Substantial proportion of ethnically diverse children from low-resource backgrounds report long-term COVID-19 complications

A substantial proportion of ethnically diverse children from low-resource backgrounds with severe COVID-19 illness are reporting long-term complications from the virus, according to research from UTHealth Houston.

The study, published Monday in the International Journal of Environmental Research and Public Health, found that pediatric patients with private health insurance were 66% less likely to report long COVID symptoms versus those with government insurance.

Most pediatric COVID-19 cases are asymptomatic; however, a small number of children are diagnosed with multisystem inflammatory syndrome in children (MIS-C) — a rare but severe condition that is associated with SARS-CoV-2 infection. Persistent symptoms of COVID-19 illness in children diagnosed with and without MIS-C is largely unknown.

“Over 27% of patients diagnosed with MIS-C and 15% of patients not diagnosed with MIS-C reported symptoms lasting more than four months,” said Sarah Messiah, PhD, MPH, first author of the study and professor of epidemiology at UTHealth Houston School of Public Health Dallas Campus. “These findings suggest that COVID illness is impacting a significant proportion of children long-term and that we need to start thinking about this not only as an acute, but a chronic pediatric condition.”

Researchers, many of whom were School of Public Health graduate students, conducted survey interviews with over 300 families who had a child diagnosed with COVID-19 illness. Acute long COVID symptoms last less than 30 days, while chronic long COVID symptoms can last more than 120 days. Patients and caregivers then completed a follow-up survey from March 2021 to January 2022 to assess the presence of long COVID.

Key findings included:

• Children who were not diagnosed with MIS-C (54.49% Hispanic, 19.23% non-Hispanic Black, 79.49% on government insurance) were younger than children who were diagnosed with MIS-C (mean age 6.43 years versus 9.08 years).
• Approximately 11.5% of children with MIS-C and 37.8% without MIS-C reported acute long COVID, while 26.9% and 15.3% reported chronic long COVID, respectively.
• Female children were almost twice as likely to report long COVID symptoms versus male children.

“Our research also highlighted the disparities of age, sex, and race/ethnicity in terms of risk for long COVID symptoms,” said Luyu Xie, PharmD, PhD, postdoctoral research fellow and lead data analyst of the study at the school’s Dallas campus. “Specifically, we found older age, being female, and identifying as an ethnic minority were all more likely to report long COVID symptoms. These findings can inform future tailored interventions.”

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