Publication

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

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Last modified
  • 06/17/2025
Type of Material
Authors
    Aline B. Maddux, University of Colorado, AuroraCameron C. Young, Boston Children's HospitalSuden Kucukak, Boston Children's HospitalLaura D. Zambrano, Centers for Disease Control and PreventionMargaret M. Newhams, Boston Children's HospitalCaitlin K. Rollins, Harvard UniversityNatasha B. Halasa, Vanderbilt UniversityShira J. Gertz, Cooperman Barnabas Medical CenterElizabeth H. Mack, University of South CarolinaStephanie Schwartz, University of North Carolina at Chapel HillMichele Kong, University of Alabama at BirminghamLaura L. Loftis, Texas Children's HospitalKatherine Irby, Arkansas Children's HospitalCourtney M. Rowan, Indiana University, IndianapolisKeiko Tarquinio, Emory UniversityMatt S. Zinter, University of California, San FranciscoHillary Crandall, University of Utah, Salt Lake CityNatalie Z. Cvijanovich, University of California, San FranciscoJennifer E. Schuster, Children's Mercy Kansas CityJulie C. Fitzgerald, University of PennsylvaniaMary A. Staat, University of CincinnatiCharlotte V. Hobbs, University of MississippiRyan A. Nofziger, Akron Children's HospitalSteven Shein, Rainbow Babies and Children's HospitalHeidi Flori, University of MichiganMelissa L. Cullimore, Children's Hospital and Medical CenterBrandon M. Chatani, AdventHealth for ChildrenEmily R. Levy, Mayo Clinic, RochesterKatri V. Typpo, University of ArizonaJanet R. Hume, University of MinnesotaAngela P. Campbell, Centers for Disease Control and PreventionAdrienne G. Randolph, Boston Children's Hospital
Language
  • English
Date
  • 2023-10-18
Publisher
  • Frontiers
Publication Version
Copyright Statement
  • © 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.
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Final Published Version (URL)
Title of Journal or Parent Work
Volume
  • 11
Start Page
  • 1260372
Grant/Funding Information
  • This study was funded by the Centers for Disease Control and Prevention (contracts #75D30120C07725 and #75D30121C10297 to AR) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (AM, K23HD096018).
Supplemental Material (URL)
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.
Author Notes
Keywords
Research Categories
  • Health Sciences, Epidemiology
  • Health Sciences, Public Health

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