Pediatric Long COVID subphenotypes: An EHR-based study from the RECOVER Program
Lorman, V; Bailey, LC; Song, X; et al., PLOS Digital Health
Published
April 2025
Journal
PLOS Digital Health
Abstract
Pediatric Long COVID has been associated with a wide variety of symptoms, conditions, and organ systems, but distinct clinical presentations, or subphenotypes, are still being elucidated. In this exploratory analysis, we identified a cohort of pediatric (age <21) patients with evidence of Long COVID and no pre-existing complex chronic conditions using electronic health record data from 38 institutions and used an unsupervised machine learning-based approach to identify subphenotypes. Our method, an extension of the Phe2Vec algorithm, uses tens of thousands of clinical concepts from multiple domains to represent patients' clinical histories to then identify groups of patients with similar presentations. The results indicate that cardiorespiratory presentations are most common (present in 54% of patients) followed by subphenotypes marked (in decreasing order of frequency) by musculoskeletal pain, neuropsychiatric conditions, gastrointestinal symptoms, headache, and fatigue.
Authors
Vitaly Lorman, L Charles Bailey, Xing Song, Suchitra Rao, Mady Hornig, Levon Utidjian, Hanieh Razzaghi, Asuncion Mejias, John Erik Leikauf, Seuli Bose Brill, Andrea Allen, H Timothy Bunnell, Cara Reedy, Abu Saleh Mohammad Mosa, Benjamin D Horne, Carol Reynolds Geary, Cynthia H Chuang, David A Williams, Dimitri A Christakis, Elizabeth A Chrischilles, Eneida A Mendonca, Lindsay G Cowell, Lisa McCorkell, Mei Liu, Mollie R Cummins, Ravi Jhaveri, Saul Blecker, Christopher B Forrest; RECOVER Consortium
Keywords
Not available
Short Summary
This RECOVER study aimed to better understand how Long COVID affects kids in different ways. Researchers looked at the electronic health records (EHRs) of pediatric patients under the age of 21 who had signs of Long COVID. The study focused on children who were generally healthy and did not have serious long-term health problems before they got sick with COVID-19. Researchers used a special computer method to look for patterns of symptoms in children’s EHRs. This helped them find groups of kids who had similar health problems after having COVID-19, meaning that they had similar experiences with Long COVID. They found that more than half of the children in the study had heart, lung, and breathing problems related to Long COVID. Other common symptoms included muscle and joint pain, mood and thinking problems, stomach issues, headaches, and feeling tired. These findings give researchers a clearer picture of how Long COVID shows up in kids, which can guide future studies.