{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T19:11:53Z","timestamp":1785870713685,"version":"3.56.0"},"reference-count":27,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,9,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>To evaluate risk factors for postdischarge sequelae in children and adolescents hospitalized for acute coronavirus disease 2019 (COVID-19) or multisystem inflammatory syndrome in children (MIS-C).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Multicenter prospective cohort study conducted in 25 United States pediatric hospitals. Patients &amp;lt;21-years-old, hospitalized May 2020 to May 2021 for acute COVID-19 or MIS-C with follow-up 2 to 4 months after admission. We assessed readmissions, persistent symptoms or activity impairment, and new morbidities. Multivariable regression was used to calculate adjusted risk ratios (aRR) and 95% confidence intervals (CI).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Of 358 eligible patients, 2 to 4 month survey data were available for 119 of 155 (76.8%) with acute COVID-19 and 160 of 203 (78.8%) with MIS-C. Thirteen (11%) patients with acute COVID-19 and 12 (8%) with MIS-C had a readmission. Thirty-two (26.9%) patients with acute COVID-19 had persistent symptoms (22.7%) or activity impairment (14.3%) and 48 (30.0%) with MIS-C had persistent symptoms (20.0%) or activity impairment (21.3%). For patients with acute COVID-19, persistent symptoms (aRR, 1.29 [95% CI, 1.04\u20131.59]) and activity impairment (aRR, 1.37 [95% CI, 1.06\u20131.78]) were associated with more organ systems involved. Patients with MIS-C and pre-existing respiratory conditions more frequently had persistent symptoms (aRR, 3.09 [95% CI, 1.55\u20136.14]) and those with obesity more frequently had activity impairment (aRR, 2.52 [95% CI, 1.35\u20134.69]). New morbidities were infrequent (9% COVID-19, 1% MIS-C).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Over 1 in 4 children hospitalized with acute COVID-19 or MIS-C experienced persistent symptoms or activity impairment for at least 2 months. Patients with MIS-C and respiratory conditions or obesity are at higher risk of prolonged recovery.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2022-057798","type":"journal-article","created":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T04:02:03Z","timestamp":1656475323000},"source":"Crossref","is-referenced-by-count":40,"title":["Health Impairments in Children and Adolescents After Hospitalization for Acute COVID-19 or MIS-C"],"prefix":"10.1542","volume":"150","author":[{"given":"Aline B.","family":"Maddux","sequence":"first","affiliation":[{"name":"aDepartment of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Berbert","sequence":"additional","affiliation":[{"name":"bBiostatistics and Research Design Center, Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cameron C.","family":"Young","sequence":"additional","affiliation":[{"name":"cDepartment of Anesthesiology, Critical Care, and Pain Medicine, Boston Children\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leora R.","family":"Feldstein","sequence":"additional","affiliation":[{"name":"dCOVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura D.","family":"Zambrano","sequence":"additional","affiliation":[{"name":"dCOVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suden","family":"Kucukak","sequence":"additional","affiliation":[{"name":"cDepartment of Anesthesiology, Critical Care, and Pain Medicine, Boston Children\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret M.","family":"Newhams","sequence":"additional","affiliation":[{"name":"cDepartment of Anesthesiology, Critical Care, and Pain Medicine, Boston Children\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen","family":"Miller","sequence":"additional","affiliation":[{"name":"aDepartment of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madyson M.","family":"FitzGerald","sequence":"additional","affiliation":[{"name":"cDepartment of Anesthesiology, Critical Care, and Pain Medicine, Boston Children\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"He","sequence":"additional","affiliation":[{"name":"bBiostatistics and Research Design Center, Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha B.","family":"Halasa","sequence":"additional","affiliation":[{"name":"eDivision of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie Z.","family":"Cvijanovich","sequence":"additional","affiliation":[{"name":"fDivision of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura L.","family":"Loftis","sequence":"additional","affiliation":[{"name":"gSection of Critical Care Medicine, Department of Pediatrics, Texas Children\u2019s Hospital, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracie C.","family":"Walker","sequence":"additional","affiliation":[{"name":"hDepartment of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie P.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"hDepartment of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shira J.","family":"Gertz","sequence":"additional","affiliation":[{"name":"iDivision of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiko M.","family":"Tarquinio","sequence":"additional","affiliation":[{"name":"jDivision of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie C.","family":"Fitzgerald","sequence":"additional","affiliation":[{"name":"kDepartment of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Kong","sequence":"additional","affiliation":[{"name":"lDivision of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer E.","family":"Schuster","sequence":"additional","affiliation":[{"name":"mDivision of Pediatric Infectious Disease, Department of Pediatrics, Children\u2019s Mercy Kansas City, Kansas City, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth H.","family":"Mack","sequence":"additional","affiliation":[{"name":"nDivision of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston, South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte V.","family":"Hobbs","sequence":"additional","affiliation":[{"name":"oDepartment of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, Mississippi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney M.","family":"Rowan","sequence":"additional","affiliation":[{"name":"pDivision of Pediatric Critical Care Medicine, Department of Pediatrics, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary A.","family":"Staat","sequence":"additional","affiliation":[{"name":"qDepartment of Pediatrics, University of Cincinnati, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matt S.","family":"Zinter","sequence":"additional","affiliation":[{"name":"rDepartment of Pediatrics, Division of Critical Care, University of California San Francisco, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Irby","sequence":"additional","affiliation":[{"name":"sSection of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock, Arkansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hillary","family":"Crandall","sequence":"additional","affiliation":[{"name":"tDivision of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Flori","sequence":"additional","affiliation":[{"name":"uDivision of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa L.","family":"Cullimore","sequence":"additional","affiliation":[{"name":"vDivision of Pediatric Critical Care, Department of Pediatrics, Children\u2019s Hospital and Medical Center, Omaha, Nebraska"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan A.","family":"Nofziger","sequence":"additional","affiliation":[{"name":"wDivision of Critical Care Medicine, Akron Children\u2019s Hospital, Akron, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven L.","family":"Shein","sequence":"additional","affiliation":[{"name":"xDivision of Pediatric Critical Care Medicine, Rainbow Babies and Children\u2019s Hospital, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Glas","family":"Gaspers","sequence":"additional","affiliation":[{"name":"yUniversity of Arizona, Diamond Children\u2019s Banner Children\u2019s Medical Center, Tucson, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet R.","family":"Hume","sequence":"additional","affiliation":[{"name":"zDivision of Pediatric Critical Care, University of Minnesota Masonic Children\u2019s Hospital, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily R.","family":"Levy","sequence":"additional","affiliation":[{"name":"aDepartment of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado"},{"name":"aaDivisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina R.","family":"Chen","sequence":"additional","affiliation":[{"name":"cDepartment of Anesthesiology, Critical Care, and Pain Medicine, Boston Children\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manish M.","family":"Patel","sequence":"additional","affiliation":[{"name":"dCOVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark W.","family":"Tenforde","sequence":"additional","affiliation":[{"name":"dCOVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edie","family":"Weller","sequence":"additional","affiliation":[{"name":"bBiostatistics and Research Design Center, Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, Massachusetts"},{"name":"bbDepartments of Pediatrics, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela P.","family":"Campbell","sequence":"additional","affiliation":[{"name":"dCOVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrienne G.","family":"Randolph","sequence":"additional","affiliation":[{"name":"cDepartment of Anesthesiology, Critical Care, and Pain Medicine, Boston Children\u2019s Hospital, Boston, Massachusetts"},{"name":"bbDepartments of Pediatrics, Harvard Medical School, Boston, Massachusetts"},{"name":"ccDepartment of Anaesthesia, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Overcoming COVID-19 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Demographic trends of COVID-19 cases and deaths in the US reported to CDC. Available at: https:\/\/covid.cdc.gov\/covid-data-tracker\/#demographics. Accessed March 28, 2022"},{"key":"2023110816365433800_B2","unstructured":"Centers for Disease Control and Prevention\n          . COVID data tracker. Available at: https:\/\/covid.cdc.gov\/covid-data-tracker\/#new-hospital-admissions. Accessed March 28, 2022"},{"key":"2023110816365433800_B3","unstructured":"CDC Health Alert Network\n          . Emergency preparedness and response: HAN00432. Available at: https:\/\/emergency.cdc.gov\/han\/2020\/han00432.asp. Accessed May 14, 2020"},{"issue":"11","key":"2023110816365433800_B4","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1001\/jama.2021.2091","article-title":"Characteristics and outcomes of US children and adolescents with multisystem inflammatory syndrome in children (MIS-C) compared with severe acute COVID-19","volume":"325","author":"Feldstein","year":"2021","journal-title":"JAMA"},{"issue":"9","key":"2023110816365433800_B5","doi-asserted-by":"crossref","first-page":"e005427","DOI":"10.1136\/bmjgh-2021-005427","article-title":"Characterising long COVID: a living systematic review","volume":"6","author":"Michelen","year":"2021","journal-title":"BMJ Glob Health"},{"issue":"5","key":"2023110816365433800_B6","doi-asserted-by":"crossref","first-page":"e2111417","DOI":"10.1001\/jamanetworkopen.2021.11417","article-title":"Assessment of the frequency and variety of persistent symptoms among patients with COVID-19: a systematic review","volume":"4","author":"Nasserie","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"11","key":"2023110816365433800_B7","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1001\/jamapediatrics.2021.2281","article-title":"Setting priorities to address research gaps in long-term COVID-19 outcomes in children","volume":"175","author":"Munblit","year":"2021","journal-title":"JAMA Pediatr"},{"issue":"2","key":"2023110816365433800_B8","doi-asserted-by":"crossref","first-page":"e2147053","DOI":"10.1001\/jamanetworkopen.2021.47053","article-title":"Prevalence of select new symptoms and conditions among persons aged younger than 20 years and 20 years or older at 31 to 150 days after testing positive or negative for SARS-CoV-2","volume":"5","author":"Hernandez-Romieu","year":"2022","journal-title":"JAMA Netw Open"},{"issue":"5","key":"2023110816365433800_B9","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1007\/s12519-021-00457-6","article-title":"Long COVID in children and adolescents","volume":"17","author":"Asadi-Pooya","year":"2021","journal-title":"World J Pediatr"},{"issue":"2","key":"2023110816365433800_B10","doi-asserted-by":"crossref","first-page":"2101341","DOI":"10.1183\/13993003.01341-2021","article-title":"Risk factors for long covid in previously hospitalised children using the ISARIC Global follow-up protocol: a prospective cohort study","volume":"59","author":"Osmanov","year":"2021","journal-title":"Eur Respir J"},{"issue":"7","key":"2023110816365433800_B11","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1016\/S2352-4642(21)00138-3","article-title":"6-month multidisciplinary follow-up and outcomes of patients with paediatric inflammatory multisystem syndrome (PIMS-TS) at a UK tertiary paediatric hospital: a retrospective cohort study","volume":"5","author":"Penner","year":"2021","journal-title":"Lancet Child Adolesc Health"},{"issue":"2","key":"2023110816365433800_B12","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1111\/apa.16191","article-title":"Population-based study of multisystem inflammatory syndrome associated with COVID-19 found that 36% of children had persistent symptoms","volume":"111","author":"Kahn","year":"2022","journal-title":"Acta Paediatr"},{"key":"2023110816365433800_B13","unstructured":"Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion\n          . Defining childhood weight status, BMI for children and teens. Available at: https:\/\/www.cdc.gov\/obesity\/childhood\/defining.html. 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