{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T10:16:18Z","timestamp":1771409778330,"version":"3.50.1"},"reference-count":35,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: The aim of this study was to identify patient clusters based on acute symptom profiles and individual characteristics most likely to develop pediatric post-acute sequelae of SARS-CoV-2 infection (PASC), as well as clusters among patients with PASC based on post-acute sequelae and associated characteristics. Methods: This multicenter cohort study in 12 Italian pediatric units enrolled patients aged 0\u201317 years within three months of a laboratory-confirmed SARS-CoV-2 infection. Participants who completed at least two surveys developed by the ISARIC over one year were analyzed. PASC was defined per WHO criteria. Multiple Correspondence Analysis and Hierarchical Clustering were performed. Results: Of 1137 children enrolled, 850 (76%) completed at least two surveys. The most prevalent age group was older children (6\u201311 years) (46%); adolescents (12\u201317) and young children (0\u20135) were numerically similar. Males were more represented (51.9%), except for the adolescent group (45.1%). PASC occurred in 32.8% of participants, with the distribution of sequelae types varying by age. Clustering in COVID-19 cases identified three clusters: young children mainly presented with respiratory symptoms and with a higher risk of hospitalization, while older children were spared in both acute and post-acute phases. Adolescents, particularly females, reported more pronounced acute symptoms and developed PASC more frequently. Clustering analysis of cases with PASC identified three clusters, confirming these age-related patterns. Young children still exhibited respiratory sequelae, and older children confirmed good recovery with minimal complications, while adolescents, especially females, remained the most affected subgroup, reporting persistent neuropsychological sequelae such as fatigue and insomnia. Conclusions: Findings support age-tailored follow-up, emphasizing respiratory monitoring for young children and targeted neuropsychological care for adolescents, particularly girls.<\/jats:p>","DOI":"10.3390\/children13020279","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T09:22:46Z","timestamp":1771406566000},"page":"279","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Phenotyping Pediatric Long COVID: Symptom Clusters from a Longitudinal Multicenter Italian Cohort"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4103-2837","authenticated-orcid":false,"given":"Susanna Maria Roberta","family":"Esposito","sequence":"first","affiliation":[{"name":"Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4497-1872","authenticated-orcid":false,"given":"Giuseppe","family":"Maglietta","sequence":"additional","affiliation":[{"name":"Clinical and Epidemiological Research Unit, University Hospital of Parma, 43126 Parma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatrice Rita","family":"Campana","sequence":"additional","affiliation":[{"name":"Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4601-7484","authenticated-orcid":false,"given":"Valentina","family":"Fainardi","sequence":"additional","affiliation":[{"name":"Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7515-1394","authenticated-orcid":false,"given":"Marco","family":"Poeta","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Disease Unit, Department of Maternal and Child Health, University Hospital \u201cFederico II\u201d, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefania","family":"Zampogna","sequence":"additional","affiliation":[{"name":"Department Pediatrics, Hospital of Crotone, 88900 Crotone, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3245-9396","authenticated-orcid":false,"given":"Claudia","family":"Colomba","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Diseases, \u201cG. Di Cristina\u201d Hospital, ARNAS Civico Di Cristina Benfratelli, University of Palermo, 90128 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5130-1450","authenticated-orcid":false,"given":"Agnese","family":"Suppiej","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences-Pediatric Section, University of Ferrara, 44121 Ferrara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Cardinale","sequence":"additional","affiliation":[{"name":"Complex Operating Unit Paediatrics, Giovanni XXIII Paediatric Hospital, University of Bari, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha","family":"Bosis","sequence":"additional","affiliation":[{"name":"Pneumology and Infectious Diseases Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5336-8429","authenticated-orcid":false,"given":"Elio","family":"Castagnola","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Unit, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Midulla","sequence":"additional","affiliation":[{"name":"Department of Maternal, Infantile and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo","family":"Giaquinto","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Diseases, Department of Women\u2019s and Children\u2019s Health, University of Padua, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paola","family":"Giordano","sequence":"additional","affiliation":[{"name":"Pediatric Unit, Department of Interdisciplinary Medicine, University of Bari \"Aldo Moro\", 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7441-9248","authenticated-orcid":false,"given":"Giacomo","family":"Biasucci","sequence":"additional","affiliation":[{"name":"Pediatrics and Neonatology Unit, Department of Medicine and Surgery, University of Parma, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7351-4104","authenticated-orcid":false,"given":"Francesco","family":"Nunziata","sequence":"additional","affiliation":[{"name":"General Pediatrics and Immuno-Rheumatology Unit, Santobono-Pausilipon Children\u2019s Hospital, AORN, 80129 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Grandinetti","sequence":"additional","affiliation":[{"name":"Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Condemi","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo 90100, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Raiola","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, \u201cPugliese-Ciaccio\u201d Hospital, 88100 Catanzaro, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfredo","family":"Guarino","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Disease Unit, Department of Maternal and Child Health, University Hospital \u201cFederico II\u201d, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6372-225X","authenticated-orcid":false,"given":"Francesca","family":"Diodati","sequence":"additional","affiliation":[{"name":"Clinical and Epidemiological Research Unit, University Hospital of Parma, 43126 Parma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3196-2435","authenticated-orcid":false,"given":"Caterina","family":"Caminiti","sequence":"additional","affiliation":[{"name":"Clinical and Epidemiological Research Unit, University Hospital of Parma, 43126 Parma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"05022","DOI":"10.7189\/jogh.14.05022","article-title":"Excess risks of long COVID symptoms compared with identical symptoms in the general population: A systematic review and meta-analysis of studies with control groups","volume":"14","author":"Xu","year":"2024","journal-title":"J. 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