Predicting post-COVID-19 condition in children and young people up to 24 months after a positive SARS-CoV-2 PCR-test: the CLoCk study
Abstract Background Predicting which children and young people (CYP) are at the highest risk of developing post-COVID-19 condition (PCC) could improve care pathways. We aim to develop and validate prediction models for persistent PCC up to 24 months post-infection in CYP. Methods CYP who were PCR-po...
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BMC
2024-11-01
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| Online Access: | https://doi.org/10.1186/s12916-024-03708-1 |
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| author | Manjula D. Nugawela Terence Stephenson Roz Shafran Trudie Chalder Emma Dalrymple Tamsin Ford Lana Fox-Smith Anthony Harnden Isobel Heyman Shamez N. Ladhani Kelsey McOwat Ruth Simmons Olivia Swann Elizabeth Whittaker CLoCk Consortium Snehal M. Pinto Pereira |
| author_facet | Manjula D. Nugawela Terence Stephenson Roz Shafran Trudie Chalder Emma Dalrymple Tamsin Ford Lana Fox-Smith Anthony Harnden Isobel Heyman Shamez N. Ladhani Kelsey McOwat Ruth Simmons Olivia Swann Elizabeth Whittaker CLoCk Consortium Snehal M. Pinto Pereira |
| author_sort | Manjula D. Nugawela |
| collection | DOAJ |
| description | Abstract Background Predicting which children and young people (CYP) are at the highest risk of developing post-COVID-19 condition (PCC) could improve care pathways. We aim to develop and validate prediction models for persistent PCC up to 24 months post-infection in CYP. Methods CYP who were PCR-positive between September 2020 and March 2021, with follow-up data up to 24-months post-infection, were analysed. Persistent PCC was defined in two ways, as PCC at (a) 3, 6, 12 and 24 months post-infection (N = 943) or (b) 6, 12 and 24 months post-infection (N = 2373). Prediction models were developed using logistic regression; performance was assessed using calibration and discrimination measures; internal validation was performed via bootstrapping; the final model was adjusted for overfitting. Results While 24.7% (233/943) of CYP met the PCC definition 3 months post-infection, only 7.2% (68/943) continued to meet the PCC definition at all three subsequent timepoints, i.e. at 6, 12 and 24 months. The final models predicting risk of persistent PCC (at 3, 6, 12 and 24 months and at 6, 12 and 24 months) contained sex (female), history of asthma, allergy problems, learning difficulties at school and family history of ongoing COVID-19 problems, with additional variables (e.g. older age at infection and region of residence) in the model predicting PCC at 6, 12 and 24 months. Internal validation showed minimal overfitting of models with good calibration and discrimination measures (optimism-adjusted calibration slope: 1.064–1.142; C-statistic: 0.724–0.755). Conclusions To our knowledge, these are the only prediction models estimating the risk of CYP persistently meeting the PCC definition up to 24 months post-infection. The models could be used to triage CYP after infection. CYP with factors predicting longer-term symptomology, may benefit from earlier support. |
| format | Article |
| id | doaj-art-0a7d6a2b1e0845acb183100c25b3331f |
| institution | Kabale University |
| issn | 1741-7015 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj-art-0a7d6a2b1e0845acb183100c25b3331f2024-11-10T12:28:53ZengBMCBMC Medicine1741-70152024-11-0122111110.1186/s12916-024-03708-1Predicting post-COVID-19 condition in children and young people up to 24 months after a positive SARS-CoV-2 PCR-test: the CLoCk studyManjula D. Nugawela0Terence Stephenson1Roz Shafran2Trudie Chalder3Emma Dalrymple4Tamsin Ford5Lana Fox-Smith6Anthony Harnden7Isobel Heyman8Shamez N. Ladhani9Kelsey McOwat10Ruth Simmons11Olivia Swann12Elizabeth Whittaker13CLoCk ConsortiumSnehal M. Pinto Pereira14UCL Great Ormond Street Institute of Child HealthUCL Great Ormond Street Institute of Child HealthUCL Great Ormond Street Institute of Child HealthDepartment of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonUCL Great Ormond Street Institute of Child HealthDepartment of Psychiatry, University of Cambridge, Hershel Smith Building Cambridge Biomedical CampusUCL Great Ormond Street Institute of Child HealthNuffield Department of Primary Care Health Sciences, University of OxfordUCL Great Ormond Street Institute of Child HealthImmunisations and Vaccine Preventable Diseases, UK Health Security AgencyImmunisations and Vaccine Preventable Diseases, UK Health Security AgencyImmunisations and Vaccine Preventable Diseases, UK Health Security AgencyCentre for Medical Informatics, Usher Institute, University of EdinburghDepartment of Paediatric Infectious Diseases, Imperial College Healthcare NHS TrustDivision of Surgery & Interventional Science, Faculty of Medical Sciences, University College LondonAbstract Background Predicting which children and young people (CYP) are at the highest risk of developing post-COVID-19 condition (PCC) could improve care pathways. We aim to develop and validate prediction models for persistent PCC up to 24 months post-infection in CYP. Methods CYP who were PCR-positive between September 2020 and March 2021, with follow-up data up to 24-months post-infection, were analysed. Persistent PCC was defined in two ways, as PCC at (a) 3, 6, 12 and 24 months post-infection (N = 943) or (b) 6, 12 and 24 months post-infection (N = 2373). Prediction models were developed using logistic regression; performance was assessed using calibration and discrimination measures; internal validation was performed via bootstrapping; the final model was adjusted for overfitting. Results While 24.7% (233/943) of CYP met the PCC definition 3 months post-infection, only 7.2% (68/943) continued to meet the PCC definition at all three subsequent timepoints, i.e. at 6, 12 and 24 months. The final models predicting risk of persistent PCC (at 3, 6, 12 and 24 months and at 6, 12 and 24 months) contained sex (female), history of asthma, allergy problems, learning difficulties at school and family history of ongoing COVID-19 problems, with additional variables (e.g. older age at infection and region of residence) in the model predicting PCC at 6, 12 and 24 months. Internal validation showed minimal overfitting of models with good calibration and discrimination measures (optimism-adjusted calibration slope: 1.064–1.142; C-statistic: 0.724–0.755). Conclusions To our knowledge, these are the only prediction models estimating the risk of CYP persistently meeting the PCC definition up to 24 months post-infection. The models could be used to triage CYP after infection. CYP with factors predicting longer-term symptomology, may benefit from earlier support.https://doi.org/10.1186/s12916-024-03708-1Children and young peoplePost-COVID-19 conditionPrediction modelCohort study |
| spellingShingle | Manjula D. Nugawela Terence Stephenson Roz Shafran Trudie Chalder Emma Dalrymple Tamsin Ford Lana Fox-Smith Anthony Harnden Isobel Heyman Shamez N. Ladhani Kelsey McOwat Ruth Simmons Olivia Swann Elizabeth Whittaker CLoCk Consortium Snehal M. Pinto Pereira Predicting post-COVID-19 condition in children and young people up to 24 months after a positive SARS-CoV-2 PCR-test: the CLoCk study BMC Medicine Children and young people Post-COVID-19 condition Prediction model Cohort study |
| title | Predicting post-COVID-19 condition in children and young people up to 24 months after a positive SARS-CoV-2 PCR-test: the CLoCk study |
| title_full | Predicting post-COVID-19 condition in children and young people up to 24 months after a positive SARS-CoV-2 PCR-test: the CLoCk study |
| title_fullStr | Predicting post-COVID-19 condition in children and young people up to 24 months after a positive SARS-CoV-2 PCR-test: the CLoCk study |
| title_full_unstemmed | Predicting post-COVID-19 condition in children and young people up to 24 months after a positive SARS-CoV-2 PCR-test: the CLoCk study |
| title_short | Predicting post-COVID-19 condition in children and young people up to 24 months after a positive SARS-CoV-2 PCR-test: the CLoCk study |
| title_sort | predicting post covid 19 condition in children and young people up to 24 months after a positive sars cov 2 pcr test the clock study |
| topic | Children and young people Post-COVID-19 condition Prediction model Cohort study |
| url | https://doi.org/10.1186/s12916-024-03708-1 |
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