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Leveraging Serologic Testing to Identify Children at Risk For Post-Acute Sequelae of SARS-CoV-2 Infection: An Electronic Health Record–Based Cohort Study from the RECOVER Program - 17/06/23

Doi : 10.1016/j.jpeds.2023.02.005 
Asuncion Mejias, MD, PhD, MsCS 1, , Julia Schuchard, PhD 2, , Suchitra Rao, MBBS, MSCS 3, Tellen D. Bennett, MD, MS 3, Ravi Jhaveri, MD 4, Deepika Thacker, MD 5, L. Charles Bailey, MD, PhD 2, Dimitri A. Christakis, MD, MPH 6, Nathan M. Pajor, MD, MS 7, Hanieh Razzaghi, MPH 2, Christopher B. Forrest, MD, PhD 2, Grace M. Lee, MD, MPH 8
1 Division of Infectious Diseases, Department of Pediatrics, Nationwide Children’s Hospital and The Ohio State University, Columbus, OH 
2 Applied Clinical Research Center, Children’s Hospital of Philadelphia, Philadelphia, PA 
3 Department of Pediatrics, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO 
4 Division of Infectious Diseases, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL 
5 Division of Cardiology, Nemours Children’s Health, Wilmington, DE 
6 Center for Child Health, Behavior and Development, Seattle Children’s Hospital, Seattle, WA 
7 Division of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH 
8 Department of Pediatrics (Infectious Diseases), Stanford University School of Medicine, Stanford, CA 

Reprint requests: Asuncion Mejias, MD, PhD, MsCS, Nationwide Children’s Hospital, 700 Children’s Drive, WA4022, Columbus, OH 43205. Nationwide Children’s Hospital 700 Children’s Drive, WA4022 Columbus OH 43205

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Abstract

Using an electronic health record–based algorithm, we identified children with Coronavirus disease 2019 (COVID-19) based exclusively on serologic testing between March 2020 and April 2022. Compared with the 131 537 polymerase chain reaction–positive children, the 2714 serology-positive children were more likely to be inpatients (24% vs 2%), to have a chronic condition (37% vs 24%), and to have a diagnosis of multisystem inflammatory syndrome in children (23% vs <1%). Identification of children who could have been asymptomatic or paucisymptomatic and not tested is critical to define the burden of post-acute sequelae of severe acute respiratory syndrome coronavirus 2 infection in children.

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Keywords : PEDSnet, COVID-19 serology, anti-N antibodies, anti-S antibodies, post-acute sequelae of COVID-19, long COVID, chronic COVID-19 syndrome, late sequelae of COVID-19, long-haul COVID-19, long-term COVID-19, post–COVID-19 syndrome, post-acute COVID-19, post-acute sequelae of SARS-CoV-2 infection

Abbreviations and Acronyms : COVID-19, EHR, N, PASC, PCR, MIS-C, RBD, S, SARS-CoV-2


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  This research was funded by National Institutes of Health (NIH) Agreement OT2HL161847-01 as part of the Researching COVID to Enhance Recovery (RECOVER) program. The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the RECOVER Program, the NIH, or other funders.
  A.M. reports funding from Janssen and Merck for research support and from Janssen , Merck , and Sanofi-Pasteur for advisory board participation. S.R. reports prior grant support from GSK and BioFire and serves as a consultant for Sequiris. R.J. serves as a consultant for AstraZeneca, Seqirus, and Dynavax and receives an editorial stipend from Elsevier. The other authors declare no conflicts of interest.


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