Notable COVID Studies Including Persistent Post-COVID Symptoms in Children

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COVID-19 Advice from CHOA:

D Kim et al. Clin Gastroenterol Hepatol 2021; 19: 1469-1479. Full text: Predictors of Outcomes of COVID-19 in Patients With Chronic Liver Disease: US Multi-center Study

Key findings:

  • The overall all-cause mortality in this cohort with chronic liver disease was 14.0% (n = 121 of 867), and 61.7% (n = 535) had severe COVID-19
  • Liver-specific factors associated with independent risk of higher overall mortality were alcohol-related liver disease (ALD) (hazard ratio [HR] 2.42), decompensated cirrhosis (HR 2.91) and hepatocellular carcinoma (HCC) (HR 3.31)
  • Related blog post: Aspen Webinar 2021: COVID-19 and the Liver

BK Elmunzer et al (>120 authors!) Clin Gastroenterol Hepatol 2021; 19: 1355-1365. Full text: Digestive Manifestations in Patients Hospitalized With Coronavirus Disease 2019

Key findings:

  • In this cohort with 1992 patients hospitalized with COVID-19, gastrointestinal symptoms and liver test abnormalities were common, but the majority were mild and their presence was not associated with a more severe clinical course: GI symptoms had OR of 0.93 and liver test abnormalities had OR of 1.31 for mechanical ventilation or death.
  • Common GI symptoms: diarrhea (34%), nausea (27%), vomiting (16%), and abdominal pain (11%). 35% of patients developed an abnormal alanine aminotransferase or total bilirubin level; these were increased to less than 5 times the upper limit of normal in 77% of cases.

Lancet Child Adolesc Health 2021. Published Online August 3, 2021. https://doi.org/10.1016/S2352-4642(21)00198-X. Open Access: Illness duration and symptom profile in symptomatic UK school-aged children tested for SARS-CoV-2.

  • Key finding: In this prospective cohort study, 25 of 1379 (1.8%) children (5-17 yrs) had symptoms lasting at least 56 days and 4.4% had symptoms lasting more than 4 weeks.

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