Leveraging Serologic Testing to Identify Children at Risk For Post-Acute Sequelae of SARS-CoV-2 Infection: An Electronic Health Record-Based Cohort Study from the RECOVER Program

J Pediatr. 2023 Jun:257:113358. doi: 10.1016/j.jpeds.2023.02.005. Epub 2023 Feb 22.

Abstract

Using an electronic health record-based algorithm, we identified children with Coronavirus disease 2019 (COVID-19) based exclusively on serologic testing between March 2020 and April 2022. Compared with the 131 537 polymerase chain reaction-positive children, the 2714 serology-positive children were more likely to be inpatients (24% vs 2%), to have a chronic condition (37% vs 24%), and to have a diagnosis of multisystem inflammatory syndrome in children (23% vs <1%). Identification of children who could have been asymptomatic or paucisymptomatic and not tested is critical to define the burden of post-acute sequelae of severe acute respiratory syndrome coronavirus 2 infection in children.

Keywords: COVID-19 serology; PEDSnet; anti-N antibodies; anti-S antibodies; chronic COVID-19 syndrome; late sequelae of COVID-19; long COVID; long-haul COVID-19; long-term COVID-19; post-acute COVID-19; post-acute sequelae of COVID-19; post-acute sequelae of SARS-CoV-2 infection; post–COVID-19 syndrome.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural

MeSH terms

  • Antibodies, Viral
  • COVID-19 Testing
  • COVID-19* / complications
  • COVID-19* / diagnosis
  • Child
  • Cohort Studies
  • Disease Progression
  • Electronic Health Records
  • Humans
  • Post-Acute COVID-19 Syndrome
  • SARS-CoV-2
  • Systemic Inflammatory Response Syndrome

Substances

  • Antibodies, Viral

Supplementary concepts

  • pediatric multisystem inflammatory disease, COVID-19 related