International Care programs for Pediatric Post-COVID Condition (Long COVID) and the way forward.
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Brackel Caroline L H, Noij Lieke C E, Vijverberg Susanne J H, Legghe Camille L, Maitland-van der Zee Anke H, van Goudoever Johannes B, Buonsenso Danilo, Munblit Daniel, Sigfrid Louise, McFarland Sammie, Anmyr Lena, Ashkenazi-Hoffnung Liat, Bellinat Ana P N, Dias Nathália L S, Edwards Amy, Fashina Tomini, Juraški Romana Gjergja, Gonçalves Ana L N, Hansted Edita, Herczeg Vivien, Hertting Olof, Jankauskaite Lina N, Kaswandani Nastiti, Kevalas Rimantas, Krivácsy Péter, Lorenz Michael, Malone Laura A, McVoy Molly, Miller David W, Morrow Amanda K, Nugawela Manjula D, Oliveira Carlos R, Oliveira Pablo R S, Osmanov Ismael M, Overmars Isabella M, Paintsil Elijah, Pinto Pereira Snehal M, Prawira Yogi, Putri Nina Dwi, Ramos Regina C F, Rasche Marius, Ryd-Rinder Malin, De Rose Christina, Samitova Elmira, Jovanović Tatjana Savić, Say Daniela, Scott Janet T, Shachar-Lavie Iris, Shafran Roz, Shmueli Einat, Snipaitiene Ausra, Stephenson Terence, Ténai Nikolett, Tosif Shidan, Turkalj Mirjana, Valentini Piero, Vasconcelos Luydson R S, Villard Li, Vilser Daniel, Hashimoto Simone, Terheggen-Lagro Suzanne W J
Аннотация
METHODS: We performed a cross-sectional international, multicenter study on used PPCC definitions; the organization of PPCC care programs and patients characteristics. We compared aggregated data from PPCC cohorts and identified priorities to improve PPCC care.
RESULTS: Ten PPCC care programs and six COVID-19 follow-up research cohorts participated. Aggregated data from 584 PPCC patients was analyzed. The most common symptoms included fatigue (71%), headache (55%), concentration difficulties (53%), and brain fog (48%). Severe limitations in daily life were reported in 31% of patients. Most PPCC care programs organized in-person visits with multidisciplinary teams. Diagnostic testing for respiratory and cardiac morbidity was most frequently performed and seldom abnormal. Treatment was often limited to physical therapy and psychological support.
CONCLUSIONS: We found substantial heterogeneity in both the diagnostics and management of PPCC, possibly explained by scarce scientific evidence and lack of standardized care. We present a list of components which future guidelines should address, and outline priorities concerning PPCC care pathways, research and international collaboration.
IMPACT: Pediatric Post-COVID Condition (PPCC) Care programs have been initiated in many countries. Children with PPCC in different countries are affected by similar symptoms, limiting many to participate in daily life. There is substantial heterogeneity in diagnostic testing. Access to specific diagnostic tests is required to identify some long-term COVID-19 sequelae. Treatments provided were limited to physical therapy and psychological support. This study emphasizes the need for evidence-based diagnostics and treatment of PPCC. The International Post-COVID Collaboration for Children (IP4C) provides guidance for guideline development and introduces a framework of priorities for PPCC care and research, to improve PPCC outcomes.