Standardized Approach to Pediatric Post-COVID Syndrome and Its Impact on Children and Adolescents: A Perspective From a Tertiary Center

Background:Pediatric post-COVID syndrome (pPCS) affects a notable number of children. This study aims to describe its clinical manifestations, biopsychosocial impact and management strategies.Methods:A prospective, single-center study was conducted to analyze data of pPCS patients presenting to our institution between May 2021 and November 2022. Functional impact was evaluated by assessing school absenteeism and by using the Adolescent Depression Rating Scale (ADRS), Pediatric Quality of Life Inventory (PedsQL) and Fatigue Severity Scale.Results:Among the 50 patients included [median age (interquartile range): 14.0 (12.9-15.8) years; females: 70%], the most common symptoms were extreme fatigue (84%), exertion intolerance (82%), orthostatism (66%), dyspnea (66%) and headache (66%); 25% had an abnormal Schellong test. Median (interquartile range) ADRS, PedsQL and Fatigue Severity Scale scores were 3.0 (1.0-5.0), 56% (49%-71%) and 45.0 (32.0-53.0), respectively. Sixty percent experienced partial (34%) or complete (26%) school absenteeism. The most common referrals to specialized consultations were child psychiatry (48%), pulmonology (46%), physiotherapy (36%) and an ear-nose-throat specialist (24%). Eighty percent had a typical form of pPCS, whereas 20% had a clinical presentation suggestive of a functional disorder triggered by COVID-19. The latter had more frequent thoracic pain (P = 0.012) and more referrals to pediatric neurology (P = 0.01), gastroenterology (P = 0.011), ophthalmology (P = 0.037) and child psychiatry (P = 0.035), but less to pulmonology (P = 0.014). School absenteeism and social withdrawal were also more common in this group, with more severe PedsQL and ADRS scores.Conclusion:pPCS is associated with a significant socio-educational burden that should be taken into account in medical, social and educational care.