Characterizing Long COVID in Children and Adolescents
Authors: Gross Rachel S. , Thaweethai Tanayott , Kleinman Lawrence C. , Snowden Jessica N. , Rosenzweig Erika B. , Milner Joshua D. , Tantisira Kelan G. , Rhee Kyung E. , Jernigan Terry L. , Kinser Patricia A. , Salisbury Amy L. , Warburton David , Mohandas Sindhu , Wood John C. , Newburger Jane W. , Truong Dongngan T. , Flaherman Valerie J. , Metz Torri D. , Karlson Elizabeth W. , Chibnik Lori B. , Pant Deepti B. , Krishnamoorthy Aparna , Gallagher Richard , Lamendola-Essel Michelle F. , Hasson Denise C. , Katz Stuart D. , Yin Shonna , Dreyer Benard P. , Carmilani Megan , Coombs K. , Fitzgerald Megan L. , Güthe Nick , Hornig Mady , Letts Rebecca J. , Peddie Aimee K. , Taylor Brittany D. , Foulkes Andrea S. , Stockwell Melissa S. ,   RECOVER-Pediatrics Consortium,   RECOVER-Pediatrics Group Authors, Balaraman Venkataraman , Bogie Amanda , Bukulmez Hulya , Dozor Allen J. , Eckrich Daniel , Elliott Amy J. , Evans Danielle N. , Farkas Jonathan S. , Faustino E. Vincent S. , Fischer Laura , Gaur Sunanda , Harahsheh Ashraf S. , Hasan Uzma N. , Hsia Daniel S. , Huerta-Montanez Gredia , Hummel Kathy D. , Kadish Matt P. , Kaelber David C. , Krishnan Sankaran , Kosut Jessica S. , Larrabee Jerry , Lim Peter Paul C. , Michelow Ian C. , Oliveira Carlos R. , Raissy Hengameh , Rosario-Pabon Zaira , Ross Judith L. , Sato Alice I. , Stevenson Michelle D. , Talavera-Barber Maria M. , Teufel Ronald J. , Weakley Kathryn E. , Zimmerman Emily , Bind Marie-Abele C. , Chan James , Guan Zoe , Morse Richard E. , Reeder Harrison T. , Akshoomoff Natascha , Aschner Judy L. , Bhattacharjee Rakesh , Cottrell Lesley A. , Cowan Kelly , D'Sa Viren A. , Fiks Alexander G. , Gennaro Maria L. , Irby Katherine , Khare Manaswitha , Landeo Guttierrez Jeremy , McCulloh Russell J. , Narang Shalu , Ness- Cochinwala Manette , Nolan Sheila , Palumbo Paul , Ryu Julie , Salazar Juan C. , Selvarangan Rangaraj , Stein Cheryl R. , Werzberger Alan , Zempsky William T. , Aupperle Robin , Baker Fiona C. , Banich Marie T. , Barch Deanna M. , Baskin-Sommers Arielle , Bjork James M. , Bookheimer Susan Y. , Brown Sandra A. , Casey BJ , Chang Linda , Clark Duncan B. , Dale Anders M. , Dapretto Mirella , Ernst Thomas M. , Fair Damien A. , Feldstein Ewing Sarah W. , Foxe John J. , Freedman Edward G. , Friedman Naomi P. , Garavan Hugh , Gee Dylan G. , Gonzalez Raul , Gray Kevin M. , Heitzeg Mary M. , Herting Megan M. , Jacobus Joanna , Laird Angela R. , Larson Christine L. , Lisdahl Krista M. , Luciana Monica , Luna Beatriz , Madden Pamela A.F. , McGlade Erin C. , Müller-Oehring Eva M. , Nagel Bonnie J. , Neale Michael C. , Paulus Martin P. , Potter Alexandra S. , Renshaw Perry F. , Sowell Elizabeth R. , Squeglia Lindsay M. , Tapert Susan , Uddin Lucina Q. , Wilson Sylia , Yurgelun-Todd Deborah A. , Snowden Jessica N. , Darden Paul M. , Dixon Lexie , Ahmed Amal , Garbe Connor , Hobart-Porter Laura , Akerlundh Almary , Howard Lee , Hummel Kathy , Krehbiel Hannah , Spradlin Haley , Yount Paula , Alshawabkeh Akram , Ross Judith , McDevitt Carol , Eckrich Dan , Anderson Brett , Ikomi Chijoke , Katz Cheyenne , Katz Danielle , Aschner Judy , Kowal Karen , Meyer Marisa , Atz Andy , Atz Andrew , Nguyen Connie , Pellicciotti Gwen , Phan Thao-Ly , Ravin Karen , Reynolds Victoria , Baker Fiona , Baker Annette , Strang Abigail , Thacker Deepika , Goetter Annabelle , Banerjee Dithi , Barch Deanna , Cheung JoAnn , Hong Travis K.F. , Kalua Shanelle , Minami Evan , Siu Andrea , Tong Micah , Albarado Baylea , Allen Tracey , Attuso Allison , Ayers Taylor , Bebler Emily , Bella Grace , Bennett Alexa , Brown John , Brown Ryan , Brown Alexis , Brown Sandra , Carville Alison , Bjork James , Darby Sydnie , Devall Kara , Dragg Amber , Elderedge Angela , Fontenot Elisabeth , Fry Greta , Gildersleeve Bethany , Goff Sara , Harrington Lauren , Boyd Jackie , Jones Lisa , Kaiser Victoria , Kaiser Cassidy , Lee Yejee , Lee Stephen , Lee Donna , LeJeune Erin , Leonhard Robert , Levatino Jennifer , Buchbinder Natalie C. , Lewis Donald , Lloyd Angrielle , Monce Ron , Munro Susannah , Phillips Meghan , Pucheu Blair , Rachal Emily , Rood Jennifer , Roussel Stacey , Rumsey Renee , Sanford Connor , Casey Virginia , Santos Monica , Santos Melissa , Stafford Aryelle , Castro Norma , Thomassie Amy , Waguespack Celeste , Walgamotte Katherine , Welch Meredith , Windham Aubrey , Stevenson Michelle , Stevenson Lindsey , Bell Tiffany , Bell Liz , Dasgupta Soham , Deans Sarah , Harris Katie , Harris Donna , Harris Lori , Hemmerle Molly , King Sarah , McGuire Cameo , Chrisant Maryanne , Merten Brie , Morris Sarah , Ray Madison , Reinhardt Brooklyn , Clark Katelynne , Clark Duncan , Shemwell Shellese , Simeon Theresa , Walker Katherine , Clouser Katharine , Watson Sara , Connors Tom , Weakley Kathryn , McCulloh Russell , Figliomeni Johnathon , Costello John , Gamboa Laura , Cottrell Lesley , Morse Megan , Nabower Aleisha , Roberts Evan , Sato Alice , Simonsen Kari , Cummins Caroline , Von Bon Joann , Hoover Denise , D'Sa Viren , Dabney Sean , Fahrner Marie-Christine , Gallagher Torrey , Martini Karilyn , McNally Mary , Vivensi Stiverson Sarah , Archuleta David , Brito Rebecca , Campbell Richard , Chavez Jude , Chavez Sonia , Dehority Walter , Garcia-Soberanez Noelle , Gronert Eve , Kadish Matthew , Lovato Debbie , Luo Karen , Martinez Noah , Merlino Analyse , Diaz Maricela , Sterling Marcus , Ward Sarah , Ward Emily , Dionne Audrey , Wilson Kevin , Fergeson Gina , Dozor Allen , Karfonta Brittany , McKee Ryan , Moore Tiffany , Owens Valorie , Stubbs Sarah , VanWagoner Timothy , Elias Matthew , Walsh Tim , Agosto Roman Genesis , Elliott Amy , Ayala Ortiz Ishwara , Cordero Jose , De Jesus Jocelyn , Galan Crystal , Otero Nilda , Rivera Robles Mayra , Faustino Vince , Roman Priscilla , Roman Genesis , Fiks Alexander , Fiks Alex , Santiago Xiodenis , Velez-Vega Carmen , Vergara Carlos , Dantas Marina , Kasmarcak Tyler , Forsha Daniel , Milks Kreighton , Foxe John , Adam Grace , Andrew Rebecca , Freedman Edward , Angal Jyoti , Barber Maria , Cerkovnik Shelby , Dos Reis Clayton , Friedrich Christa , Garcia Carolina , Garcia Sergio , Garcia Sonia , Geigle Kellie , Gyasi Rachel , Gee Dylan , Hockett Christine , Gennaro Maria , Johannsen Rachel , Johnson Emily , Johnson Madison , Johnson Paige , Lang Jennifer , Lang Sean , Lim Peter , McCoy Meggie , Miler Lorie , Seiler Jessica , Sundleaf Bret , Torbert Nic , Trosper Billy , Werpy Jaime , Gray Kevin , Young Scott , Chassereau Laurie , Lahiri Thomas , Rampone Katherine , Lake Lauren , Moffett Kathy , Polak Emily , Stutler Sarah , Workman Charlotte , Warburton David , Mohandas Sindhu , Wood John C. , Hasbani Karen , Cain Rosalba , Carpenter Emma , Mejia Samantha , Heath Andrew , Moghadam Nelly , Mulder Candice , O'Neil Sharon , Rios Adrian , Rosen Sydney , Seals Natayla , Hester Christina M. , Smith Andrea , Smith Paulette , Tabibi Deeba , Hill Anthony , Milner Joshua , Rosenzweig Erika B. , Stockwell Melissa , Aquino Tawanda , Berg Elizabeth , Caddle Steve , Catallozzi Marina , Chung Wendy , Chung Anthony , De Aliva , Diaz Perez Anny , DiLorenzo Michael , Dumitriu Dani , Farooqi Kanwal , Fremed Michael , Goldman Sylvie , Kaplan Kayla , Krishnan Usha , Krishnan Anita , Layton Aimee , Lignelli-Dipple Angela , McClaren Son , Overdevest Jonathan , Rodriguez Michelle , Selman Jay , Silver Wendy , Jernigan Terry , Silverio Raul , Valdez de Romero Ana , Vargas Celibell , Vargas Crystal , Caputo Daniella , Leggieri Camille , Pretsch Pamela , Kleinman Lawrence , Cerracchio Lisa , Folnagy Amber , Kaelber David , Gzemski Sherri , Hao Yue , Li Simon , Moroso Sandee , Patel Akhil , Richlin Benjamin , Sharma Harsh , Soto Damaris , Kim Eugenia , Kim Doyeon (Dan) , Suarez Christian , Suarez Maira , Vargas Forero Bibiana , Kinser Patricia , Bean Emily , Kluko Matthew , DeFelice Carlie , El Chebib Hassan , Herbst Katherine W. , Lesmes Stephanie , Schulman Noah , Pace Wilson D. , Brooks-Greien Alicia , Colin Karinne , Juarez-Colunga Ariadna , Laird Angela , Manning Brian , Shields Joel , Westfall Jack , York Daphne , Olson Lynn , Larson Christine , Davis Kristin , Griffith Miranda , Macario Everly , Steffes Jennifer , Torres Alessandra , Griswold Justine , Nowakowski Amanda , Riordan Maryellen , Lisdahl Krista , Aamir Rozina , Abuzahrieh Mohammed , Liu Iris , Dalton Wendy , Fortuna Suzanne , Minium Judi , Rosolowski Bonnie , Nolan Sheila M. , Braniecki Suzanne , Mack Elizabeth , Contreras Montserrat , Jain Supriya , Kaseta Suzanne , Messer Zachary , Ramirez Armando , Singh Aalok , Singh Gautam , WIlliams Randy , Hasan Uzma , Ricciardi Elizabeth , Trespalacios Vanessa , Carter Yvonne , McCrindle Brian , Howell Kelsye , Mains Megan , Regis Trina , Tantisira Kelan , Tantisira Kelan G. , Rhee Kyung , Rhee Kyung E. , Warner Megan R. , Landeo Gutierrez Jeremy , Mitchell Elizabeth , Akshoomoff Natacha , Matta Ileana , Sanchez Cinthia , Sanchez Cinthia E. , Arroyo Maria , Chao Bryant Y. , Chao Bryant , Holguin Margarita , Reyes Sofia , Barrientos Wendy , Gomez Guadalupe , Herrera Trinidad , Kiernan Elizabeth , Schreck Andrea , Neale Mike , Newburger Jane , Celso Janelle , Franco Lizbeth , O'Connor Shawn , Glenn-Arroyo M. Rosie , Gutierrez Jeremy , Oster Matt , Joskowitz M. Katie , Moran Christine , Pyatt David , Ramos Vallej Lisa , Paulus Martin , Baroni Argelinda , Castro Ovalle Thomas Dylan , Farkas Jonathan S , Isidoro-Chino Maria , Kesebir Deniz , Quarless Ashley , Siddiqui Sarwat , Potter Alexandra , Srinivasan Ranjini , Thomason Moriah , Burton Phoebe , Cano Lorente Rosa , Wehbe Stephanie , Salisbury Amy , Espinoza Jocelyn , Espinoza Abby , Moyer Sara , Rider Amy , Russell Sally , Russell Mark , Schecter Michael , Rao Suchitra , Dale Anders , Aguilar Jose , Benjamin David , Emerson Brandy , Graves Jennifer , Guerrero Amanda , Linkersdoerfer Janosch , Schooley Robert , Thompson Wes , Trinh Thanh , Yang Ron , Herting Megan , Sowell Elizabeth , Cisneros Cynthia , Goedde Lauren , Manlhiot Cedric , Limia Jorge , Curry^ Melanie , El-Sabbagh Nour S. , Squeglia Lindsay , Agbeh Samuel , Herring Cori , Sanil Yamuna , Mckenzie Brittany , Nagel Bonnie , Morales Angie , Colrain^ Ian , Muller-Oehring Eva , Durley Ingrid , Uddin Lucina , Bookheimer Susan , Caldera Christina , Dzul Jennifer , Zarate Cinthia , Banich Marie , Badilla Paola , Keith Jennifer , Kumar G , Messinger^ David , Prazak Katie , Nixon Sara Jo , Cardoso Melanie , Sullivan Meagan , Sullivan Nancy , Villard Stephen , Ernst Thomas , Cloak Christine , Liang Huajun , Ryan Meghann C. , Heitzerg Mary , Conley Jennifer , Puttler^ Leonard , Srivastava Shubhika , Iacono^ William , Schroeder Aaron , Retucci Megan , Ni Mhurchu Sile , Spallina Samantha , McGlade Erin , Yurgelun-Todd Deborah , Cline Kirsten , Heinrich Lauren , Renshaw Perry , Szmuszkovicz Jackie , Barrett Cass , Lozon Sofia , Spear Samantha , Clearwater^ Tory , Kaiver^ Christine , Nelson Caitlin , Paltzer Zach , Peteet Bridgette , Calonge Olive , Slattery Noah , Straub Lisa , Truong Dongngan , Madden Pamela , Powell Taylor , Schmitz Denise , Epie^ Boris , Hobbs^ Rebekah , Williams^ Alex , Xiang Zhouran (Rick) , Miller Julie , Trachtenberg Felicia , Amarnath Ayesha , Ambrosoli James , Artis Denise , Bandari Sachin , Birmingham Emily , Wang Shuo , Eyob Lozan , Hayes Kerri , Hu Chenwei , Watkins Dara , Joyce Melissa , Joyce Emma , Kazlova Valentina , Marshall Amanda , Mbizdenyuy Devine , Mu PJ , Rowe Robin , Sayles Brooke , Zhang Mo , Burnett Melissa , Sanders-Lewis Kolby , McHugh Kim , Bickford Megan , Wong Pierre , Buckley Jason , Dennis Delany , Emrath-Zwick Elizabeth , Freeman Mary , Jackson Lanier , Pletzer Scott , Ruth Natasha , Taylor Carolyn , Zyblewski Sinai , Dunn Andrea , Fagatele Lilly , Lambert Linda , Sexson Kristin , Moussi Elias , Olukayode David , Pena Sandra , Pignatelli Ricardo , Serrano Faridis , Sexson Tejtel Sara , Shekerdemian Lara , DeFerrantini Sarah , Giorgio Thomas , Khan Numaira , Mahanta Simran , Son MaryBeth , Reis Georgia , Behzadian Fariborz , Canas Carla , Cheng Andrew , Scott Brandi , Gawad Mike , Kazarians Alicia , Sarkissian Anastasia , Secules Consuelo , Su Jennifer , Votava-Smith Jodie , Wagner-Lees Sharon , Aggarwal Sanjeev , Almasnaah Aiman , Kannikeswaran Nirupama , Meert Kathleen , Spencer Priya , Sundaralingam Sureja , Undyala Vishnu , Weber Amanda , Williams Farr Charmaine , Bradford Tamara , Johnston Marla , Forrest Chris , Albizem Dana , Coffin Susan , Giglia Therese , Lupton Katherine , Marks Grace , Morrison Tonia , Nelson^ Jennifer , Sachdeva Rachel , Britton Jordyn , Fetch Alix , Almaguer Marisa , Cnota Jim , Dugan Lauryn , Pickering Elise , Rathge Kathleen , Capone Christine , Misra Nilanjana , Shamailova Olga , Doman Tammy , Jani Sagar , Bainton Jessica , Alaby Doris , Barton Norma , Prospero Carol , Williams Ed , Zadokar Varsha , Sabati Arash , Domian Kylie , Herzberg Ashley , Khanna Sanjana , Nowlen Todd , Park Susan , Porche Jade , Stack Samantha , Dummer Kirsten , Bandy Sherrie , Burns Jane , Crane Katheryn , Hedge Sanjeet , Pancheri Joan , Tremoulet Adriana , Payne Ronald Mark , Stumpf Mary , Portman Michael , Kajimoto Hidemi , Osakwe Onyekachukwu , Morato Jemylle , Shakti^ Divya , Golub Katrina , Rojas Chanel , Rosalind Korsin , Sanchez Chantal , Anderson^ Brett , Sharma Kavita , Anguiano William , Ikemba Catherine , Lozano Alejandra , Martinez Maria , Rojas Wendy , Handler Stephanie , Block Joe , Cole Regina , Maldonado Jennifer , Jone Pei-Ni , Carr Michael , Goodell Lauren , Kar Wantanabe , Van't Hof Kathleen , Hebson Camden , Hock Krissie , Morgan Lerraughn , Macias Isaura , Owada Carl , Rangel Mayra , Sykes Michelle , Kadish Matt , Newman Lisa T. , Abella Julie , Barnette Quinn , Bevc Christine , Beverly Jennifer , Croxford Julie , Farris Tonya , Hanlon Sean , Hines David , Johnson-Lawrence Vicki , Lefebvre Craig , Linas Beth , Luukinen Bryan , Mandal Meisha , McKoy Nikki J. , Pasquarelli Demian , Quiner Claire , Sembajwe Rita , Thornburg Vanessa , Tosco Kendall , Wright Hannah , Gross Rachel S. , Hochman Judith S. , Horwitz Leora I. , Katz Stuart D. , Troxel Andrea B. , Adler Lenard , Akinbo Precious , Almenana Ramona , Aschalew^ Malate , Balick^ Lara , Bello Ola , Bhuiyan Sultana , Blachman Nina , Branski Ryan , Briscoe Jasmine , Brosnahan Shari , Bueler Elliott , Burgos Yvette , Caplin Nina , Chaplin Domonique , Chen Yu , Cheng Shen , Choe Peter , Choi Jess , Chung Alicia , Church Richard , Cobos Stanley , Croft Nakia , Cruz Irving Angelique , Del Boccio Phoebe , Díaz Iván , Divers Jasmin , Doshi Vishal , Dreyer Benard , Ebel Samantha , Esquenazi-Karonika Shari , Faustin Arline , Febres Elias , Fine Jeffrey , Fink Sandra , Freeland Catherine , Frontera Jennifer , Gallagher Richard , Gonzalez-Duarte Alejandra , Gross Rachel , Hasson Denise , Hill Sophia , Hochman Judith , Horwitz Leora , Hossain^ Jennifer , Islam Shahidul , Saint Jean Christina , Johnson Stephen , Kansal Neha , Katz Stuart , Kenney Rachel , Kershner^ Tammy , Kewlani Deepshikha , Kwak^ Judy , Lamendola-Essel Michelle F. , Laury^ Sarah , Laynor Gregory , Lei^ Lei , Leon Terry , Linton Janelle , Logan Max , Malik Nadia , Mamistvalova Lia , Mandel Hannah , Maranga Gabrielle , Mattoo Aprajita , Mei Tony , Mendelsohn Alan , Mercier Emmanuelle , Millar Vernetti Patricio , Miller Marc , Mitchell Maika , Moreira Andre , Mudumbi Praveen C. , Nahin Erica , Nair Nandini , Nekulak Joseph , Owens Kellie , Parent Brendan , Patibandla Nandan , Petrov Peter , Postelnicu Radu , Pratt Francesca , Randall Isabelle , Rao Priyatha , Rapkiewicz Amy , Rizzo JohnRoss , Rosas Johana , Rose Chelsea , Saint-Jean Christina , Santacatterina Michelle , Shah Binita , Shaukat Aasma , Simon Naomi , Simsir Aylin , Stinson Miranda , Tang Wenfei , Tatapudi Vasishta , Thawani Sujata , Thomas Mary , Thorpe Lorna , Tom MeeLee , Treiha Ethan , Troxel Andrea , Truong Jennifer , Udosen Mmekom , Valencia^ Carlos , Velazquez-Perez Jessica , Vidal Crystal , Viswanathan Anand , Willerford^ Amy , Williams^ Natasha , Wong Crystal , Wood Marion J. , Wuller Shannon , Yin Shonna H. , Young Chloe , Zaretsky Jonah , Zavlunova Susanna , Foulkes Andrea , Karlson Elizabeth , Murphy Shawn , Ahirwar Shreya , Ahmed Shifa , Ainsworth Layne Lyle , Atchley-Challenner Rachel , Avilach Paul , Balan Trisha Teston , Benik Nicholas , Benoit Barbara , Bind Marie-Abèle C. , Bonaventura William John , Boutin Natalie , Brion Beverly , Cagan Andrew , Cai Tianrun , Cao Tingyi , Castro Victor Manuel , Cerretani Xander R. , Chan James Gin Man , Chang Simon , Cheng David , Chibnik Lori Beth , Ciriello Mark , Costenbader Karen , Dimitrov Dimitar S. , Estiri Hossein , Fayad Maria , Feldman Candace H. , Gainer Vivian , Ghosh Bhaswati , Gollub Randy , Harris Alan , Helmer Karl , Hendrix Andrew , Holzbach Ana , Huang Weixing , Kaufman Daniel , Keogh Diane , Kerr James David , Klann Jeffrey Gordon , Krishnamoorthy Aparna , Lasky-Su Jessica A. , Liao Katherine P. , MacFadden Doug , Maram Anupama , Martel Megan Wilson , Mendis Michael , Metta Reeta , Monteiro Jonathan , Morales Eduardo , Nazaire Marc-Danie , Neils Gregory , Nguyen Amber Nghi , Norman James , Paik Henry Hyun-Il , Pant Deepti , Park HeeKyong , Rabideau Dustin John , Reeder Harrison Thomas , Rossi-Roh Kathleen , Santacroce Leah Mary , Schlepphorst Katherine , Schulte Carolin , Selvaggi Caitlin Ann , Shinnick Daniel James , Simons William , Simpson Lynn A. , St. Jean Flanders Mary Louise , Strasser Zachary , Thakrar Mansi R. , Thaweethai Tanayott , Thorn Madeleine , Trewett Philip , Van Fleet Dustin , Wagholikar Kavishwar B. , Wang Taowei David , Wattanasin Nich , Weber Griffin , Williams Michael Allyn , Zhang Ren Zhe , Cicek Mine , Boysen Erik M. , Chang Nancy , Flotte Thomas J , Frisch Erika , Welch Gary , Wirkus Samantha , Zahnle Nicole , Adams^   Sonseeahray (Ray) , Akintonwa   Teresa , Aragon   Leyna , Bander   Bryan , Bishof   Karyn , Blancero   Frank , Brooks^   Gail , Carignan   Etienne , Carmilani   Megan , Castro-Baucom   Leah , Cerda   Marta , Coombs   Krista , Copeland   Debra , Corchado   Claudia , Davis   Hannah , Blakley   Felicia D. , Diggs   Marissa , Edwards   Belinda , Brown   Heather E. , Favors   Umar , Fields^   Whitney , Fisher   Liza , Fitzgerald   Megan , Gaffney   Alicia , Gage Witvliet  Margot , Garcia^   Roberto , Gustafson   Tyler , Guthe   Nick , Hall   Yvonka , Holmes   Verna , Hornig   Mady , Hornig   Maxwell , Jefferson^   Wendy , Kim   Christina , Kochis   Nancy , Kondo   Kevin , Lam   Julie , Lawrence   Fadwa , Lerma   Lydia , Letts   Rebecca , Lewis   Juan , Lindsay   Jacqui , Lopez   Silcia , Marti   Heather , Martinez   Thomas , Maughan   Christine , McCorkell   Lisa , McGrath   Rebecca , Minor   Thomas T. , Moore   Charita , Nguyen   Kian , Nichols   Lauren , O'Brien   Lisa , Olson   Holly , Peddie   Aimee , Perlowski   Alice , Lorenzo   Elizabeth P. , Prentiss   Lisa , Raytselis   Nadia , Regino   Lidia , Roberts   Marjorie , Rochez   Nitza , Rockwell   Megan , Rutter   Jacqueline , Rochez^   Nitza , Seibert   Elle , Sekar   Anisha , Smith^   Chimere , Stiles   Lauren , Taylor   Brittany , Taylor   Emily , Thompson   Julie , Trapp^   Stephen , Valdiva   Stephen , Vincent   Hyatt , Wallace   Ann , Wilensky   Rochelle , Williams   Melissa , Williams   Neely , Dawson   Kay W. , Wylam   Andrew , Zissis  Mike , Balaraman Venkataraman , Bogie Amanda , Bukulmez Hulya , Dozor Allen J. , Eckrich Daniel , Elliott Amy J. , Evans Danielle N. , Farkas Jonathan S. , Faustino E. Vincent S. , Fischer Laura , Gaur Sunanda , Harahsheh Ashraf S. , Hasan Uzma N. , Hsia Daniel S. , Huerta-Montañez Gredia , Hummel Kathy D. , Kadish Matt P. , Kaelber David C. , Krishnan Sankaran , Kosut Jessica S. , Larrabee Jerry , Lim Peter Paul C. , Michelow Ian C. , Oliveira Carlos R. , Raissy Hengameh , Rosario-Pabon Zaira , Ross Judith L. , Sato Alice I. , Stevenson Michelle D. , Talavera-Barber Maria M. , Teufel Ronald J. , Weakley Kathryn E. , Zimmerman Emily , Bind Marie-Abele C. , Chan James , Guan Zoe , Morse Richard E. , Reeder Harrison T. , Akshoomoff Natascha , Aschner Judy L. , Bhattacharjee Rakesh , Cottrell Lesley A. , Cowan Kelly , D'Sa Viren A. , Fiks Alexander G. , Gennaro Maria L. , Irby Katherine , Khare Manaswitha , Guttierrez Jeremy Landeo , McCulloh Russell J. , Narang Shalu , Ness-Cochinwala Manette , Nolan Sheila , Palumbo Paul , Ryu Julie , Salazar Juan C. , Selvarangan Rangaraj , Stein Cheryl R. , Werzberger Alan , Zempsky William T. , Aupperle Robin , Baker Fiona C. , Banich Marie T. , Barch Deanna M. , Baskin-Sommers Arielle , Bjork James M. , Bookheimer Susan Y. , Brown Sandra A. , Casey BJ , Chang Linda , Clark Duncan B. , Dale Anders M. , Dapretto Mirella , Ernst Thomas M. , Fair Damien A. , Feldstein Ewing Sarah W. , Foxe John J. , Freedman Edward G. , Friedman Naomi P. , Garavan Hugh , Gee Dylan G. , Gonzalez Raul , Gray Kevin M. , Heitzeg Mary M. , Herting Megan M. , Jacobus Joanna , Laird Angela R. , Larson Christine L. , Lisdahl Krista M. , Luciana Monica , Luna Beatriz , Madden Pamela A.F. , McGlade Erin C. , Müller-Oehring Eva M. , Nagel Bonnie J. , Neale Michael C. , Paulus Martin P. , Potter Alexandra S. , Renshaw Perry F. , Sowell Elizabeth R. , Squeglia Lindsay M. , Tapert Susan , Uddin Lucina Q. , Wilson Sylia , Yurgelun-Todd Deborah A. 
Published: August 2024

Importance

Most research to understand postacute sequelae of SARS-CoV-2 infection (PASC), or long COVID, has focused on adults, with less known about this complex condition in children. Research is needed to characterize pediatric PASC to enable studies of underlying mechanisms that will guide future treatment.

Objective

To identify the most common prolonged symptoms experienced by children (aged 6 to 17 years) after SARS-CoV-2 infection, how these symptoms differ by age (school-age [6-11 years] vs adolescents [12-17 years]), how they cluster into distinct phenotypes, and what symptoms in combination could be used as an empirically derived index to assist researchers to study the likely presence of PASC.

Design, Setting, and Participants

Multicenter longitudinal observational cohort study with participants recruited from more than 60 US health care and community settings between March 2022 and December 2023, including school-age children and adolescents with and without SARS-CoV-2 infection history.

Exposure

SARS-CoV-2 infection.

Main Outcomes and Measures

PASC and 89 prolonged symptoms across 9 symptom domains.

Results

A total of 898 school-age children (751 with previous SARS-CoV-2 infection [referred to as infected] and 147 without [referred to as uninfected]; mean age, 8.6 years; 49% female; 11% were Black or African American, 34% were Hispanic, Latino, or Spanish, and 60% were White) and 4469 adolescents (3109 infected and 1360 uninfected; mean age, 14.8 years; 48% female; 13% were Black or African American, 21% were Hispanic, Latino, or Spanish, and 73% were White) were included. Median time between first infection and symptom survey was 506 days for school-age children and 556 days for adolescents. In models adjusted for sex and race and ethnicity, 14 symptoms in both school-age children and adolescents were more common in those with SARS-CoV-2 infection history compared with those without infection history, with 4 additional symptoms in school-age children only and 3 in adolescents only. These symptoms affected almost every organ system. Combinations of symptoms most associated with infection history were identified to form a PASC research index for each age group; these indices correlated with poorer overall health and quality of life. The index emphasizes neurocognitive, pain, and gastrointestinal symptoms in school-age children but change or loss in smell or taste, pain, and fatigue/malaise–related symptoms in adolescents. Clustering analyses identified 4 PASC symptom phenotypes in school-age children and 3 in adolescents.

Conclusions and Relevance

This study developed research indices for characterizing PASC in children and adolescents. Symptom patterns were similar but distinguishable between the 2 groups, highlighting the importance of characterizing PASC separately for these age ranges.