Racial/ethnic differences in post-acute sequelae of SARS-CoV-2 in children and adolescents in the United States
Zhang, D; Zhang, B; Wu, Q; et al., Nature Communications
Published
January 2025
Journal
Nature Communications
Abstract
Racial/ethnic differences are associated with the symptoms and conditions of post-acute sequelae SARS-CoV-2 infection (PASC) in adults. These differences may exist among children and warrant further exploration. We conducted a retrospective cohort study with difference-in-differences analyzes to assess these differences in children and adolescents under the age of 21. The study utilized data from the RECOVER Initiative in the United States, which aims to learn about the long-term effects of COVID-19. The cohort included 225,723 patients with SARS-CoV-2 infection or COVID-19 diagnosis between March 2020 and October 2022. The study compared minority racial/ethnic groups to Non-Hispanic White (NHW) individuals, stratified by severity during the acute phase of COVID-19. Within the severe group, Asian American/Pacific Islanders (AAPI) had a higher prevalence of fever/chills and respiratory signs and symptoms, Hispanic patients showed greater hair loss prevalence in severe COVID-19 cases, while Non-Hispanic Black (NHB) patients had fewer skin symptoms in comparison to NHW patients. Within the non-severe group, AAPI patients had increased POTS/dysautonomia and respiratory symptoms, and NHB patients showed more cognitive symptoms than NHW patients. In conclusion, racial/ethnic differences related to COVID-19 exist among PASC symptoms and conditions in pediatrics, and these differences are associated with the severity of illness during acute COVID-19.
Authors
Dazheng Zhang, Bingyu Zhang, Qiong Wu, Ting Zhou, Jiayi Tong, Yiwen Lu, Jiajie Chen, Huiyuan Wang, Deena J Chisolm, Ravi Jhaveri, Rachel C Kenney, Russell L Rothman, Suchitra Rao, David A Williams, Mady Hornig, Linbo Wang, Jeffrey S Morris, Christopher B Forrest, Yong Chen
Keywords
Humans; COVID-19/epidemiology/ethnology; Adolescent; Child; United States/epidemiology; Male; Female; Retrospective Studies; SARS-CoV-2/isolation & purification; Child, Preschool; Post-Acute COVID-19 Syndrome; Ethnicity/statistics & numerical data; Young Adult; Infant; Severity of Illness Index; White People/statistics & numerical data; Prevalence; Hispanic or Latino/statistics & numerical data; Black or African American/statistics & numerical data; Ethnic and Racial Minorities/statistics & numerical data; White
Short Summary
This RECOVER study looked at how a child’s race or ethnicity might affect their chances of developing long-term health problems after getting COVID-19. Researchers studied data from 225,723 children and teens across 13 US hospitals and clinics from March 2020 to October 2022. They compared children who were diagnosed with COVID or had a positive COVID test to those who never tested positive. The study found that children with COVID were more likely to develop many health problems weeks or months after getting COVID than those who never had it. These problems included trouble breathing, feeling very tired (fatigue), and mental health problems.
Researchers also found that the chance of having these problems was different depending on a child's race or ethnicity. For example, Hispanic children with severe COVID were more likely to have hair loss after getting sick than Non-Hispanic White children with severe cases. Non-Hispanic Black children with less severe COVID were more likely to experience cognitive symptoms (related to thinking, memory, or concentration) than Non-Hispanic White children with less severe COVID. In children with less severe COVID, Asian American/Pacific Islander children were more likely to have more fever, chills, and respiratory symptoms (related to breathing) than Non-Hispanic White children. This study shows that long-term health problems in children and teens after COVID may be different between racial and ethnic groups. This can help doctors better understand and treat Long COVID in people who are more likely to get it.