Clinical and laboratory predictors of long-COVID in children: a single center retrospective study

OBJECTIVE: The majority of chil-dren experience a mild course of acute Corona -virus Disease 2019 (COVID-19). Only few studies have looked at long-term recovery from COVID-19 infection in children. The purpose of this study was to identify the predictors of long-COVID by performing a thorough analysis of the clinical, laboratory, and demographic characteristics of children with COVID-19. PATIENTS AND METHODS: Between August and October 2021, data were obtained retro-spectively from the medical records of 251 chil-dren diagnosed with COVID-19 at a tertiary sin-gle-center hospital. The prognostic effects of admission-related factors were compared be-tween patients who experienced long-lasting symptoms and those who did not. RESULTS: Long-COVID symptoms were noted in 12.4% of patients. Joint pain (7.6%), lumbago (4.8%), and headache (3.2%) were the most com-mon symptoms. The mean onset of long-COVID symptoms was 1.35 & PLUSMN;0.49 months. The onset of long-COVID symptoms was 4 weeks after initial diagnosis in 64.5% of patients and 4-8 weeks lat-er in 35.5% of the patients. The mean duration of long-COVID symptoms was 5.32 +/- 2.51 months. Children with long-COVID had higher leuko-cytes, neutrophils, monocytes, basophils, plate-lets, and D-dimer when compared with patients without long-COVID (p < 0.001). Leukocytes, neutrophils, monocytes, platelets, and D-dimer had the highest AUC in the ROC analysis (0.694, 0.658, 0.681, 0.667, and 0.612, respectively) and were statistically significant. CONCLUSIONS: Despite the majority of chil-dren with COVID-19 having mild or asymptom-atic acute disease, the majority of long-COVID symptoms were associated with functional im-pairment between 1 and 9 months after the start of the infection. Increased leukocytes, mono-cytes, neutrophils, platelets, and D-dimer ap-pear to be the most powerful laboratory predic-tors for long-COVID and monitoring these pre-dictors may assist clinicians to identify and fol-low-up patients with higher risk for long-COVID.