Post-coronavirus disease 2019-associated symptoms among children and adolescents in the SARS-CoV-2 Omicron era.

Purpose: Lack of a control group(s) and selection bias were the main criticisms of previous studies investigating the prevalence of post-coronavirus disease 2019 (COVID-19) syndrome (PCS). There are insufficient data regarding paediatric PCS, particularly in the SARS-CoV-2 Omicron era. As such, our study investigated PCS-associated symptoms in a representative control-matched cohort.

Methods: This multicentre, cross-sectional, cohort study within the "Immunebridge" project of the German Network University Medicine (NUM) recruited children and adolescents (five to 17 years old) between July and October 2022. Children with polymerase chain reaction-confirmed SARS-CoV-2 infection in 2022 (COVID-19 group) were compared with those without history of SARS-CoV-2 infection and negative for SARS-CoV-2 antibodies. Queries included vaccinations, quality of life (QoL), and mental and physical symptoms potentially associated with PCS in the previous three months. An additional composite item, "physical performance", was created from the responses.

Results: The number of children with ≥ 1 PCS symptom(s) was comparable between the COVID-19 (n = 114 [62.1%]) and control (n = 66 [64.9%]) groups. Concentration disorders were reported more frequently in the COVID-19 group (12.3% versus 1.5%; p = 0.012) and "physical performance" was significantly impaired (p = 0.016) regardless of age, sex, and SARS-CoV-2 vaccination. The frequencies of other symptoms were similar in both groups. The COVID-19 group rated their fitness as worse, with otherwise equal QoL ratings regarding general and mental health. Conclusion Children with and without previous infections did not differ in most PCS-associated symptoms. Exceptions included physical performance and cognitive problems, which appeared to be more impaired after Omicron infection than in controls.

What is known: • Mainly due to too few controlled studies, knowledge about the prevalence of individual symptoms in paediatric post-COVID-19 syndrome (PCS) for the Omicron era is poor.

What is new: • In a representative control-matched cohort most parent-reported PCS-associated symptoms and quality of life scores in children and adolescents with PCR-confirmed SARS-CoV-2 infection did not differ from those without infection. • Exceptions were physical performance and cognitive problems, which were apparently more severely impaired after SARS-CoV-2-Omicron infection than in the control subjects.