OBJECTIVES To evaluate risk factors for postdischarge sequelae in children and adolescents hospitalized for acute coronavirus disease 2019 (COVID-19) or multisystem inflammatory syndrome in children (MIS-C). METHODS Multicenter prospective cohort study conducted in 25 United States pediatric hospitals. Patients <21-years-old, hospitalized May 2020 to May 2021 for acute COVID-19 or MIS-C with follow-up 2 to 4 months after admission. We assessed readmissions, persistent symptoms or activity impairment, and new morbidities. Multivariable regression was used to calculate adjusted risk ratios (aRR) and 95% confidence intervals (CI). RESULTS Of 358 eligible patients, 2 to 4 month survey data were available for 119 of 155 (76.8%) with acute COVID-19 and 160 of 203 (78.8%) with MIS-C. Thirteen (11%) patients with acute COVID-19 and 12 (8%) with MIS-C had a readmission. Thirty-two (26.9%) patients with acute COVID-19 had persistent symptoms (22.7%) or activity impairment (14.3%) and 48 (30.0%) with MIS-C had persistent symptoms (20.0%) or activity impairment (21.3%). For patients with acute COVID-19, persistent symptoms (aRR, 1.29 [95% CI, 1.04-1.59]) and activity impairment (aRR, 1.37 [95% CI, 1.06-1.78]) were associated with more organ systems involved. Patients with MIS-C and pre-existing respiratory conditions more frequently had persistent symptoms (aRR, 3.09 [95% CI, 1.55-6.14]) and those with obesity more frequently had activity impairment (aRR, 2.52 [95% CI, 1.35-4.69]). New morbidities were infrequent (9% COVID-19, 1% MIS-C). CONCLUSIONS Over 1 in 4 children hospitalized with acute COVID-19 or MIS-C experienced persistent symptoms or activity impairment for at least 2 months. Patients with MIS-C and respiratory conditions or obesity are at higher risk of prolonged recovery.

中文翻译：

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儿童和青少年因急性 COVID-19 或 MIS-C 住院后的健康损害。

目的 评估因 2019 年急性冠状病毒病 (COVID-19) 或儿童多系统炎症综合征 (MIS-C) 住院的儿童和青少年出院后后遗症的危险因素。方法 在美国 25 家儿科医院进行的多中心前瞻性队列研究。患者年龄<21岁，2020年5月至2021年5月因急性COVID-19或MIS-C住院，入院后2至4个月进行随访。我们评估了再入院、持续症状或活动障碍以及新发病情况。使用多变量回归计算调整后的风险比 (aRR) 和 95% 置信区间 (CI)。结果 在 358 名符合条件的患者中，155 名急性 COVID-19 患者中的 119 名 (76.8%) 和 203 名 MIS-C 患者中的 160 名 (78.8%) 可获得 2 至 4 个月的调查数据。13 名 (11%) 急性 COVID-19 患者和 12 名 (8%) 患有 MIS-C 的患者再次入院。32 名 (26.9%) 急性 COVID-19 患者有持续症状 (22.7%) 或活动障碍 (14.3%)，48 名 (30.0%) 患有 MIS-C 的患者有持续症状 (20.0%) 或活动障碍 (21.3%) ）。对于急性 COVID-19 患者，持续症状（aRR，1.29 [95% CI，1.04-1.59]）和活动障碍（aRR，1.37 [95% CI，1.06-1.78]）与更多器官系统受累相关。患有 MIS-C 和既往存在呼吸系统疾病的患者更常出现持续症状（aRR，3.09 [95% CI，1.55-6.14]），而肥胖患者更常出现活动障碍（aRR，2.52 [95% CI，1.35-1.35]）。 4.69]）。新发病率并不常见（9% 为 COVID-19，1% 为 MIS-C）。结论 超过四分之一的因急性 COVID-19 或 MIS-C 住院的儿童出现持续症状或活动障碍至少 2 个月。患有 MIS-C 和呼吸系统疾病或肥胖的患者长期康复的风险较高。