Maddux, Aline B.Young, Cameron C.Kucukak, SudenZambrano, Laura D.Newhams, Margaret M.Rollins, Caitlin K.Halasa, Natasha B.Gertz, Shira J.Mack, Elizabeth H.Schwartz, StephanieKong, MicheleLoftis, Laura L.Irby, KatherineRowan, Courtney M.Tarquinio, Keiko M.Zinter, Matt S.Crandall, HillaryCvijanovich, Natalie Z.Schuster, Jennifer E.Fitzgerald, Julie C.Staat, Mary A.Hobbs, Charlotte V.Nofziger, Ryan A.Shein, StevenFlori, HeidiCullimore, Melissa L.Chatani, Brandon M.Levy, Emily R.Typpo, Katri V.Hume, Janet R.Campbell, Angela P.Randolph, Adrienne G.Overcoming COVID-19 Investigators2024-04-182024-04-182023-10-18Maddux AB, Young CC, Kucukak S, et al. Risk factors for health impairments in children after hospitalization for acute COVID-19 or MIS-C. Front Pediatr. 2023;11:1260372. Published 2023 Oct 18. doi:10.3389/fped.2023.1260372https://hdl.handle.net/1805/40111Objective: 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.en-USAttribution 4.0 InternationalPost-acute COVID-19 syndromeCOVID-19 post-intensive care syndromeCritical care outcomesSARS-CoV-2Multisystem inflammatory syndrome in childrenMIS-CCOVID-19PediatricsArticle