Abstract
Introduction: Although prolonged respiratory symptoms following
SARS-CoV-2 infection have been reported in adults, there is a paucity of
literature describing post-acute symptoms in pediatric patients
following COVID-19. In this study we describe health data and
respiratory findings in pediatric patients presenting with complaints of
persistent respiratory symptoms following acute COVID-19 infection.
Methods: This study included patients referred to Pulmonary
Clinic at the Children’s Hospital of Philadelphia between December 2020
and April 2021 (n=29). Inclusion criteria included a history of
SARS-CoV-2 RNA positivity or confirmed close household contact. A
retrospective chart review was performed and demographic, clinical,
imaging, and functional test data were collected.
Results: The mean age at presentation to clinic was 13.1 years
(range: 4-19 years). Patients had persistent respiratory symptoms
ranging from 1.3 to 6.7 months post-acute infection. Persistent dyspnea
and/or exertional dyspnea were present in nearly all (96.6%) of the
patients at the time of clinic presentation. Other reported chronic
symptoms included cough (51.7%) and exercise intolerance (48.3%).
Fatigue was reported in 13.7% of subjects. Many subjects were
overweight or obese (62.1%) and eleven subjects had a prior history of
asthma. Lung function was normal in most patients. The six-minute walk
test (6MWT) revealed exercise intolerance and significant tachycardia in
two-thirds of children tested.
Conclusion: Exertional dyspnea, cough and exercise intolerance
were the most common respiratory symptoms in children with post-acute
COVID-19 respiratory symptoms seen in an outpatient pulmonary clinic.
Lung function, however, was mostly normal, and exertional intolerance
was frequently demonstrated using the 6MWT.