMary A. Staat, Charlotte V. Hobbs, Ryan A. Nofziger, Steven Shein, Heidi Flori, Melissa L. Cullimore, Brandon M. Chatani, Emily R. Levy, Katri V. Typpo, Janet R. Hume, Angela P. Campbell, Adrienne G. Randolph

Pediatrics - Pediatric Critical Care

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

Objective: To identify risk factors for persistent impairments after pediatric hospitalization for acute coronavirus disease 2019 (COVID-19) or multisystem inflammatory syndrome in children (MIS-C) during the SARS-CoV-2 pandemic. Methods: Across 25 U.S. Overcoming COVID-19 Network hospitals, we conducted a prospective cohort study of patients <21-years-old hospitalized for acute COVID-19 or MIS-C (May 2020 to March 2022) surveyed 2- to 4-months post-admission. Multivariable regression was used to calculate adjusted risk ratios (aRR) and 95% confidence intervals (CI). Results: Of 232 children with acute COVID-19, 71 (30.6%) had persistent symptoms and 50 (21.6%) had activity impairments at follow-up; for MIS-C (n = 241), 56 (23.2%) had persistent symptoms and 58 (24.1%) had activity impairments. In adjusted analyses of patients with acute COVID-19, receipt of mechanical ventilation was associated with persistent symptoms [aRR 1.83 (95% CI: 1.07, 3.13)] whereas obesity [aRR 2.18 (95% CI: 1.05, 4.51)] and greater organ system involvement [aRR 1.35 (95% CI: 1.13, 1.61)] were associated with activity impairment. For patients with MIS-C, having a pre-existing respiratory condition was associated with persistent symptoms [aRR 3.04 (95% CI: 1.70, 5.41)] whereas obesity [aRR 1.86 (95% CI: 1.09, 3.15)] and greater organ system involvement [aRR 1.26 (1.00, 1.58)] were associated with activity impairments. Discussion: Among patients hospitalized, nearly one in three hospitalized with acute COVID-19 and one in four hospitalized with MIS-C had persistent impairments for ≥2 months post-hospitalization. Persistent impairments were associated with more severe illness and underlying health conditions, identifying populations to target for follow-up.

Original language	English (US)
Article number	1260372
Journal	Frontiers in Pediatrics
Volume	11
DOIs	https://doi.org/10.3389/fped.2023.1260372
State	Published - 2023

Bibliographical note

Publisher Copyright:
2023 Maddux, Young, Kucukak, Zambrano, Newhams, Rollins, Halasa, Gertz, Mack, Schwartz, Kong, Loftis, Irby, Rowan, Tarquinio, Zinter, Crandall, Cvijanovich, Schuster, Fitzgerald, Staat, Hobbs, Nofziger, Shein, Flori, Cullimore, Chatani, Levy, Typpo, Hume, Campbell, Randolph and the Overcoming COVID-19 Investigators.

Keywords

COVID-19
COVID-19 post-intensive care syndrome
MIS-C
SARS-CoV-2
critical care outcomes
multisystem inflammatory syndrome in children
pediatrics
post-acute COVID-19 syndrome

PubMed: MeSH publication types

Journal Article

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.3389/fped.2023.1260372

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Maddux, A. B., Young, C. C., Kucukak, S., Zambrano, L. D., Newhams, M. M., Rollins, C. K., Halasa, N. B., Gertz, S. J., Mack, E. H., Schwartz, S., Kong, M., Loftis, L. L., Irby, K., Rowan, C. M., Tarquinio, K. M., Zinter, M. S., Crandall, H., Cvijanovich, N. Z., Schuster, J. E., ... Randolph, A. G. (2023). Risk factors for health impairments in children after hospitalization for acute COVID-19 or MIS-C. Frontiers in Pediatrics, 11, Article 1260372. https://doi.org/10.3389/fped.2023.1260372

Maddux, AB, Young, CC, Kucukak, S, Zambrano, LD, Newhams, MM, Rollins, CK, Halasa, NB, Gertz, SJ, Mack, EH, Schwartz, S, Kong, M, Loftis, LL, Irby, K, Rowan, CM, Tarquinio, KM, Zinter, MS, Crandall, H, Cvijanovich, NZ, Schuster, JE, Fitzgerald, JC, Staat, MA, Hobbs, CV, Nofziger, RA, Shein, S, Flori, H, Cullimore, ML, Chatani, BM, Levy, ER, Typpo, KV, Hume, JR, Campbell, AP & Randolph, AG 2023, 'Risk factors for health impairments in children after hospitalization for acute COVID-19 or MIS-C', Frontiers in Pediatrics, vol. 11, 1260372. https://doi.org/10.3389/fped.2023.1260372

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title = "Risk factors for health impairments in children after hospitalization for acute COVID-19 or MIS-C",

abstract = "Objective: To identify risk factors for persistent impairments after pediatric hospitalization for acute coronavirus disease 2019 (COVID-19) or multisystem inflammatory syndrome in children (MIS-C) during the SARS-CoV-2 pandemic. Methods: Across 25 U.S. Overcoming COVID-19 Network hospitals, we conducted a prospective cohort study of patients <21-years-old hospitalized for acute COVID-19 or MIS-C (May 2020 to March 2022) surveyed 2- to 4-months post-admission. Multivariable regression was used to calculate adjusted risk ratios (aRR) and 95% confidence intervals (CI). Results: Of 232 children with acute COVID-19, 71 (30.6%) had persistent symptoms and 50 (21.6%) had activity impairments at follow-up; for MIS-C (n = 241), 56 (23.2%) had persistent symptoms and 58 (24.1%) had activity impairments. In adjusted analyses of patients with acute COVID-19, receipt of mechanical ventilation was associated with persistent symptoms [aRR 1.83 (95% CI: 1.07, 3.13)] whereas obesity [aRR 2.18 (95% CI: 1.05, 4.51)] and greater organ system involvement [aRR 1.35 (95% CI: 1.13, 1.61)] were associated with activity impairment. For patients with MIS-C, having a pre-existing respiratory condition was associated with persistent symptoms [aRR 3.04 (95% CI: 1.70, 5.41)] whereas obesity [aRR 1.86 (95% CI: 1.09, 3.15)] and greater organ system involvement [aRR 1.26 (1.00, 1.58)] were associated with activity impairments. Discussion: Among patients hospitalized, nearly one in three hospitalized with acute COVID-19 and one in four hospitalized with MIS-C had persistent impairments for ≥2 months post-hospitalization. Persistent impairments were associated with more severe illness and underlying health conditions, identifying populations to target for follow-up.",

keywords = "COVID-19, COVID-19 post-intensive care syndrome, MIS-C, SARS-CoV-2, critical care outcomes, multisystem inflammatory syndrome in children, pediatrics, post-acute COVID-19 syndrome",

author = "Maddux, {Aline B.} and Young, {Cameron C.} and Suden Kucukak and Zambrano, {Laura D.} and Newhams, {Margaret M.} and Rollins, {Caitlin K.} and Halasa, {Natasha B.} and Gertz, {Shira J.} and Mack, {Elizabeth H.} and Stephanie Schwartz and Michele Kong and Loftis, {Laura L.} and Katherine Irby and Rowan, {Courtney M.} and Tarquinio, {Keiko M.} and Zinter, {Matt S.} and Hillary Crandall and Cvijanovich, {Natalie Z.} and Schuster, {Jennifer E.} and Fitzgerald, {Julie C.} and Staat, {Mary A.} and Hobbs, {Charlotte V.} and Nofziger, {Ryan A.} and Steven Shein and Heidi Flori and Cullimore, {Melissa L.} and Chatani, {Brandon M.} and Levy, {Emily R.} and Typpo, {Katri V.} and Hume, {Janet R.} and Campbell, {Angela P.} and Randolph, {Adrienne G.}",

note = "Publisher Copyright: 2023 Maddux, Young, Kucukak, Zambrano, Newhams, Rollins, Halasa, Gertz, Mack, Schwartz, Kong, Loftis, Irby, Rowan, Tarquinio, Zinter, Crandall, Cvijanovich, Schuster, Fitzgerald, Staat, Hobbs, Nofziger, Shein, Flori, Cullimore, Chatani, Levy, Typpo, Hume, Campbell, Randolph and the Overcoming COVID-19 Investigators.",

year = "2023",

doi = "10.3389/fped.2023.1260372",

language = "English (US)",

volume = "11",

journal = "Frontiers in Pediatrics",

issn = "2296-2360",

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TY - JOUR

T1 - Risk factors for health impairments in children after hospitalization for acute COVID-19 or MIS-C

AU - Maddux, Aline B.

AU - Young, Cameron C.

AU - Kucukak, Suden

AU - Zambrano, Laura D.

AU - Newhams, Margaret M.

AU - Rollins, Caitlin K.

AU - Halasa, Natasha B.

AU - Gertz, Shira J.

AU - Mack, Elizabeth H.

AU - Schwartz, Stephanie

AU - Kong, Michele

AU - Loftis, Laura L.

AU - Irby, Katherine

AU - Rowan, Courtney M.

AU - Tarquinio, Keiko M.

AU - Zinter, Matt S.

AU - Crandall, Hillary

AU - Cvijanovich, Natalie Z.

AU - Schuster, Jennifer E.

AU - Fitzgerald, Julie C.

AU - Staat, Mary A.

AU - Hobbs, Charlotte V.

AU - Nofziger, Ryan A.

AU - Shein, Steven

AU - Flori, Heidi

AU - Cullimore, Melissa L.

AU - Chatani, Brandon M.

AU - Levy, Emily R.

AU - Typpo, Katri V.

AU - Hume, Janet R.

AU - Campbell, Angela P.

AU - Randolph, Adrienne G.

N1 - Publisher Copyright: 2023 Maddux, Young, Kucukak, Zambrano, Newhams, Rollins, Halasa, Gertz, Mack, Schwartz, Kong, Loftis, Irby, Rowan, Tarquinio, Zinter, Crandall, Cvijanovich, Schuster, Fitzgerald, Staat, Hobbs, Nofziger, Shein, Flori, Cullimore, Chatani, Levy, Typpo, Hume, Campbell, Randolph and the Overcoming COVID-19 Investigators.

PY - 2023

Y1 - 2023

N2 - Objective: To identify risk factors for persistent impairments after pediatric hospitalization for acute coronavirus disease 2019 (COVID-19) or multisystem inflammatory syndrome in children (MIS-C) during the SARS-CoV-2 pandemic. Methods: Across 25 U.S. Overcoming COVID-19 Network hospitals, we conducted a prospective cohort study of patients <21-years-old hospitalized for acute COVID-19 or MIS-C (May 2020 to March 2022) surveyed 2- to 4-months post-admission. Multivariable regression was used to calculate adjusted risk ratios (aRR) and 95% confidence intervals (CI). Results: Of 232 children with acute COVID-19, 71 (30.6%) had persistent symptoms and 50 (21.6%) had activity impairments at follow-up; for MIS-C (n = 241), 56 (23.2%) had persistent symptoms and 58 (24.1%) had activity impairments. In adjusted analyses of patients with acute COVID-19, receipt of mechanical ventilation was associated with persistent symptoms [aRR 1.83 (95% CI: 1.07, 3.13)] whereas obesity [aRR 2.18 (95% CI: 1.05, 4.51)] and greater organ system involvement [aRR 1.35 (95% CI: 1.13, 1.61)] were associated with activity impairment. For patients with MIS-C, having a pre-existing respiratory condition was associated with persistent symptoms [aRR 3.04 (95% CI: 1.70, 5.41)] whereas obesity [aRR 1.86 (95% CI: 1.09, 3.15)] and greater organ system involvement [aRR 1.26 (1.00, 1.58)] were associated with activity impairments. Discussion: Among patients hospitalized, nearly one in three hospitalized with acute COVID-19 and one in four hospitalized with MIS-C had persistent impairments for ≥2 months post-hospitalization. Persistent impairments were associated with more severe illness and underlying health conditions, identifying populations to target for follow-up.

AB - Objective: To identify risk factors for persistent impairments after pediatric hospitalization for acute coronavirus disease 2019 (COVID-19) or multisystem inflammatory syndrome in children (MIS-C) during the SARS-CoV-2 pandemic. Methods: Across 25 U.S. Overcoming COVID-19 Network hospitals, we conducted a prospective cohort study of patients <21-years-old hospitalized for acute COVID-19 or MIS-C (May 2020 to March 2022) surveyed 2- to 4-months post-admission. Multivariable regression was used to calculate adjusted risk ratios (aRR) and 95% confidence intervals (CI). Results: Of 232 children with acute COVID-19, 71 (30.6%) had persistent symptoms and 50 (21.6%) had activity impairments at follow-up; for MIS-C (n = 241), 56 (23.2%) had persistent symptoms and 58 (24.1%) had activity impairments. In adjusted analyses of patients with acute COVID-19, receipt of mechanical ventilation was associated with persistent symptoms [aRR 1.83 (95% CI: 1.07, 3.13)] whereas obesity [aRR 2.18 (95% CI: 1.05, 4.51)] and greater organ system involvement [aRR 1.35 (95% CI: 1.13, 1.61)] were associated with activity impairment. For patients with MIS-C, having a pre-existing respiratory condition was associated with persistent symptoms [aRR 3.04 (95% CI: 1.70, 5.41)] whereas obesity [aRR 1.86 (95% CI: 1.09, 3.15)] and greater organ system involvement [aRR 1.26 (1.00, 1.58)] were associated with activity impairments. Discussion: Among patients hospitalized, nearly one in three hospitalized with acute COVID-19 and one in four hospitalized with MIS-C had persistent impairments for ≥2 months post-hospitalization. Persistent impairments were associated with more severe illness and underlying health conditions, identifying populations to target for follow-up.

KW - COVID-19

KW - COVID-19 post-intensive care syndrome

KW - MIS-C

KW - SARS-CoV-2

KW - critical care outcomes

KW - multisystem inflammatory syndrome in children

KW - pediatrics

KW - post-acute COVID-19 syndrome

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VL - 11

JO - Frontiers in Pediatrics

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ER -

Risk factors for health impairments in children after hospitalization for acute COVID-19 or MIS-C

Abstract

Bibliographical note

Keywords

PubMed: MeSH publication types

UN SDGs

Access

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