{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T17:54:15Z","timestamp":1789754055013,"version":"4.0.1"},"reference-count":43,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100022100","name":"Women\u2019s & Children\u2019s Hospital Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100022100","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The effects of SARS-Cov-2 infection can extend beyond the acute phase of the illness, often described as Long COVID, post-COVID condition (PCC) or Post-acute sequelae of COVID (PASC). Post-acute sequelae (PAS) are also likely to be a problem for a small proportion of children and adolescents following influenza infection. However, there is no comprehensive ongoing data collection in Australian children and adolescents, and global data on both PCC during the SARS-Cov-2 Omicron variant period and PAS following influenza is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study aims to determine the cumulative incidence of PCC in Australian children and adolescents five years after the start of the COVID-19 pandemic. Secondary aims include identifying the cumulative incidence of PAS in children and adolescents following influenza infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This longitudinal cohort study will recruit children and adolescents aged 0\u201318 years in South Australia who tested positive for SARS-Cov-2 or influenza in the previous 2 months. Following consent, participants will complete an online baseline survey and then at 3, 6, and 12 months post-infection. The survey has been adapted from the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) Paediatric COVID-19 follow-up survey. The survey includes validated assessment tools such as the Pediatric Quality of Life Inventory (PedsQL), Multidimensional Fatigue Scale, and the Malm\u00f6 Postural Orthostatic Tachycardia Syndrome (POTS) Score questionnaire. PCC following COVID-19 and PAS following influenza infection will be identified according to an adapted World Health Organization definition of PCC in children and adolescents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This study addresses gaps in understanding PCC and PAS following influenza in children and adolescents during Omicron circulation. Whilst it is no longer feasible to prospectively compare post-acute sequelae in children and adolescents who have never had COVID-19, this design allows a comparison with another common viral infection, influenza, informing clinical management of children post-infection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0341566","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T18:39:41Z","timestamp":1770316781000},"page":"e0341566","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Children and adolescents: Respiratory infection and long-term effects longitudinal study (CARE Study): Study protocol"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6490-7707","authenticated-orcid":true,"given":"Mark","family":"McMillan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Beazley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Vasilunas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas R.","family":"Sullivan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tess","family":"Edmond","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ailish","family":"Battersby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2993-6000","authenticated-orcid":true,"given":"Philip N.","family":"Britton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brendan","family":"McMullan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Jureidini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Del Fante","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen S.","family":"Marshall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,2,5]]},"reference":[{"issue":"7","key":"pone.0341566.ref001","first-page":"1227","article-title":"Symptom Profiles of Children and Young People 12 Months after SARS-CoV-2 Testing: A National Matched Cohort Study (The CLoCk Study)","volume":"10","author":"SM Pinto Pereira","year":"2023","journal-title":"Children (Basel)"},{"issue":"1","key":"pone.0341566.ref002","doi-asserted-by":"crossref","first-page":"3884","DOI":"10.1038\/s41598-024-54397-y","article-title":"Natural course of post-COVID symptoms in adults and children","volume":"14","author":"A Sugiyama","year":"2024","journal-title":"Sci Rep"},{"issue":"5","key":"pone.0341566.ref003","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2021.10323","article-title":"Characteristics Associated With Multisystem Inflammatory Syndrome Among Adults With SARS-CoV-2 Infection","volume":"4","author":"GE Davogustto","year":"2021","journal-title":"JAMA Netw Open"},{"key":"pone.0341566.ref004","unstructured":"Paediatric Active Enhanced Disease Surveillance (PAEDS). 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[cited 2025 Mar 11]. Available from: https:\/\/www.sahealth.sa.gov.au\/wps\/wcm\/connect\/public\u00b1content\/sa\u00b1health\u00b1internet\/clinical\u00b1resources\/health\u00b1notifications\/notifiable\u00b1disease\u00b1reporting\/notifiable\u00b1disease\u00b1reporting?finderTab=tab-2"},{"key":"pone.0341566.ref031","doi-asserted-by":"crossref","first-page":"103208","DOI":"10.1016\/j.jbi.2019.103208","article-title":"The REDCap consortium: Building an international community of software platform partners","volume":"95","author":"PA Harris","year":"2019","journal-title":"J Biomed Inform"},{"key":"pone.0341566.ref032","unstructured":"International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) - COVID19 Clinical research resources. University of Oxford; [cited 2023 Nov]. Available from: https:\/\/isaric.org\/research\/covid-19-clinical-research-resources\/"},{"issue":"8","key":"pone.0341566.ref033","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1097\/00005650-200108000-00006","article-title":"PedsQL 4.0: reliability and validity of the Pediatric Quality of Life Inventory version 4.0 generic core scales in healthy and patient populations","volume":"39","author":"JW Varni","year":"2001","journal-title":"Med Care"},{"issue":"12","key":"pone.0341566.ref034","first-page":"2494","article-title":"The PedsQL Multidimensional Fatigue Scale in pediatric rheumatology: reliability and validity","volume":"31","author":"JW Varni","year":"2004","journal-title":"J Rheumatol"},{"issue":"1","key":"pone.0341566.ref035","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1111\/joim.13566","article-title":"Malm\u00f6 POTS symptom score: Assessing symptom burden in postural orthostatic tachycardia syndrome","volume":"293","author":"JM Spahic","year":"2023","journal-title":"J Intern Med"},{"issue":"3","key":"pone.0341566.ref036","doi-asserted-by":"crossref","first-page":"200","DOI":"10.7326\/0003-4819-158-3-201302050-00583","article-title":"SPIRIT 2013 statement: defining standard protocol items for clinical trials","volume":"158","author":"A-W Chan","year":"2013","journal-title":"Ann Intern Med"},{"issue":"1","key":"pone.0341566.ref037","article-title":"Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis (TRIPOD): explanation and elaboration","volume":"162","author":"KGM Moons","year":"2015","journal-title":"Ann Intern Med"},{"key":"pone.0341566.ref038","unstructured":"Australian New Zealand Clinical Trials Registry (ANZCTR). 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