Longterm Impact of COVID-19 in Hospitalized and Ambulatory Jamaican Children

Background: Within the Caribbean, COVID-19 and its sequelae in the pediatric population have been understudied. We sought to characterize Long COVID-19 in this population. Predictors and outcomes of Long COVID-19 were evaluated in hospitalized and ambulatory patients aged <16 years receiving treatment during 2021-2023 at the University Hospital of the West Indies, Jamaica. Methods: This retrospective observational cohort study, approved by the University Ethics Committee, extracted medical records data from ill SARS-CoV-2 positive patients and then surveyed this cohort for symptoms of Long COVID-19. Poisson regression models accounted for varying follow-up times after acute COVID-19 and generated univariate and multivariable models for predictors of Long COVID-19. Results: Forty-seven percent of the 74 survey responders met the WHO 2023 pediatric criteria for Long COVID-19. Common symptoms of Long COVID-19 included cough, chest tightness, fatigue, congestion, ageusia, anosmia, anorexia, and insomnia. Acute illness symptoms associated with Long COVID-19 included fatigue, vomiting, diarrhea, anosmia, abdominal pain, confusion, brain fog, persistent chest tightness, cough, nasal congestion, ageusia, anosmia, insomnia, and chest pain (IRR=1.61-2.56; p=0.000-0.034). Between those with and without Long COVID-19, there were no significant differences in demographics, comorbidities, SARS-CoV-2 variant, site of care, functional impairment and quality of life. Acute illness univariate Long COVID-19 predictors were vomiting, abdominal pain, ageusia, fatigue, confusion, brain fog, and multisystem inflammatory syndrome of children (MIS-C) (p<0.05; IRR>1.0). Multivariable composite predictors were MIS-C, vomiting, and ageusia (Pseudo R2:11.9%; p<0.001). Conclusion: This 47% prevalence of Long COVID-19 in pediatric patients implies potential negative outcomes in productivity, academic performance, and comorbidity development.