Introduction
The novel coronavirus (COVID-19) began spreading through the U.S. in early 2020, and there have been over 30 million cases in the U.S. as of June 2021, of which over 4 million have been reported in children (14.2% of all cases). The overall rate is 5,347 cases of COVID-19 per 100,000 children in the population 1,2. Although severe illness due to COVID-19 is rare among children3, there is a lack of data on the longer-term impacts of the pandemic on children, including the long-term physical harm on the health of infected children 4. Although there is little data in children, increasing reports have emerged that adult patients frequently experience long-term adverse outcomes related to COVID-19 following resolution of the acute illness5-11. In a recent study by JK Logue et al., persistent symptoms were reported by 32.7% of adult outpatients following mild acute COVID-19 infection 8. In a study of 180 mild cases of COVID-19 from the Faroe Islands, 53% of patients were symptomatic at mean 4-month follow up with fatigue in 30%, dyspnea in 10%, and chest tightness in 5% 9. In a large longitudinal study of hospitalized patients from Wuhan, among individuals who did not require supplemental oxygen during acute COVID-19, 81% reported residual symptoms six months after acute illness7. Previous studies have reported that even among young adults aged 18–34 years with no chronic medical conditions, approximately one in five had not returned to their usual state of health 14–21 days after acute infection 10. The National Institute of Health and Care Excellence defines “long COVID” as symptoms that persistent beyond four weeks, and distinguishes between ongoing symptomatic COVID-19 as signs and symptoms of COVID-19 from four to twelve weeks and post-COVID-19 syndrome as signs and symptoms that continue for more than twelve weeks 12. There is currently a paucity of literature describing such post-acute symptoms in pediatric patients with COVID-19. The aim of this study is to describe baseline health data and respiratory findings in a cohort of pediatric patients experiencing prolonged symptoms following acute COVID-19 infection.