Pediatric SARS-CoV-2 long term outcomes study (PECOS): cross sectional analysis at baseline
Authors: Montealegre Sanchez Gina A. , Arrigoni Lauren E. , Yonts Alexandra B. , Rubenstein Kevin B. , Bost James E. , Wolff Max T. , Barrix Mallory C. , Bandettini W. Patricia , Boateng Bema , Bulas Dorothy I. , Burklow Thomas R. , Carlyle Kayla P. , Chen Marcus , Das Sanchita , Dewar Robin L. , Dixon Austin A. , Edu Maureen A. , Falik Rachel L. , Geslak Monika L. , Gierdalski Marcin , Harahsheh Ashraf S. , Herbert Linda J. , Highbarger Jeroen , Huq Saira R. , Ko Arthur , Koumbourlis Anastassios C. , Lacey Stephanie R. , Lipton Andrew J. , Monaghan Maureen , Ndour Anta S. , Olivieri Laura J. , Pillai Dinesh K. , Rehm Catherine A. , Sable Craig A. , Sachdev Vandana , Thurm Audrey E. , Truong Uyen T. , Turkbey Evrim B. , Vilain Eric , Weyers Shera , White Jacob S. , Williams Abigail A. , Zember Jonathan , Liang C. Jason , Delaney Meghan , Batshaw Mark L. , Notarangelo Luigi D. , Wessel David L. , Barron Karyl , DeBiasi Roberta L. 
Published: December 2024

Abstract
Background
PECOS is an ongoing study aimed to characterize long-term outcomes following pediatric SARS-CoV-2 infection.

Methods
This is a cross-sectional analysis of infected and uninfected cohorts at baseline. Participants (0–21 years) with laboratory-confirmed SARS-CoV-2 infection were enrolled as infected. Uninfected were defined as individuals without history or laboratory evidence of SARS-CoV-2 infection. Outcome measures included demographics, medical history, review of symptoms, physical exam, cardiopulmonary evaluation and validated psychological and developmental surveys. Primary outcomes were cohort comparisons for abnormalities on all measures.

Results
654 participants (541 infected, 113 uninfected) completed baseline visits by June 30, 2023. Infected participants were more likely to report constitutional (OR: 2.24), HEENT (OR: 3.74); respiratory (OR: 2.41), or gastrointestinal (OR: 2.58) symptoms. Infected had worse scores in domains of Pain, Fatigue, Global Health, Physical and Cognitive functioning, Mobility and Sleep disturbances when compared to uninfected controls using Patient Reported Outcomes. Cardiopulmonary findings were similar among cohorts.

Conclusions
The first report of this ongoing longitudinal study demonstrates that infected participants were more likely to report symptoms compared to uninfected controls, which may affect performance and quality of life of these individuals. Longitudinal data will increase understanding of long-term effects of SARS-CoV-2 infection in children. ClinicalTrials.gov Identifier: NCT04830852

Impact

This study establishes a large, diverse, prospective, longitudinal, multi-center cohort of children with history of SARS-CoV-2 infection compared to an uninfected cohort to be followed for 3 years.

Cross-sectional cohort analysis at study entry showed infected participants were more likely to report constitutional, respiratory, and GI symptoms compared to uninfected controls.

Infected participants were more likely to have significantly worse parent-reported performance in 6 of 10 Patient Reported Outcome Measures domains.

Continued study of this cohort will help identify clinical sequelae of COVID-19, characterize the immune response to SARS-CoV-2 infection, and identify potential genetic/immunologic factors associated with long-term outcomes.