gms | German Medical Science

Background and status of (inter)national research: Some children and adolescents suffer from late effects of SARS-CoV-2 infection despite frequently mild courses of the initial coronavirus disease (COVID-19). Post-viral symptoms beyond three months after the infection were defined as post-COVID condition/post-COVID syndrome (PCS). There is an urgent need for a multimodal, intersectoral and comprehensive care network for children and adolescents with PCS. The “Post COVID Kids Bavaria” (PoCo) network provides multi-level care for children, adolescents and young people, who suffer from PCS.

Research question and objective: Does the health care provided within the PoCo network improve the subjective health status of children, adolescents and young people with PCS? How are patients’ care pathways? Which health care services are prescribed and utilized?

Method or hypothesis: It is envisaged to recruit 160 children, adolescents and young adults up to 24 years with PCS who are diagnosed and treated in 16 participating outpatient clinics in Bavaria. Health care utilization and patient reported outcomes (PROs) will be assessed at different time points (at baseline, after four weeks as well as after three and six months) using routine data, interviews and self-report questionnaires. The primary outcome is the visual analogue scale (VAS) of the EQ-5D (European Quality of Life 5 Dimensions). Secondary outcomes are fatigue measured the PROMIS^® Pediatric Short Form v2.0 – Fatigue 10a questionnaire, Post-Exertional Malaise (PEM) measured by the DePaul Symptom Questionnaire Post-Exertional Malaise (DSQ-PEM) and mental health, which is assessed by the Strength and Difficulties Questionnaire (SDQ). A pre-post study design will be used to assess patients´ subjective health status regarding PCS.

Discussion: The prospective evaluation of health care services for children, adolescents and young people with PCS brings some challenges, including the consideration of heterogeneous symptoms of PCS and the complex therapeutic measures. In addition, different age groups make it difficult to identify outcome measures suitable for all participants and severely affected patients may have problems completing the self-reported instruments due to fatigue and/or exertion intolerance. Moreover, as in many longitudinal studies patients might drop out of the study early, for example due to the presumed improvement of symptoms through the care provided in the network.

Practical implications: This study will improve our knowledge on the role of multi-modal and intersectoral care of PCS in children, adolescents and young people. Risk groups can be identified, which are particularly affected by the long-term effects of SARS-CoV-2 infection, including patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Avenues for optimizing care may be identified.

Appeal for practice (science and/or care) in one sentence: Due to an accumulation of PCS cases, it is becoming increasingly important to conduct further research on the development of care structures for children, adolescents and young adults.

Funding: Sonstige Förderung