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Child Health Nursing Case Study

Care for one is love, and care for thousands is nursing is a wise saying that speaks volumes about nurses. And that too child health nursing or pediatric nursing is an art of science to take care of children from birth through adolescence. The responsibilities of child health nurses are taking care of children’s physical, emotional, and mental health. Also, it is to show concern for the cultural, social, and environmental influence on the children and their families.

Hence, institutes worldwide want their students to write child health nursing case studies about the challenges they could face in their future careers. Since it involves caring for children, including babies who cannot inform their issues or wants, writing these case studies is challenging. Hence, only the best  child health nursing case study help  experts who have real-time experience in taking care of children can help students write excellent case studies to get good grades.

Child Health Nursing Case Study Writing Help by Top Writers

The international laws and regulations prescribe many professional and practice standards for protecting children’s rights and families. It is vital to write the case study involving them to get recognition from the supervisors and good grades. A few of the professional and practice standards for child health nurses include:

  • All the health nursing practices should be within the tenets of an international and national child and family health protection.
  • Should inform all the rights prescribed in the laws and regulations to the child and the family
  • Create verbal and written links between care and the exemplary aspects of the child and family health protection
  • Promote informed decision making by telling the risks, benefits, and outcomes of using the healthcare regimes
  • Identify the theoretical principles and concepts that underlie the children’s growth and show the knowledge of physical, psychosocial, and spiritual health for their wellbeing.
  • Demonstrate many attributes like empathy, care, passion, dignity, respect, compassion, and others for the wellbeing
  • There are a few tools used in nursing statistics you need to have in-depth knowledge about proper ethics. As a candidate you may help the hospital with forecasting, data enrolment, and data representation.

The child health case study should concentrate on an understandable and concise text and the responsibilities of the child health nurses. In addition, it should focus on following them to take care of their physical, emotional, and mental health and demonstrate the concern for social, cultural, and environmental influence. Also, the case study should incorporate the philosophy, standards, trends, and goals of child health nursing. Finally, the child health case study should explain the problems faced by the hospitalized child, prenatal pediatrics, and other factors that influence their development. Only then will the case study get its due appreciation from the professors and be useful for future child health nursing careers.

Avail Nursing Case Study Writers for Your Assignment

Child health nurses take care of the children and specialize in specific fields of children’s health like anesthetics, oncology, neurology, and others. Hence, only the best MyCaseStudyHelp.Com  nursing assignment writers  can help students write these assignments in-depth research and real-time experience. But such excellent and experienced nursing assignment writers will be available only the best  child health nursing care study help  for students to seek their guidance and get top grades for their assignments, along with the proper appreciation by the supervisors.

Nursing Case Study Assignment Writing Assistance

Apart from nursing assignment writers with real-time experience, there is a need for a team of many such writers to write assignments on the diverse topics of childcare nursing topics. And only the best  assignment writing assistance  will have a top-notch team of expert and practical writers for students to write case studies and assignments on any childcare nursing topic. Also, we help students in the following ways to get the maximum grades for their childcare nursing assignments and case studies for a prosperous nursing career in the future.

  • The firsthand experienced  case study writers will help students write about children’s social and health care from babies to adolescence.
  • The team of real-time working MyCaseStudyHelp nursing assignment writers puts in their combined effort to make the childcare assignments have all the aspects required for the specific topic for the students to get recognition from the supervisors.
  • My Case Study Help expert researchers as writers for finding the relevant information for writing on diverse childcare nursing topics which are changing with time because of many factors like new illnesses, contagious diseases, parents’ lifestyles to affect the mental health of children, among others
  • We guide nursing students writing on clinical research on the past and present childcare research, along with the many health conditions commonly affecting children and their treatment methods, to have a promising nursing career in the future.
  • Our  nursing assignment help students understand the intricacies of childcare nursing and the challenges they may face during real-time nursing care to write successfully on such topics.
  • We guide students to write on care for the babies, including breastfeeding, vaccination, general health advice, routine checkups, and other emergency needs.
  • We assist students in writing case studies or assignments on treatment to parents for their anxiety, emotional issues, postnatal depression, and others.
  • Our  nursing case study writing service supports students in writing case studies and assignments on childcare problems like hospitalized children, behavioral issues, and factors influencing their growth, pediatric nursing unit, genetics, and prenatal pediatrics, among others.

For undergraduates and graduate students, we are available 24 hours a day, 7 days a week to help them ace their case studies and get outstanding grades. Only the best nursing case study service – My Case Study Help will help the students in all the above ways and write excellent case studies and assignments to get good grades and help them be in demand worldwide for a prosperous and soul-satisfying nursing career.

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Study guide for Maternal & child health nursing : care of the childbearing and childrearing family, seventh edition

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Paediatrics in Russia: past, present and future

Alexander baranov.

Federal State Autonomous Institution ‘National Scientific and Practical Center of Children’s Health’ of the Ministry of Health of the Russian Federation, Moscow, Russia

Leyla Namazova-Baranova

Valery albitsky, natalia ustinova, rimma terletskaya, olga komarova.

Russia is the largest country in the world, with an area spanning more than 17 million km 2 . Her population, according to the official statistics (as of 1 January 2014), is 143 666 931 people (which is the ninth place in the world). Children under the age of 18 make for approximately 19.1% of Russia’s population (27  374 352). This population is spread extremely unevenly over her huge territory: 72.2% of Russians live in the European part of the country, which comprises only 25% of the whole territory. 1 The Moscow region has the highest population density among all other regions, with more than 4626 persons/km 2 . The least density belongs to the Chukotka Autonomous Region, with less than 0.07 persons/km 2 .

Evolution of the Russian child care system: from the Russian Empire to modern days

The Russian child care system has been supported by state and private contributions since the times of monarchy. The state’s first steps towards building a childhood and motherhood protection system date back to the 18th century when the first orphanages appeared by the orders of Empress Catherine II (1763 in Moscow and 1770 in St Petersburg). These orphanages had their own hospitals where the children received medical treatment. 2 3

The drive behind the formation of the system of mothers and children care was the struggle for reducing child mortality rates, which was named as one of the most important Russian social issues in the late 19th century and in the beginning of the 20th century. 4 High mortality rates were largely due to poor social, cultural and economic conditions.

Russian paediatrics has always been an integral part of world science and practice. For example, Karl Martens was the first chief doctor of the Moscow foundling hospital, and saved the wards from the plague epidemic of 1771–1773. His treatise on this subject (published in Paris in 1784) had a big impact on the medical science of the day, and was republished 35 times in Europe and America in five languages. Another German doctor, Johann Heinrich Jänish, was the first doctor to vaccinate against smallpox at the same hospital in 1773–1780.

The healthcare model as formulated after the 1917 coup (the Soviet healthcare system) was based on the six following principles 5 6 :

  • the state’s responsibility for healthcare
  • free healthcare for everyone
  • special attention to maternity and childhood
  • promotion of a healthy lifestyle, prevention and prophylaxis
  • preventive treatment of socially significant diseases
  • involving society into healthcare activities.

The issues of maternal and child health have received special attention in the Soviet healthcare system from its very beginning, adult and child healthcare were separated, and special highly qualified child doctors (paediatricians) were being trained. For the first time in the world, medical faculties of universities began the training of child doctors in 1930 in the USSR. Paediatric education included special hours for teaching all medical subjects (anatomy, physiology, biochemistry, etc) as applied specifically to children.

The outpatient polyclinic was (and still is) the main place for the protection of children’s health (the central figure is the district paediatrician). Child polyclinics deliver all preventive and therapeutic activities (including vaccination and health monitoring), and if necessary the child can be directed for inpatient treatment to child hospitals, then depending on the situation, he or she either returns back to be observed by the local paediatrician or is sent to the next stage—sanatorium/resort rehabilitation.

During the first years of the Soviet power, there was much bidirectional academic exchange that continued after the end of the Stalin era. For the majority of doctors, however, participation in international conferences and congresses was impossible (due to the ‘iron curtain’), but leading scientists and clinicians preserved the connection to the world paediatric community.

We should note that the Soviet healthcare model for children had obvious advantages, including the following:

  • high accessibility of primary and specialised medical help
  • state-guaranteed free medical help
  • maternity and childhood protection priority
  • preventive orientation
  • step-by-step medical treatment.

At the same time, the Soviet model had some clear problems:

  • lack of funding
  • problems with supplying enough modern medicines, high tech medical equipment and expendables.

At the end of the 1980s there was some reorganisation of the child healthcare system that focused primarily on the neonatal and perinatal services after one of the authors of this article (AAB) became head of the child and maternity protection service of the USSR Health Ministry.

Post-Soviet child healthcare development: main state and social initiatives

The Russian healthcare system, although retaining a lot of key Soviet principles, has been greatly altered in terms of funding and management since 1991. The state healthcare has been divided into federal and regional systems. The funding became mixed—state-based and insurance-based.

The Ministry of Health order ‘On the transfer to WHO live and still birth criteria’ was signed in 1992, with a subsequent programme being developed for reaching these criteria (criteria came into effect in 2012). 

From 1999, adolescents under the age of 18 were added to the paediatric service area of responsibility. Before this paediatricians dealt only with children up to 15 years old.

In order to reduce the infant mortality rate further, more than 100 modern perinatal centres were created and new ones are being built all the time. This allowed achieving a reduction in perinatal and obstetric pathology through rationally applying modern expensive neonatal and obstetric technologies.

  • Vaccination. The programme is in line with WHO recommendations, although it does not currently include rotavirus and papillomavirus immunisation and is totally funded by the federal budget. Some regions of Federation have adopted a broader local calendar of preventive vaccines, including 17 diseases (at the expenses of regional budgets).
  • Neonatal screening. In accordance with international recommendations, Russia conducted neonatal screening on phenylketonuria and congenital hypothyroidism. Since 2006 adrenogenital syndrome, galactosaemia and cystic fibrosis have been included in screening. Audiological screening of first-year children, which helps to diagnose hearing infringements in children at an early stage and thus make a rehabilitation possible, was started in 2007.
  • Professional societies. Over the years following the collapse of the Soviet Union, the paediatric community (one of the biggest medical communities), being united into the Union of Pediatricians of Russia, has developed an active social position. For example, in 2005 the community managed to save the unique structure of primary paediatric aid with the local paediatrician being the key figure, instead of the Western model with the general practitioner, which doesn’t take into account the special features of the Russian child healthcare system.

International collaboration After 1991 the international cooperation has greatly increased in terms of child healthcare. The two main trends of international cooperation in this area are political and professional.

These include the direct participation of Government and Health Ministry leaders as part of defining the global strategy, and the Russian healthcare’s role in the global and regional processes such as forming the position towards the plans and programmes of international organisations, international treaties and priority areas of international cooperation.

Further work is being undertaken as part of professional international community interchange. The Russian paediatric society actively communicates with international professional organisations, and in 2009 the IV EUROPAEDIATRICS was held for the first time in history in Moscow. In 2013 a Russian paediatrician (L Namazova-Baranova) was elected as President of the European Paediatric Association and Union of National European Pediatric Societies and Associations (UNEPSA) (which was created in 1976 to unite paediatricians from both parts of Europe through the ‘iron curtain’).

The Scientific Centre of Children’s Health is the leading paediatric facility that coordinates the scientific and research activities concerning the protection of child health in Russia. It is notable that over the centuries, child health protection is still being secured by the successor of the first Moscow hospital (now called the Scientific Centre of Children’s Health), which celebrated its 250th birthday in 2013. 7

The present day

Today there is a united healthcare system in Russia that consists of subsystems ordered hierarchically. The Ministry of Health exercises the coordinating functions.

The child healthcare system is composed of a network of outpatient and inpatient facilities and health resorts, which provide all types of preventive, diagnostic, medical, rehabilitative and palliative treatment, and a network of paediatric institutions such as orphanages and palliative facilities.

Inpatient facilities include multiprofile child hospitals, infectious child hospitals, maternity hospitals, perinatal centres and child departments of special hospitals (psychiatric, narcological).

Historically the mental health services (psychoneurological dispensaries) for children and teenagers were separated from paediatric services. Recently the situation has started changing: in some regions the psychiatrist is being included into the child polyclinic’s multidisciplinary team.

Sanatorium resort care is provided at paediatric sanatoriums/resorts. Palliative care for children is provided at home, as outpatients (offices of palliative care), in hospitals (palliative wards in paediatric hospitals) and at paediatric hospices.

Primary health for children is provided on a territorial basis (to maximise its proximity to the place of residence of a child) and based on a free choice of doctor.

The basic structural unit of primary health care (PHC) is the outpatient and polyclinic institutions (paediatric polyclinics) providing continuity, and based on the neighbourhood principle the provision of free medical care for children aged 0–18. District paediatricians, paediatric medical specialists, auxiliary medical personnel, necessary diagnostic, therapeutic and rehabilitation equipment for outpatient care, and provision of hospital-replacing technologies are located at the abovementioned paediatric polyclinics. The structure of paediatric polyclinics is determined in accordance with the assigned tasks ( figure 1 ).

An external file that holds a picture, illustration, etc.
Object name is archdischild-2015-310152f01.jpg

Structure of a paediatric polyclinic in Russia.

Responsibilities of polyclinics are presented in figure 2 .

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Object name is archdischild-2015-310152f02.jpg

Responsibilities of paediatric polyclinics in Russia.

Continuity and interdepartmental cooperation with educational institutions (preschool and school) is provided by the department of medical care to children at educational institutions. Medical examinations of children are carried out directly at schools and kindergartens.

Evident preventative orientation of paediatric healthcare is reflected in the organisation of regular preventive examinations of healthy children in the decreed time. A paediatrician and medical specialists up to 26 times during first year of life conduct preventive examinations of infants. Subsequently, children are assessed annually by a paediatrician until the age of 18 years. Preventive examinations in the aforementioned periods encompass from 90% to 92% of children aged 0–18 (according to the data of the Ministry of Health). Vaccination covers up to 95%–97% of children, one of the highest in the world.

Support for vulnerable and maltreated children is an important activity of paediatric polyclinics. Departments of health and psychosocial care of paediatric polyclinics provide professionals such as paediatrician, psychologists, social workers and lawyers. Special attention is given to the early detection of psychosocial risk factors and interdisciplinary care for children at social risk. 8

When hospital treatment or high tech medical care is required, a child is transferred to other levels of the system: to the nearby paediatric hospital, or in severe cases to republican or federal specialised centres.

Paediatricians are still trained at paediatric faculties of universities. The unique potentialities of the newly constructed, highly specialised simulating training centre on the basis of medical schools are used widely.

Insufficient funding remains a serious problem today: the government health spendings are still below 6%—the WHO recommended minimum—and are still around 4% gross domestic product.

Dynamics of the main indicators of children’s health in Russia

Infant mortality.

During the post-Soviet period, there was a significant decrease in the infant mortality rate—from 17.4 per 1000 live births in 1990 to 6.5 per 1000 live births in 2015 ( figure 3 ). The maximum rate of decline of infant mortality has been observed within the past decade and showed the effect of improvement of living standards on infant mortality. 9 10

An external file that holds a picture, illustration, etc.
Object name is archdischild-2015-310152f03.jpg

Infant mortality in Russia (per 1000 live births).

The last increase in infant mortality in 2012 (8.6 per 1000 live births) was associated with the transition to the new criteria of live birth registration. The 24.7% difference between rural and urban infant mortality still needs to be addressed, and there remain wide provincial differences: 4.1 per 1000 live births in the Tambov region to 21.2 in the Chukotka Autonomous Region (2012).

The mortality of children under 5 has decreased twice within the past decade (from 21.3 in 1990 to 9.6 in 2014 per 1000 children of the relevant year of birth) ( figure 4 ).

An external file that holds a picture, illustration, etc.
Object name is archdischild-2015-310152f04.jpg

Mortality under 5 in Russia (per 1000 live birth).

In terms of death of children under 5, the leading positions are occupied by certain conditions originating from the perinatal period (46.4% in 2012) and congenital anomalies (20%). It is noted that the third place is occupied by external causes of death (10.6%)—injuries, poisoning and accidents. A significant proportion in this age group is occupied by such controlled factors as respiratory diseases (5.4%) and infectious diseases (4.3%). The proportion of deaths of cancer is up to 2%.

Adolescent mortality has fallen ( figure 5 ), although it continues to remain the highest among economically developed countries and many (70%) are from preventable causes such as injuries and poisoning.

An external file that holds a picture, illustration, etc.
Object name is archdischild-2015-310152f05.jpg

Adolescent mortality in Russia (per 100 000 of corresponding age).

The main external causes of adolescent deaths are suicides, which amount to about one-quarter (24.3%) of all traumatic deaths in this age group; other causes are traffic accidents (23.9%) and accidental poisoning (9.4%). The suicide rate among Russian adolescents is the highest in Europe. The increase in this rate is of particular concern. Thus, whereas in 2009, 260 suicidal deaths were registered, in 2012 the rate amounted to 487 deaths as a result of deliberate self-inflicted injury.

The rate of mortality of injuries inflicted with uncertain intentions or injuries (not specified) remains extremely high in Russia. 10 A significant part of mortality caused by such socially driven and socially important causes as murder and drug poisoning can be disguised in the aforementioned causes.

The reduction of mortality caused by infectious diseases (50%), injury and poisoning (37.4%), and cancer (27.3%) has been considered to be the most significant over the past 10 years.

Reducing child mortality

The Russian experience of universal paediatric care coverage for child population as an instrument for achieving Millennium Development Goals.

The Russian Federation is a country with the most child-oriented and even child rights-oriented systems of paediatric healthcare, and has achieved considerable success in reducing infant, child and maternal mortality, as well as in the prevention, diagnosis and treatment of infectious and non-infectious diseases in children, and continues its consistent steps to other states on achievement of the Millennium Development Goals.

Since 2010, as part of the implementation of the Muskoka Initiative on maternal, newborn and children under 5 health, Russia has assisted with the transfer of health service experience to countries with developing economies. For this purpose during the last 5 years, the Government of the Russian Federation has funded a number of projects on supplementary training for paediatricians, neonatologists, anaesthetists and other paediatric specialists from Asia, Africa and Latin America. The Russian Federation also provided a 3-year (2012–2014) project funding to be administered by the WHO to support improvement in the paediatric quality of care at first-level hospitals in Africa and Central Asia. 11

The main objectives of the project were to (1) improve the quality of paediatric care in at least 80 selected first-level referral hospitals in the four countries; (2) provide support to expand the experience nationally; (3) introduce the concept of paediatric care standards in the national education and training of health professional to sustain the project's results; and (4) update and develop relevant international guidelines and tools on the basis of experience gained through the project implementation.

Over the past 3 years, the Scientific Centre of Children’s Health has worked closely with the WHO to decrease child mortality in low/middle-income countries of Asia and Africa (Angola, Ethiopia, Kyrgyzstan and Tajikistan). 12 A modern simulative training centre for paediatricians of different specialisations was opened in the Scientific Center of Children's Health (SCCH) as part of this project.

This project has provided a very excellent model of collaboration with the Russian institutions. The capacity of the National Scientific Centre of Child Health has been very instrumental in participating and supporting various activities that have so far been implemented.

In accordance with the Prime Minister’s Decree, 11 nine medical educational seminars were conducted in 2014–2015. These were attended by 270 paediatricians from 10 countries (Angola, Armenia, Botswana, Kirgizstan, Moldova, Mongolia, Nicaragua, Tajikistan, Uzbekistan and Vietnam). The course was devoted to treating emergency acute states in children. The programme of each seminar was planned for 72 hours, including lections (24 hours) and practical skills training (48 hours).

From the very first days of the formation, Russian paediatrics has always been an integral part of the world’s science and practice. At the same time, Russia has a healthcare system that possesses its own distinctive features, many of which were inherited from the Soviet model.

Contributors: Conception or design of the work: A

B, LN-B, VA, NU.

Data collection: VA, NU, RT.

Data analysis and interpretation: AB, LN-B, VU, NU, RT.

Drafting the article: LN-B, VA, NU.

Critical revision of the article: AB, LN-B, VA, NU, RT, OK.

Final approval of the version to be published: AB, LN-B, VA, NU, RT, OK.

Competing interests: None declared.

Provenance and peer review: Commissioned; externally peer reviewed.

Correction notice: This paper has been amended since it was published Online First. Owing to a scripting error, some of the publisher names in the references were replaced with 'BMJ Publishing Group'. This only affected the full text version, not the PDF. We have since corrected these errors and the correct publishers have been inserted into the references.

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  • Open access
  • Published: 01 February 2024

Event rates and incidence of post-COVID-19 condition in hospitalised SARS-CoV-2 positive children and young people and controls across different pandemic waves: exposure-stratified prospective cohort study in Moscow (StopCOVID)

  • Ekaterina Pazukhina 1 , 2   na1 ,
  • Mikhail Rumyantsev 3   na1 ,
  • Dina Baimukhambetova 3   na1 ,
  • Elena Bondarenko 3   na1 ,
  • Nadezhda Markina 3   na1 ,
  • Yasmin El-Taravi 3   na1 ,
  • Polina Petrova 3   na1 ,
  • Anastasia Ezhova 3   na1 ,
  • Margarita Andreeva 3 ,
  • Ekaterina Iakovleva 3 ,
  • Polina Bobkova 3 ,
  • Maria Pikuza 3 ,
  • Anastasia Trefilova 3 ,
  • Elina Abdeeva 3 ,
  • Aysylu Galiautdinova 3 ,
  • Yulia Filippova 3 ,
  • Anastasiia Bairashevskaia 3 ,
  • Aleksandr Zolotarev 3 ,
  • Nikolay Bulanov 4 ,
  • Audrey DunnGalvin 3 , 7 ,
  • Anastasia Chernyavskaya 8 ,
  • Elena Kondrikova 3 ,
  • Anastasia Kolotilina 3 ,
  • Svetlana Gadetskaya 3 ,
  • Yulia V. Ivanova 3 ,
  • Irina Turina 3 ,
  • Alina Eremeeva 3 ,
  • Ludmila A. Fedorova 3 ,
  • Pasquale Comberiati 9 ,
  • Diego G. Peroni 9 ,
  • Nikita Nekliudov 10 ,
  • Jon Genuneit 11 ,
  • Luis Felipe Reyes 12 , 13 ,
  • Caroline L. H. Brackel 14 , 15 ,
  • Lyudmila Mazankova 17 ,
  • Alexandra Miroshina 18 ,
  • Elmira Samitova 17 , 18 ,
  • Svetlana Borzakova 6 , 19 ,
  • Gail Carson 20 ,
  • Louise Sigfrid 20 ,
  • Janet T. Scott 21 ,
  • Sammie McFarland 22 ,
  • Matthew Greenhawt 23 ,
  • Danilo Buonsenso 24 , 25 , 26 ,
  • Malcolm G. Semple 27 , 28 ,
  • John O. Warner 29 ,
  • Piero Olliaro 20 ,
  • Ismail M. Osmanov 6 , 18   na1 ,
  • Anatoliy A. Korsunskiy 3   na1 ,
  • Daniel Munblit   ORCID: orcid.org/0000-0001-9652-6856 3 , 5 , 16 , 30   na1 &

Sechenov StopCOVID Research Team

BMC Medicine volume  22 , Article number:  48 ( 2024 ) Cite this article

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Long-term health outcomes in children and young people (CYP) after COVID-19 infection are not well understood and studies with control groups exposed to other infections are lacking. This study aimed to investigate the incidence of post-COVID-19 condition (PCC) and incomplete recovery in CYP after hospital discharge and compare outcomes between different SARS-CoV-2 variants and non-SARS-CoV-2 infections.

A prospective exposure-stratified cohort study of individuals under 18 years old in Moscow, Russia. Exposed cohorts were paediatric patients admitted with laboratory-confirmed COVID-19 infection between April 2 and December 11, 2020 (Wuhan variant cohort) and between January 12 and February 19, 2022 (Omicron variant cohort). CYP admitted with respiratory and intestinal infections, but negative lateral flow rapid diagnostic test and PCR-test results for SARS-CoV-2, between January 12 and February 19, 2022, served as unexposed reference cohort. Comparison between the ‘exposed cohorts’ and ‘reference cohort’ was conducted using 1:1 matching by age and sex. Follow-up data were collected via telephone interviews with parents, utilising the long COVID paediatric protocol and survey developed by the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC). The WHO case definition was used to categorise PCC.

Of 2595 CYP with confirmed COVID-19, 1707 (65.7%) participated in follow-up interviews, with 1183/1707 (69%) included in the final ‘matched’ analysis. The median follow-up time post-discharge was 6.7 months. The incidence of PCC was significantly higher in the Wuhan variant cohort (89.7 cases per 1000 person-months, 95% CI 64.3–120.3) compared to post-infection sequalae in the reference cohort (12.2 cases per 1000 person-months, 95% CI 4.9–21.9), whereas the difference with the Omicron variant cohort and reference cohort was not significant. The Wuhan cohort had higher incidence rates of dermatological, fatigue, gastrointestinal, sensory, and sleep manifestations, as well as behavioural and emotional problems than the reference cohort. The only significant difference between Omicron variant cohort and reference cohort was decreased school attendance. When comparing the Wuhan and Omicron variant cohorts, higher incidence of PCC and event rates of fatigue, decreased physical activity, and deterioration of relationships was observed. The rate of incomplete recovery was also significantly higher in the Wuhan variant cohort than in both the reference and the Omicron variant cohorts.

Conclusions

Wuhan variant exhibited a propensity for inducing a broad spectrum of physical symptoms and emotional behavioural changes, suggesting a pronounced impact on long-term health outcomes. Conversely, the Omicron variant resulted in fewer post-infection effects no different from common seasonal viral illnesses. This may mean that the Omicron variant and subsequent variants might not lead to the same level of long-term health consequences as earlier variants.

Peer Review reports

Multiple studies have attempted to determine the incidence and risk factors associated with SARS-CoV-2 sequelae in children and young people (CYP) [ 1 ]. However, these studies were often impeded by methodological heterogeneity, biases, and inconsistent definitions of COVID-19 consequences [ 2 , 3 ]. The difficulty of appropriate reference or control group selection has subjected available studies to criticism [ 4 ].

One possible approach to obtaining a reference group is to recruit uninfected CYP whose negative status has been previously verified by PCR testing. In the CLoCk study, PCR-positive CYP were matched to test-negative CYP using the national SARS-CoV-2 testing dataset [ 5 ]. Similarly, a nationwide cohort study of CYP in Denmark included an exposed group with SARS-CoV-2 infection, verified by RT-PCR, and a reference group of randomly selected individuals who have never been test-positive for SARS-CoV-2 [ 6 ]. In a mobile app-based study, Molteni and co-authors recruited a reference group of CYP whose self-reported test results were negative [ 7 ]. In other studies, the exposed cohorts were formed from randomly selected schools based on RT-PCR test results, and reference cohorts were recruited from CYP who visited their doctor routinely, with both negative RT-PCR and antibody-based SARS-CoV-2 analysis [ 8 , 9 ].

Previous efforts suffer from blending symptomatic and asymptomatic CYP in the infected groups, which does not address the possible confounding effect of severity or confounding by factors predisposing to more severe symptoms. Additionally, misdiagnosis may have occurred, as acknowledged by some authors [ 5 ]. One approach is to limit the scope of the infected group to those CYP who are symptomatic. However, the results of such studies are challenging to interpret, as previously ill CYP are compared to a generally healthy reference, and the incremental effect cannot be evaluated in the context of other previously known illnesses [ 10 ]. Previous expert statements [ 11 , 12 ] as well as recent systematic review suggested that future studies would benefit from control group and adjustment of the study results for health and environmental factors, including SARS-CoV-2 variant [ 1 ].

A potential solution to this problem could be using a reference with comparably severe disease, yet without SARS-CoV-2 infection. To the best of our knowledge, a single study followed this consideration, recruiting reference cohort from both hospitalised and non-hospitalised CYP with other non-SARS-CoV-2 community-acquired infections, clinically and laboratory-confirmed, whereas cases were defined as CYP with previous acute phase of COVID-19 [ 13 ]. Given the relatively rare occurrence of highly severe SARS-CoV-2 infection [ 14 ], filling the gaps in understanding long consequences of SARS-CoV-2 on health and well-being of CYP in comparison to other known infection is needed. Additionally, there is a paucity of paediatric studies evaluating the long-term consequences of COVID-19 related to the most prevalent circulating variants of SARS-CoV-2 in the population during a specific time period [ 15 ].

Another limitation pertains to the broad outcome definition employed by most of the observational studies examining the consequences of COVID-19. Although the World Health Organization (WHO) has provided a definition for the post-COVID-19 Condition [ 16 ], a disappointingly small number of studies have chosen to incorporate this definition into their research methodology.

This prospective exposure-stratified cohort study aimed to investigate the incidence of post-COVID-19 condition among hospitalised CYP with COVID-19 infection compared with post-infection sequalae in a reference cohort of previously hospitalised CYP with non-COVID-19 infectious diseases. The study used standardised follow-up data collection protocols developed by the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) Global Paediatric COVID-19 follow-up working group. The study included assessment of post-COVID-19 condition corresponding to different waves of the pandemic in Moscow, Russia, as a proxy for infection with different SARS-CoV-2 variants.

The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cohort studies ( https://www.strobe-statement.org/ ) was utilised to report the present study.

Study design, setting, and participants

The present study is an exposure-stratified prospective cohort study of CYP under the age of 18 carried out in Bashlyaeva Children’s City Clinical Hospital and G.N. Speransky Children’s City Clinical Hospital No. 9. These hospitals were the primary hospitals treating COVID-19 in CYP residing in Moscow at different times of pandemic. Additional file 1 : Table S1 provides a detailed description of the criteria for hospital admission according to the local clinical guidelines.

Exposed cohorts for this study included paediatric patients hospitalised to Bashlyaeva Children’s City Clinical Hospital with a laboratory-confirmed diagnosis of COVID-19 infection, spanning from April 2, 2020, to December 11, 2020 (Wuhan variant cohort), and to G.N. Speransky Children’s City Clinical Hospital No. 9 between January 12, 2022, and February 19, 2022 (Omicron variant cohort). The dates of patient hospital admission were matched with the data on variant predominance in Moscow [ 17 ] (Additional file 1 : Figure S1).

CYP who were hospitalised to G.N. Speransky Children’s City Clinical Hospital No. 9 with confirmed respiratory and gastrointestinal infections in conjunction with negative lateral flow rapid diagnostic test and PCR-test results for SARS-CoV-2, between January 12, 2022, and February 19, 2022, served as the unexposed reference cohort for this study. They represent typical patients who are routinely admitted to the hospital with respiratory and gastrointestinal infections during seasonal outbreaks. Recruiting a reference cohort during the Wuhan wave proved to be a formidable challenge. The dearth of admissions of CYP with respiratory infections other than COVID-19, coupled with the high rate of false negatives in COVID-19 testing during the initial months of the pandemic and the scarcity of resources further compounded the difficulty.

Data management

Baseline data at admission consisted of information pertaining to patient demographics, symptoms, and comorbidities, documented at the time of admission. In addition, the dataset also encompassed results of clinical investigations, supportive care requirements during hospitalisation, and crucial clinical outcomes upon discharge.

Follow-up data have been collected via telephone interviews with parents conducted by research team members who had received standardised training in interview administration, REDCap data entry, and data security [ 18 , 19 , 20 ]. The interviews took place between January 31 and February 27, June 2 and August 1, 2021, and August 1 and September 15, 2022. The long COVID paediatric protocol and survey, which was developed by the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) and translated into Russian, was utilised to collect data from both exposed and the reference cohorts. The data included questions regarding symptoms and their onset and persistence at the time of the follow-up as well as the physical, psychosocial, and behavioural well-being of CYP (all proxy-reported by parents).

Data collection, storage, and management were performed using REDCap electronic data capture tools (Vanderbilt University, Nashville, TN, USA) hosted at Sechenov University and Microsoft Excel (Microsoft Corp, Redmond, WA, USA).

Definitions

The present study adopts the WHO case definition to categorise post-COVID-19 condition as the presence of any symptom that emerges no later than 3 months post-hospital discharge and persists for at least 2 months. In the absence of reliable objective medical record data pertaining to the date of first symptom appearance, symptom duration was calculated from the time of hospital discharge.

Post-COVID-19 condition/post-infection sequalae symptoms were categorised into nine manifestations, which encompassed cardiovascular, dermatological, fatigue, gastrointestinal, musculoskeletal, neurocognitive, respiratory, sensory, and sleep-related symptoms. This classification was formulated by drawing upon relevant prior literature and through ISARIC’s working group deliberations [ 20 ].

Emotional and behavioural changes, which were initially recorded using a five-point scale ranging from ‘much less’ to ‘much more’, have been converted into binary variables. We considered worsening of symptoms for excessive fatigue when parents were reporting ‘more’ and ‘much more’ with regard to this outcome during telephone interview.

Recovery was assessed using a Likert scale ranging from ‘1’ (no recovery) to ‘10’ (complete recovery). Responses were transformed into a binary variable, with a ‘1–6’ considered ‘incomplete recovery’ and ‘7–10’ complete recovery from the infection.

Patients in all the cohorts were defined as severe if required non-invasive ventilation, invasive ventilation, or intensive care unit (ICU) care during acute phase of COVID-19.

Statistical analysis

Baseline characteristics were analysed through descriptive statistics. We summarised continuous variables as medians (interquartile range, IQR), while categorical variables were presented as frequencies (percentages).

We utilised forest plots to depict the incidence and event rates associated with post-COVID-19 conditions and their varying manifestations. The incidence was calculated as the ratio of the total number of new cases to the total time at risk. In line with the World Health Organization’s definition of post-COVID-19 condition (PCC), an individual’s time at risk is capped at three months from the onset of symptoms (or from hospital admission if symptom onset is unknown). For manifestations of symptoms, we selected the shortest time at risk across all symptoms for each individual within a group. We calculated the rate of events as the ratio of the number of cases to the number of people at risk.

We conducted a comparison between the ‘exposed cohorts’ (Wuhan variant cohort and Omicron variant cohort) and ‘reference cohort’ using 1:1 matching by age (± 1 year) and sex. In a sensitivity analysis, two additional matching parameters severity and length of hospitalisation (± 2 days) were included (Additional file 1 : Table S2, Figures S2 and S3). We regarded age and sex as confounders, while severity (defined as the need for non-invasive or invasive ventilation, or intensive care unit admission) and length of hospitalisation may function as proxies for true severity.

We employed bootstrap methodology (30,000 iterations) to obtain 95% confidence intervals (CIs) for the estimates of post-COVID-19 condition event rates and incidence. This involved resampling from a variety of potentially matched cohorts. We have presented the demographic characteristics and comorbidities of the matched cohorts, alongside the features of the initial sample.

We considered differences in event rates and incidence of manifestations between groups as significant if the median p -value for rate ratios, acquired from the bootstrap procedure via the exact Fisher’s test, was less than 5%.

Statistical analysis was conducted using R version 4.0.2, employing the dplyr, foreign, ggraph, and ggforce libraries.

To minimise recall bias, we limited the period from the onset date of the first symptoms (or the date of hospital admission if symptom onset was missing or inconsistent) to the follow-up date to a maximum of 8 months.

Study participant characteristics

Out of the 2595 eligible CYP with laboratory-confirmed COVID-19 who were discharged between March 18, 2020, and February 20, 2022, 2520 (97.1%) had contact information available. Of these, 1707 CYP (65.7% of those discharged, 67.7% of those with contact information) participated in follow-up interviews. Upon matching, 1183 out of 1707 CYP (69%) were included in the final analysis (Fig.  1 ).

figure 1

Study flow chart

Table 1 presents the demographic and clinical characteristics of the study participants. The median time elapsed after hospital discharge was 6.7 months, ranging from 6.2 months for Omicron variant and control cohorts to 7.5 months in the Wuhan variant cohort. Before the matching process, the median age was 10.3 years (IQR 2.8–14.7) in the Wuhan variant cohort, 2.6 years (IQR 0.8–7.0) in the Omicron stain cohort, and 4.2 years (IQR 1.9–7.8) in the reference cohort. The share of severe patients ranged from 2.4% in the Wuhan variant cohorts to 6.2% in the Omicron cohort and 3.2% in the reference cohort.

The most common comorbidities in the pooled initial cohorts were food allergy (12.0%), intestinal (9.3%) and neurological (8.7%) problems, and atopic dermatitis/eczema (7.9%). However, in the matched sets, the prevalence of these comorbidities varied significantly. Higher prevalence of neurological problems (5.8%), food allergy (4.7%), and lower prevalence of malnutrition (4.6%) were observed in Wuhan variant cohort when compared with the reference cohort. Higher prevalence of atopic dermatitis/eczema (9.7%) and neurological problems (+ 5.4%) was found in Omicron variant cohort when compared with the reference cohort.

Post-COVID-19 condition/post-infection sequalae incidence

Figure  2 presents the incidence rates of PCC/post-infection sequalae and manifestations of symptoms in matched cohorts, while Fig.  3 depicts the well-being assessment results and incomplete recovery in matched cohorts. Detailed information is available in Table S 3 .

figure 2

Incidence of post-COVID-19 condition manifestations in Wuhan variant cohort, Omicron variant cohort, and post-infection sequalae manifestations in reference cohort

figure 3

Event rate for incomplete recovery and emotional and behavioural changes in Wuhan variant cohort, Omicron variant cohort, and post-infection sequalae manifestations in reference cohort. VAS, visual analogue scale

For the Wuhan variant cohort, the incidence of PCC was 89.6 cases per 1000 person-months (95% CI 64.4–120.4), compared to 11.0 cases of post-infection sequalae per 1000 person-months (95% CI 4.8–19.7) in the reference cohort ( p  < 0.001). Conversely, the difference between the matched Omicron variant cohort (14.1 cases per 1000 person-months, 95% CI 6.8–23.7) and the reference cohort (10.1 cases per 1000 person-months, 95% CI 3.4–18.2) was not statistically significant ( p  = 0.45).

When comparing the Wuhan variant cohort (87.0 cases per 1000 person-months, 95% CI 61.0–118.9) to the Omicron variant cohort (15.7 cases per 1000 person-months, 95% CI 6.5–26.7), a significant difference in the PCC event rate was noted ( p  < 0.001).

Post-COVID-19 condition/post-infection sequalae manifestations

The Wuhan variant cohort displayed a significantly higher incidence of dermatological, fatigue, gastrointestinal, sensory, and sleep manifestations of PCC than similar post-infection sequalae manifestations in the reference cohort. The largest difference in manifestation rates was observed for fatigue (31.4 cases per 1000 person-months, 95% CI 18.7–48.0 vs. 2.4 cases per 1000 person-months, 95% CI 0.0–6.0) and sleep problems (24.5 cases per 1000 person-months, 95% CI 13.6–38.8 vs. 3.6 cases per 1000 person-months, 95% CI 0.0–8.4).

For the Omicron variant cohort, no statistically significant differences in any symptom manifestations were found when compared with the reference cohort.

Comparing the Wuhan and Omicron variant cohorts, significant differences in incidence were observed for dermatological, fatigue, gastrointestinal, sensory and sleep manifestations. The largest differences were observed in incidence of dermatological manifestations in Wuhan vs Omicron variant cohorts (21.9 cases per 1000 person-months, 95% CI 10.7–35.8 vs. 0.0 cases per 1,000 person-months, 95% CI 0.0–3.8) and fatigue (28.9 cases per 1,000 person-months, 95% CI 16.1–45.3 vs. 2.5 cases per 1,000 person-months, 95% CI 0.0–6.5).

The rate of events for incomplete recovery was significantly higher in the Wuhan variant cohort (13.9%, 95% CI 9.6–18.7%) than in the reference cohort (3.6%, 95% CI 1.4–6.3%). For the Omicron variant cohort, this rate was not significantly different from the reference cohort, but it was significantly lower than the Wuhan variant cohort (7.0% (95% CI 3.8–10.7%) vs. 13.3% (95% CI 8.8–18.2%)) (Additional file 1 : Table S3).

Post-COVID-19 condition/post-infection sequalae emotional and behavioural status

Emotional and behavioural changes also differed significantly between the Wuhan variant and reference cohorts, with higher rates observed in the Wuhan variant cohort for behavioural changes (10.4%, 95% CI 6.7–14.9 vs. 4.2%, 95% CI 1.6–7.1%), emotional problems (12.9%, 95% CI 8.7–17.5% vs. 5.8%, 95% CI 3.1–9.2%), fatigue (16.0%, 95% CI 11.4–21.1% vs. 7.1%, 95% CI 4.1–10.6%), communicating with friends personally (5.4%, 95% CI 2.2–9.4% vs 1.4%, 95% CI 0.0–3.3%), worsening relationships (5.7%, 95% CI 2.7–9.2% vs. 0.8%, 95% CI 0.0–2.5%), decline in school attendance (11.5%, 95% CI 6.9–16.8% vs. 4.5%, 95% CI 1.6–8.1%), and sleep problems (12.2%, 95% CI 8.1–16.8% vs. 5.4%, 95% CI 2.9–8.5%).

In contrast, the Omicron variant cohort only showed a significant difference from the reference cohort with regard to lower school attendance (9%, 95% CI 5.1–13.6% vs. 3.8%, 95% CI 1.4–7.2%).

When the Wuhan and Omicron variant cohorts were compared, significant differences in rates of events for emotional behavioural changes were observed for fatigue (14.9%, 95% CI 10.4–19.8% vs. 7.4%, 95% CI 4.1–11.2%), decreased physical activity (9.3%, 95% CI 5.5–13.8% vs. 2.7%, 95% CI 0.8–5.2%), and deterioration of relationships (4.9%, 95% CI 2.4–8.4% vs. 0.9%, 95% CI 0.0–2.4%).

Incidence (per 1000 person-months (95% confidence interval)) of post COVID-19 condition and different manifestations in exposure and reference groups were matched by age and sex. Statistically insignificant results are presented in white; statistically significant difference of p  < 0.05 between the groups is highlighted in light green; statistically significant difference of p  < 0.01 between the groups is highlighted in light yellow; statistically significant difference of p  < 0.001 between the groups is highlighted in light grey.

Prevalence of incomplete recovery is presented as event rate (95% confidence interval). Statistically insignificant results are presented in white; statistically significant difference of p  < 0.05 between the groups is highlighted in light green; statistically significant difference of p  < 0.01 between the groups is highlighted in light yellow; statistically significant difference of p  < 0.001 between the groups is highlighted in light grey.

The importance of investigating the impact of COVID-19 on CYP has been previously emphasised, particularly in light of new variants of the virus circulating in the population [ 12 ]. However, current research on the long-term effects of COVID-19 in CYP is limited and is associated with methodological limitations, making it difficult to distinguish between the effects of the virus and the impact of social restrictions [ 21 ]. There is also a lack of studies that compare the effects of COVID-19 in CYP with a control group of individuals following other viral infections. Experts previously highlighted the importance of a control group in studies following SARS-CoV-2 infection in CYP, using standardised case definitions [ 4 ]. This study aimed to address these gaps by estimating the incidence of PCC and the impact on well-being among CYP and young people, comparing COVID-19 from different variants with a control cohort of CYP hospitalised with non-COVID-19 infections. We found that CYP hospitalised during Wuhan variant wave had a significantly higher incidence of PCC and incomplete recovery than incidence of post-infection sequalae in the controls. Emotional and behavioural changes were also observed in Wuhan cases, including behaviour changes, emotional problems, excessive fatigue, worsening of relationships, decline in school attendance, and problems with sleep. In contrast, CYP admitted to the hospital with COVID-19 during the Omicron variant wave did not differ significantly from CYP hospitalised with respiratory or gastrointestinal infections in terms of long-lasting outcomes, symptom manifestation, and recovery. However, they were shown to have distinctively more problems with school attendance.

The incidence of PCC was significantly higher in the cohort infected by the Wuhan variant compared to the post-infection sequalae incidence in reference cohort, with a disparity of 77.5 cases per 1000 person-months. Conversely, the incidence rate in the Omicron variant cohort did not show a statistically significant difference from the reference cohort. The striking difference between the Wuhan and Omicron cohorts indicates the potential difference in virulence and resultant clinical outcomes associated with the distinct viral variants. Results are somehow reassuring as Wuhan variant is very uncommon in population now, and findings allow to hypothesise that Omicron variant as well as SARS-CoV-2 circulating in the population, originating from Omicron [ 22 ], is unlikely to differ in terms of consequences compared with common seasonal viruses significantly. Such discrepancy in long-term outcomes between different variants might be attributable to the variations in the viral structure, particularly in the spike protein [ 23 ], which is known to affect the virus’s ability to bind to and enter host cells. Future studies focusing on the specific biological mechanisms behind these differences could provide more definitive answers.

When assessing symptom manifestations of PCC, the Wuhan cohort presented a markedly higher incidence of dermatological, fatigue, gastrointestinal, sensory, and sleep disturbances than the post-infection sequalae manifestations in reference cohort. Among these, fatigue and sleep problems demonstrated the largest difference in manifestation rates. Such findings corroborate the existing literature, where fatigue and sleep issues have been consistently reported as prominent manifestations of PCC, particularly in the context of the Wuhan variant. In contrast, the Omicron cohort showed no significant difference in symptom manifestations compared to the reference cohort, further highlighting the potential differential pathogenicity of the viral variants. The largest differences between the Wuhan and Omicron cohorts were found for dermatological manifestations and fatigue, again underscoring the burden of these symptoms in CYP infected with the Wuhan variant. In contrast, the Omicron cohort showed no significant difference in symptom manifestations compared to the reference cohort, further highlighting the potential differential pathogenicity of the viral variants. The largest differences between the Wuhan and Omicron cohorts were found for dermatological manifestations and fatigue, again underscoring the burden of these symptoms in CYP infected with the Wuhan variant.

Our findings also revealed that CYP infected with the Wuhan variant had significantly higher rates of incomplete recovery and emotional-behavioural changes, such as behavioural changes, emotional problems, fatigue, worsening relationships, decline in school attendance, and sleep problems, as compared to the reference cohort. These results suggest the long-lasting and pervasive impact of COVID-19 on health and well-being of CYP, especially those infected by the Wuhan variant. It is crucial for healthcare providers to recognise these long-term sequelae and to develop appropriate strategies for ongoing support and management.

The Omicron cohort showed a significant difference from the reference cohort only in terms of lower school attendance. This difference could be attributed to factors such as more conservative return-to-school policies during the Omicron wave. Additionally, parental concerns about their child’s health after infection could have contributed to lower school attendance. However, it does imply a potential impact on the children’s educational attainment and warrants further exploration.

One of the major strengths of this study is the inclusion of a control group of CYP who were admitted to the hospital with non-COVID-19 infections. This allows us to estimate the relative burden of long COVID-19 and to compare the outcomes of CYP with COVID-19 infection to those of CYP with other infections. Both cases and controls in this study were exposed to infection-related hospitalisations, which reduces the potential for bias due to differences in health-seeking behaviour. Another strength of the study is the distinction made between the early Wuhan variant and the later Omicron variant of the virus. By comparing the outcomes of CYP infected with these two variants, we are able to explore the differences in the long-term effects of the two variants of the virus on children’s health. The study utilised the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) long-term follow-up study case report forms (CRFs) for CYP. This standardised data collection method ensures that the data collected are consistent and comparable across different study sites. In addition, the study used the WHO post-COVID-19 condition definition, which provides a standardised definition of the condition that allows for more accurate and consistent identification of cases.

However, the study also has several limitations. First, all the cohorts represent hospitalised population which do not allow to extrapolate findings on all CYP. The follow-up period has been restricted to 8 months after hospital discharge. This may not be sufficient to capture the full extent of long-term effects of COVID-19 in CYP. Second, the study is limited in its ability to control for extrinsic factors and residual confounding, such as vaccinations and other viral infections, that may have affected the study outcomes. Third, the criteria for hospital admission may have changed over time, and cases across waves can have different acute severity. Fourth, the chronological association of the waves of study with COVID-19 variants was established without laboratory confirmation, and relied upon available open data sources, which may have introduced bias into the study. No patients were recruited during Delta variant wave. Fifth, the study relied on proxy-reported responses from the parents for the follow-up interviews, which may be affected by recall bias and non-blindness of respondents. Additionally, parental bias towards the health of their CYP may have influenced the accuracy of the data collected. Finally, there is a risk of potential selection bias, with those with symptoms more likely to agree to the survey and thus potentially overestimating the prevalence of post-COVID-19 condition. At the onset of the COVID-19 pandemic, when the Wuhan variant was prevalent in Russia, the only facility in Moscow equipped for the hospitalisation of infected children was the Bashlyaeva Children’s City Clinical Hospital. As the pandemic evolved and other variants, including Omicron, became dominant, the G.N. Speransky Children’s City Clinical Hospital No. 9 COVID-19 wards were set-up in response to increasingly large number of patients expected as a part of this wave. Consequently, it was not possible and feasible to gather data from just one hospital. However, given that both hospitals used identical data collection methodologies, the batch effect in the data is unlikely.

Overall, the findings of this study underscore the importance of continued monitoring and support for CYP who have been hospitalised with COVID-19 infection as well as for those who may be experiencing long-term effects of the virus. Future studies should aim to elucidate the underlying biological mechanisms behind the observed differences in clinical outcomes associated with different viral variants. The results offer some reassurance, given that the Wuhan variant is now quite rare in the population. These findings permit us to conjecture that the Omicron variant, as well as the SARS-CoV-2 variants currently circulating, is unlikely to diverge significantly from common seasonal viruses in terms of their consequences. Policymakers, healthcare providers, and families must work together to ensure that CYP are provided with the resources and support they need to recover fully and to continue to thrive despite the challenges posed by the COVID-19 pandemic.

Availability of data and materials

The data that support the findings of this study are available from the corresponding author, DM, upon reasonable request.

Abbreviations

Confidence interval

Children and young people with long COVID study

Coronavirus disease 2019

Case report form

Children and young people

Human immunodeficiency virus

International Severe Acute Respiratory and Emerging Infection Consortium

Intensive care unit

Interquartile range

  • Post-acute sequelae of SARS-CoV-2 infection

Post-COVID-19 condition

Polymerase chain reaction

Research Electronic Data Capture

Severe acute respiratory syndrome-related coronavirus 2

Strengthening the Reporting of Observational Studies in Epidemiology

World Health Organization

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Acknowledgements

We are very grateful to the Z.A. Bashlyaeva Children’s Municipal Clinical Hospital and G.N. Speransky Children’s City Clinical Hospital No. 9 clinical staff and to the patients, parents, carers, and families for their kindness and understanding during these difficult times of COVID-19 pandemic. We would like to express our very great appreciation to ISARIC Global COVID-19 follow-up working group for the survey development. We are very thankful to FLIP, Eat & Talk, Luch, Black Market, and Academia for providing us the workspace in time of need and their support of COVID-19 research. Finally, we would like to extend our gratitude to the Global ISARIC team, the ISARIC global adult and paediatric COVID-19 follow-up working group, and ISARIC Global support centre for their continuous support and expertise and for the development of the outbreak ready standardised protocols for the data collection.

Sechenov Stop COVID Research Team (group authors)

Khazhar Aktulaeva 1 , Islamudin Aldanov 1 , Nikol Alekseeva 1 , Ramina Assanova 1 , Asmik Avagyan 1 , Irina Babkova 1 , Lusine Baziyants 1 , Anna Berbenyuk 1 , Tatiana Bezbabicheva 1 , Julia Chayka 1 , Iuliia Cherdantseva 1 , Yana Chervyakova 1 , Tamara Chitanava 1 , Alexander Chubukov 1 , Natalia Degtiareva 1 , Gleb Demyanov 1 , Semen Demyanov 1 , Salima Deunezhewa 1 , Aleksandr Dubinin 1 , Anastasia Dymchishina 1 , Murad Dzhavadov 1 , Leila Edilgireeva 1 , Yulia Filippova 1 , Veronika Filippova 1 , Yuliia Frumkina 1 , Anastasia Gorina 1 , Cyrill Gorlenko 1 , Marat Gripp 1 , Mariia Grosheva 1 , Eliza Gudratova 1 , Elena Iakimenko 1 , Margarita Kalinina 1 , Ekaterina Kharchenko 1 , Anna Kholstinina 1 , Bogdan Kirillov 1 , Herman Kiseljow 1 , Natalya Kogut 1 , Polina Kondrashova 1 , Irina Konova 2 , Mariia Korgunova 1 , Anastasia Kotelnikova 1 , Alexandra Krupina 1 , Anna Kuznetsova 1 , Anastasia Kuznetsova 1 , Anna S. Kuznetsova 1 , Anastasia Laevskaya 1 , Veronika Laukhina 1 , Baina Lavginova 1 , Yulia Levina 1 , Elza Lidjieva 1 , Anastasia Butorina 1 , Juliya Lyaginskaya 1 , Ekaterina Lyubimova 1 , Shamil Magomedov 1 , Daria Mamchich 1 , Rezeda Minazetdinova 1 , Artemii Mingazov 1 , Aigun Mursalova 1 , Daria Nikolaeva 1 , Alexandra Nikolenko 1 , Viacheslav Novikov 1 , Georgiy Novoselov 1 , Ulyana Ovchinnikova 1 , Veronika Palchikova 1 , Kira Papko 1 , Mariia Pavlova 1 , Alexandra Pecherkina 1 , Sofya Permyakova 1 , Erika Porubayeva 1 , Kristina Presnyakova 1 , Maksim Privalov 1 , Alesia Prutkogliadova 1 , Anna Pushkareva 1 , Arina Redya 1 , Anastasia Romanenko 1 , Filipp Roshchin 1 , Diana Salakhova 1 , Maria Sankova 1 , Ilona Sarukhanyan 1 , Viktoriia Savina 1 , Ekaterina Semeniako 1 , Valeriia Seregina 1 , Anna Shapovalova 1 , Khivit Sharbetova 1 , Nataliya Shishkina 1 , Anastasia Shvedova 1 , Valeriia Stener 1 , Valeria Ustyan 1 , Yana Valieva 1 , Maria Varaksina 1 , Katerina Varaksina 1 , Ekaterina Varlamova 1 , Natalia Vlasova 1 , Margarita Yegiyan 1 , Nadezhda Ziskina 1 , Daniella Zolochevskaya 1 , Elena Zuykova 1

1. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia

2. ZA Bashlyaeva Children’s Municipal Clinical Hospital, Moscow, Russia

The names of the authors are in alphabetic order .

No external funding.

Author information

Ekaterina Pazukhina, Mikhail Rumyantsev, Dina Baimukhambetova, Elena Bondarenko, Nadezhda Markina, Yasmin El-Taravi, Polina Petrova, Anastasia Ezhova, Ismail M. Osmanov, Anatoliy A. Korsunskiy and Daniel Munblit contributed equally to the paper.

Authors and Affiliations

Laboratory of Health Economics, Institute of Applied Economic Studies, The Russian Presidential Academy of National Economy and Public Administration, Moscow, Russia

Ekaterina Pazukhina

Center for Advanced Financial Planning, Macroeconomic Analysis and Financial Statistics, Financial Research Institute of the Ministry of Finance of the Russian Federation, Moscow, Russia

Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child’s Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia

Mikhail Rumyantsev, Dina Baimukhambetova, Elena Bondarenko, Nadezhda Markina, Yasmin El-Taravi, Polina Petrova, Anastasia Ezhova, Margarita Andreeva, Ekaterina Iakovleva, Polina Bobkova, Maria Pikuza, Anastasia Trefilova, Elina Abdeeva, Aysylu Galiautdinova, Yulia Filippova, Anastasiia Bairashevskaia, Aleksandr Zolotarev, Audrey DunnGalvin, Elena Kondrikova, Anastasia Kolotilina, Svetlana Gadetskaya, Yulia V. Ivanova, Irina Turina, Alina Eremeeva, Ludmila A. Fedorova, Anatoliy A. Korsunskiy & Daniel Munblit

Tareev Clinic of Internal Diseases, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia

Nikolay Bulanov

Research and Clinical Center for Neuropsychiatry, Moscow, Russia

Daniel Munblit

Department of Pediatrics, Russian Medical Academy of Continuing Professional Education of the Ministry of Health, Moscow, Russia

Svetlana Borzakova & Ismail M. Osmanov

School of Applied Psychology, University College Cork, Cork City, Ireland

Audrey DunnGalvin

Department of Paediatrics and Paediatric Rheumatology, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia

Anastasia Chernyavskaya

Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy

Pasquale Comberiati & Diego G. Peroni

Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA

Nikita Nekliudov

Department of PediatricsPediatric Epidemiology, Medical Faculty, Leipzig University, Leipzig, Germany

Jon Genuneit

Universidad de La Sabana, School of Medicine, Chía, Colombia

Luis Felipe Reyes

Pandemic Sciences Institute, University of Oxford, Oxford, UK

Department of Pediatric Pulmonology, Emma Children’s Hospital, Amsterdam University Medical Centers, Amsterdam, the Netherlands

Caroline L. H. Brackel

Department of Pediatrics, Tergooi MC, Hilversum, the Netherlands

Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia

Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation, Moscow, Russia

Lyudmila Mazankova & Elmira Samitova

ZA Bashlyaeva Children’s Municipal Clinical Hospital, Moscow, Russia

Alexandra Miroshina, Elmira Samitova & Ismail M. Osmanov

Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare Department, Moscow, Russia

Svetlana Borzakova

ISARIC Global Support Centre, Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK

Gail Carson, Louise Sigfrid & Piero Olliaro

MRC-University of Glasgow Centre for Virus Research, Glasgow, UK

Janet T. Scott

Long Covid Kids & Friends Charity, Crowhurst, UK

Sammie McFarland

Department of Pediatrics, Section of Allergy/Immunology, Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora, USA

Matthew Greenhawt

Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

Danilo Buonsenso

Dipartimento Di Scienze Biotecnologiche Di Base, Cliniche Intensivologiche E Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy

Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore, Roma, Italy

Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK

Malcolm G. Semple

Department of Respiratory Medicine, Alder Hey Children’s Hospital, Liverpool, UK

Inflammation, Repair and Development Section, National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK

John O. Warner

Care for Long Term Conditions Division, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, UK

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  • Khazhar Aktulaeva
  • , Islamudin Aldanov
  • , Nikol Alekseeva
  • , Ramina Assanova
  • , Asmik Avagyan
  • , Irina Babkova
  • , Lusine Baziyants
  • , Anna Berbenyuk
  • , Tatiana Bezbabicheva
  • , Julia Chayka
  • , Iuliia Cherdantseva
  • , Yana Chervyakova
  • , Tamara Chitanava
  • , Alexander Chubukov
  • , Natalia Degtiareva
  • , Gleb Demyanov
  • , Semen Demyanov
  • , Salima Deunezhewa
  • , Aleksandr Dubinin
  • , Anastasia Dymchishina
  • , Murad Dzhavadov
  • , Leila Edilgireeva
  • , Yulia Filippova
  • , Veronika Filippova
  • , Yuliia Frumkina
  • , Anastasia Gorina
  • , Cyrill Gorlenko
  • , Marat Gripp
  • , Mariia Grosheva
  • , Eliza Gudratova
  • , Elena Iakimenko
  • , Margarita Kalinina
  • , Ekaterina Kharchenko
  • , Anna Kholstinina
  • , Bogdan Kirillov
  • , Herman Kiseljow
  • , Natalya Kogut
  • , Polina Kondrashova
  • , Irina Konova
  • , Mariia Korgunova
  • , Anastasia Kotelnikova
  • , Alexandra Krupina
  • , Anna Kuznetsova
  • , Anastasia Kuznetsova
  • , Anna S. Kuznetsova
  • , Anastasia Laevskaya
  • , Veronika Laukhina
  • , Baina Lavginova
  • , Yulia Levina
  • , Elza Lidjieva
  • , Anastasia Butorina
  • , Juliya Lyaginskaya
  • , Ekaterina Lyubimova
  • , Shamil Magomedov
  • , Daria Mamchich
  • , Rezeda Minazetdinova
  • , Artemii Mingazov
  • , Aigun Mursalova
  • , Daria Nikolaeva
  • , Alexandra Nikolenko
  • , Viacheslav Novikov
  • , Georgiy Novoselov
  • , Ulyana Ovchinnikova
  • , Veronika Palchikova
  • , Kira Papko
  • , Mariia Pavlova
  • , Alexandra Pecherkina
  • , Sofya Permyakova
  • , Erika Porubayeva
  • , Kristina Presnyakova
  • , Maksim Privalov
  • , Alesia Prutkogliadova
  • , Anna Pushkareva
  • , Arina Redya
  • , Anastasia Romanenko
  • , Filipp Roshchin
  • , Diana Salakhova
  • , Maria Sankova
  • , Ilona Sarukhanyan
  • , Viktoriia Savina
  • , Ekaterina Semeniako
  • , Valeriia Seregina
  • , Anna Shapovalova
  • , Khivit Sharbetova
  • , Nataliya Shishkina
  • , Anastasia Shvedova
  • , Valeriia Stener
  • , Valeria Ustyan
  • , Yana Valieva
  • , Maria Varaksina
  • , Katerina Varaksina
  • , Ekaterina Varlamova
  • , Natalia Vlasova
  • , Margarita Yegiyan
  • , Nadezhda Ziskina
  • , Daniella Zolochevskaya
  •  & Elena Zuykova

Contributions

DM and AAK conceptualised the project and formulated research goals and aims. EP, MR, DBa, EB, NM, YET, PP, AE, LS, DBu, JG, AAK, and DM were responsible for the study design and methodology and participated in the overall project design discussions. ADG, PC, DGP, JG, LFR, CLHB, GC, LS, JTS, MG, MGS, JOW, PO, and DM participated in the CRF development and/or provided expert input at different stages of the project. EP implemented the computer code and supporting algorithms and tested of existing code components. DM and EP tested hypotheses and discussed statistical analyses. EP performed statistical analysis. The StopCOVID Research Team, MA, EI, PBo, MP, AT, EA, AG, YF, AB, AZ, NB, ACh, EK, AK, SG, YVI, IT, AE, and LAF, conducted a research and investigation process, specifically performed data extraction, telephone interviews, and data collection. AM, ESa, EB, SB, EB, AAK, and IMO provided study materials, access to patient data, laboratory data, and computing resources. MR, DBa, YET, MA, EI, PBo, and NN managed activities to annotate metadata and maintain research data for initial use and later reuse. EP prepared visualisation and worked under DM supervision on the data presentation. DM was responsible for the oversight and leadership for the research activity planning and execution. DM, EB, AAK, MR, DBa, EB, NM, YET, PP, AE, and EP provided management and coordination for the research activity planning and execution. SM provided invaluable views from the perspective of a person with long COVID and as a parent of children with long COVID. EP, EB, and DM wrote original draft. All the authors critically reviewed and commented on the manuscript draft at both pre-and post-submission stages. All authors read and approved the final manuscript.

Authors’ Twitter handles

Daniel Munblit: @DrMunblit; Danilo Buonsenso: @surf4children.

Corresponding author

Correspondence to Daniel Munblit .

Ethics declarations

Ethics approval and consent to participate.

This study was approved by the Moscow City Independent Ethics Committee (abbreviate 1, protocol number 74). Parental consent was sought during hospital admission, and consent for the follow-up interview was sought via verbal confirmation during telephone interview. The consent process was approved by the ethics.

Consent for publication

Not applicable.

Competing interests

DM co-leads the PC-COS project, developing Core Outcome Set for post-COVID-19 condition, outside the submitted work. LFR reports grants and personal fees from Merck and Pfizer and personal fees from GSK, outside the submitted work. LS received support by the UK Foreign, Commonwealth and Development Office and Wellcome [215091/Z/18/Z] and the Bill & Melinda Gates Foundation [OPP1209135], outside the submitted work. All other authors have no conflicts of interest relevant to this article to disclose.

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Supplementary Information

Additional file 1: table s1..

Criteria for hospital admission as per local clinical guidelines. Table S2. Demographic characteristics of study participants—initial and matched cases, sensitivity analysis. Table S3. Incidence and prevalence of Post COVID-19 manifestations. Figure S1. Time of study participants hospital admission and their chronological correspondence to COVID-19 variant dominance in Moscow city. Figure S2. Incidence of post-COVID-19 condition manifestations in matched exposed and reference groups, sensitivity analysis. Figure S3. Rates of events for incomplete recovery and emotional behavioural changes in matched exposed and reference groups, sensitivity analysis.

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Pazukhina, E., Rumyantsev, M., Baimukhambetova, D. et al. Event rates and incidence of post-COVID-19 condition in hospitalised SARS-CoV-2 positive children and young people and controls across different pandemic waves: exposure-stratified prospective cohort study in Moscow (StopCOVID). BMC Med 22 , 48 (2024). https://doi.org/10.1186/s12916-023-03221-x

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Event rates and incidence of post-COVID-19 condition in hospitalised SARS-CoV-2 positive children and young people and controls across different pandemic waves: exposure-stratified prospective cohort study in Moscow (StopCOVID)

Collaborators.

  • Sechenov StopCOVID Research Team : Khazhar Aktulaeva ,  Islamudin Aldanov ,  Nikol Alekseeva ,  Ramina Assanova ,  Asmik Avagyan ,  Irina Babkova ,  Lusine Baziyants ,  Anna Berbenyuk ,  Tatiana Bezbabicheva ,  Julia Chayka ,  Iuliia Cherdantseva ,  Yana Chervyakova ,  Tamara Chitanava ,  Alexander Chubukov ,  Natalia Degtiareva ,  Gleb Demyanov ,  Semen Demyanov ,  Salima Deunezhewa ,  Aleksandr Dubinin ,  Anastasia Dymchishina ,  Murad Dzhavadov ,  Leila Edilgireeva ,  Veronika Filippova ,  Yuliia Frumkina ,  Anastasia Gorina ,  Cyrill Gorlenko ,  Marat Gripp ,  Mariia Grosheva ,  Eliza Gudratova ,  Elena Iakimenko ,  Margarita Kalinina ,  Ekaterina Kharchenko ,  Anna Kholstinina ,  Bogdan Kirillov ,  Herman Kiseljow ,  Natalya Kogut ,  Polina Kondrashova ,  Irina Konova ,  Mariia Korgunova ,  Anastasia Kotelnikova ,  Alexandra Krupina ,  Anna Kuznetsova ,  Anastasia Kuznetsova ,  Anna S Kuznetsova ,  Anastasia Laevskaya ,  Veronika Laukhina ,  Baina Lavginova ,  Yulia Levina ,  Elza Lidjieva ,  Anastasia Butorina ,  Juliya Lyaginskaya ,  Ekaterina Lyubimova ,  Shamil Magomedov ,  Daria Mamchich ,  Rezeda Minazetdinova ,  Artemii Mingazov ,  Aigun Mursalova ,  Daria Nikolaeva ,  Alexandra Nikolenko ,  Viacheslav Novikov ,  Georgiy Novoselov ,  Ulyana Ovchinnikova ,  Veronika Palchikova ,  Kira Papko ,  Mariia Pavlova ,  Alexandra Pecherkina ,  Sofya Permyakova ,  Erika Porubayeva ,  Kristina Presnyakova ,  Maksim Privalov ,  Alesia Prutkogliadova ,  Anna Pushkareva ,  Arina Redya ,  Anastasia Romanenko ,  Filipp Roshchin ,  Diana Salakhova ,  Maria Sankova ,  Ilona Sarukhanyan ,  Viktoriia Savina ,  Ekaterina Semeniako ,  Valeriia Seregina ,  Anna Shapovalova ,  Khivit Sharbetova ,  Nataliya Shishkina ,  Anastasia Shvedova ,  Valeriia Stener ,  Valeria Ustyan ,  Yana Valieva ,  Maria Varaksina ,  Katerina Varaksina ,  Ekaterina Varlamova ,  Natalia Vlasova ,  Margarita Yegiyan ,  Nadezhda Ziskina ,  Daniella Zolochevskaya ,  Elena Zuykova

Affiliations

  • 1 Laboratory of Health Economics, Institute of Applied Economic Studies, The Russian Presidential Academy of National Economy and Public Administration, Moscow, Russia.
  • 2 Center for Advanced Financial Planning, Macroeconomic Analysis and Financial Statistics, Financial Research Institute of the Ministry of Finance of the Russian Federation, Moscow, Russia.
  • 3 Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
  • 4 Tareev Clinic of Internal Diseases, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
  • 5 School of Applied Psychology, University College Cork, Cork City, Ireland.
  • 6 Department of Paediatrics and Paediatric Rheumatology, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
  • 7 Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy.
  • 8 Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
  • 9 Department of PediatricsPediatric Epidemiology, Medical Faculty, Leipzig University, Leipzig, Germany.
  • 10 Universidad de La Sabana, School of Medicine, Chía, Colombia.
  • 11 Pandemic Sciences Institute, University of Oxford, Oxford, UK.
  • 12 Department of Pediatric Pulmonology, Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, the Netherlands.
  • 13 Department of Pediatrics, Tergooi MC, Hilversum, the Netherlands.
  • 14 Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation, Moscow, Russia.
  • 15 ZA Bashlyaeva Children's Municipal Clinical Hospital, Moscow, Russia.
  • 16 Department of Pediatrics, Russian Medical Academy of Continuing Professional Education of the Ministry of Health, Moscow, Russia.
  • 17 Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare Department, Moscow, Russia.
  • 18 ISARIC Global Support Centre, Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
  • 19 MRC-University of Glasgow Centre for Virus Research, Glasgow, UK.
  • 20 Long Covid Kids & Friends Charity, Crowhurst, UK.
  • 21 Department of Pediatrics, Section of Allergy/Immunology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, USA.
  • 22 Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
  • 23 Dipartimento Di Scienze Biotecnologiche Di Base, Cliniche Intensivologiche E Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy.
  • 24 Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore, Roma, Italy.
  • 25 Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK.
  • 26 Department of Respiratory Medicine, Alder Hey Children's Hospital, Liverpool, UK.
  • 27 Inflammation, Repair and Development Section, National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK.
  • 28 Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia. [email protected].
  • 29 Research and Clinical Center for Neuropsychiatry, Moscow, Russia. [email protected].
  • 30 Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia. [email protected].
  • 31 Care for Long Term Conditions Division, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK. [email protected].
  • PMID: 38302974
  • PMCID: PMC10835884
  • DOI: 10.1186/s12916-023-03221-x

Background: Long-term health outcomes in children and young people (CYP) after COVID-19 infection are not well understood and studies with control groups exposed to other infections are lacking. This study aimed to investigate the incidence of post-COVID-19 condition (PCC) and incomplete recovery in CYP after hospital discharge and compare outcomes between different SARS-CoV-2 variants and non-SARS-CoV-2 infections.

Methods: A prospective exposure-stratified cohort study of individuals under 18 years old in Moscow, Russia. Exposed cohorts were paediatric patients admitted with laboratory-confirmed COVID-19 infection between April 2 and December 11, 2020 (Wuhan variant cohort) and between January 12 and February 19, 2022 (Omicron variant cohort). CYP admitted with respiratory and intestinal infections, but negative lateral flow rapid diagnostic test and PCR-test results for SARS-CoV-2, between January 12 and February 19, 2022, served as unexposed reference cohort. Comparison between the 'exposed cohorts' and 'reference cohort' was conducted using 1:1 matching by age and sex. Follow-up data were collected via telephone interviews with parents, utilising the long COVID paediatric protocol and survey developed by the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC). The WHO case definition was used to categorise PCC.

Results: Of 2595 CYP with confirmed COVID-19, 1707 (65.7%) participated in follow-up interviews, with 1183/1707 (69%) included in the final 'matched' analysis. The median follow-up time post-discharge was 6.7 months. The incidence of PCC was significantly higher in the Wuhan variant cohort (89.7 cases per 1000 person-months, 95% CI 64.3-120.3) compared to post-infection sequalae in the reference cohort (12.2 cases per 1000 person-months, 95% CI 4.9-21.9), whereas the difference with the Omicron variant cohort and reference cohort was not significant. The Wuhan cohort had higher incidence rates of dermatological, fatigue, gastrointestinal, sensory, and sleep manifestations, as well as behavioural and emotional problems than the reference cohort. The only significant difference between Omicron variant cohort and reference cohort was decreased school attendance. When comparing the Wuhan and Omicron variant cohorts, higher incidence of PCC and event rates of fatigue, decreased physical activity, and deterioration of relationships was observed. The rate of incomplete recovery was also significantly higher in the Wuhan variant cohort than in both the reference and the Omicron variant cohorts.

Conclusions: Wuhan variant exhibited a propensity for inducing a broad spectrum of physical symptoms and emotional behavioural changes, suggesting a pronounced impact on long-term health outcomes. Conversely, the Omicron variant resulted in fewer post-infection effects no different from common seasonal viral illnesses. This may mean that the Omicron variant and subsequent variants might not lead to the same level of long-term health consequences as earlier variants.

Keywords: COVID-19; COVID-19 sequelae; Children; Controlled study; Incidence; Long COVID; PASC; Post COVID-19 condition; Post-acute sequelae of SARS-CoV-2 infection.

© 2024. The Author(s).

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Conflict of interest statement

DM co-leads the PC-COS project, developing Core Outcome Set for post-COVID-19 condition, outside the submitted work. LFR reports grants and personal fees from Merck and Pfizer and personal fees from GSK, outside the submitted work. LS received support by the UK Foreign, Commonwealth and Development Office and Wellcome [215091/Z/18/Z] and the Bill & Melinda Gates Foundation [OPP1209135], outside the submitted work. All other authors have no conflicts of interest relevant to this article to disclose.

Study flow chart

Incidence of post-COVID-19 condition manifestations…

Incidence of post-COVID-19 condition manifestations in Wuhan variant cohort, Omicron variant cohort, and…

Event rate for incomplete recovery…

Event rate for incomplete recovery and emotional and behavioural changes in Wuhan variant…

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