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.