Diagnostic challenges of long COVID in children: a survey of pediatric health care providers’ preferences and practices

IntroductionGiven the challenges in diagnosing children with long COVID, we sought to explore diagnostic practices and preferences among clinicians.MethodsA ten-question survey assessed pediatric providers’ clinical decision making for identifying and evaluating long COVID in children. Of the 120 su...

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Main Authors: Vivian Y. Liu, Madeleine Godfrey, Matthew Dunn, Robert Fowler, Lauren Guthrie, David Dredge, Scott Holmes, Alicia M. Johnston, Tregony Simoneau, Alessio Fasano, Dawn Ericson, Lael M. Yonker
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-12-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2024.1484941/full
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author Vivian Y. Liu
Vivian Y. Liu
Madeleine Godfrey
Matthew Dunn
Robert Fowler
Lauren Guthrie
David Dredge
David Dredge
Scott Holmes
Scott Holmes
Alicia M. Johnston
Alicia M. Johnston
Tregony Simoneau
Tregony Simoneau
Alessio Fasano
Alessio Fasano
Dawn Ericson
Dawn Ericson
Lael M. Yonker
Lael M. Yonker
author_facet Vivian Y. Liu
Vivian Y. Liu
Madeleine Godfrey
Matthew Dunn
Robert Fowler
Lauren Guthrie
David Dredge
David Dredge
Scott Holmes
Scott Holmes
Alicia M. Johnston
Alicia M. Johnston
Tregony Simoneau
Tregony Simoneau
Alessio Fasano
Alessio Fasano
Dawn Ericson
Dawn Ericson
Lael M. Yonker
Lael M. Yonker
author_sort Vivian Y. Liu
collection DOAJ
description IntroductionGiven the challenges in diagnosing children with long COVID, we sought to explore diagnostic practices and preferences among clinicians.MethodsA ten-question survey assessed pediatric providers’ clinical decision making for identifying and evaluating long COVID in children. Of the 120 survey respondents, 84 (70%) were physicians, 31 (26%) nurse practitioners, and 5 (4%) physician assistants.ResultsThe most common categories of symptoms identified as raising suspicion for long COVID in children included cardiopulmonary symptoms, selected by 119 (99%) of pediatric providers, and neurocognitive symptoms, selected by 118 (98%) of providers. However, there was more ambiguity on the primary feature of long COVID, with providers selecting a range of key symptoms. Of all physical exam findings, postural orthostatic tachycardia, was most suggestive of long COVID [identified by 49 (41%) of pediatric providers], whereas one-third of providers reported no specific identifiable exam finding.DiscussionPediatric providers report variable decision making in the clinical evaluation of long COVID, with patient demographics and clinical factors impacting whether a diagnosis of long COVID is considered. This variation in diagnosing pediatric long COVID reflects ambiguity in the definition of long COVID in children and the absence of clinical guidelines to support providers in the identification of disease and treatment. This study highlights an area of need for future clinical advances in pediatric long COVID.
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spelling doaj-art-38a813a050a04e8d9185731ed6cfc8dd2024-12-23T04:18:53ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602024-12-011210.3389/fped.2024.14849411484941Diagnostic challenges of long COVID in children: a survey of pediatric health care providers’ preferences and practicesVivian Y. Liu0Vivian Y. Liu1Madeleine Godfrey2Matthew Dunn3Robert Fowler4Lauren Guthrie5David Dredge6David Dredge7Scott Holmes8Scott Holmes9Alicia M. Johnston10Alicia M. Johnston11Tregony Simoneau12Tregony Simoneau13Alessio Fasano14Alessio Fasano15Dawn Ericson16Dawn Ericson17Lael M. Yonker18Lael M. Yonker19Department of Pediatrics, Massachusetts General Hospital, Boston, MA, United StatesDepartment of Pediatrics, Harvard Medical School, Boston, MA, United StatesDepartment of Pediatrics, Pulmonary Division, Massachusetts General Hospital, Boston, MA, United StatesDepartment of Pediatrics, Pulmonary Division, Massachusetts General Hospital, Boston, MA, United StatesDivision of Pulmonary Medicine, Boston Children’s Hospital, Boston, MA, United StatesDepartment of Pediatrics, Pulmonary Division, Massachusetts General Hospital, Boston, MA, United StatesDepartment of Pediatrics, Harvard Medical School, Boston, MA, United StatesDepartment of Neurology, Massachusetts General Hospital, Boston, MA, United StatesDepartment of Pediatrics, Harvard Medical School, Boston, MA, United StatesDepartment of Anesthesia, Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, MA, United StatesDepartment of Pediatrics, Harvard Medical School, Boston, MA, United StatesDivision of Infectious Diseases, Boston Children’s Hospital, Boston, MA, United StatesDepartment of Pediatrics, Harvard Medical School, Boston, MA, United StatesDivision of Pulmonary Medicine, Boston Children’s Hospital, Boston, MA, United StatesDepartment of Pediatrics, Harvard Medical School, Boston, MA, United StatesDepartment of Pediatrics, Gastroenterology Division, Massachusetts General Hospital, Boston, MA, United StatesDepartment of Pediatrics, Harvard Medical School, Boston, MA, United StatesDivision of Pulmonary Medicine, Boston Children’s Hospital, Boston, MA, United StatesDepartment of Pediatrics, Harvard Medical School, Boston, MA, United StatesDepartment of Pediatrics, Pulmonary Division, Massachusetts General Hospital, Boston, MA, United StatesIntroductionGiven the challenges in diagnosing children with long COVID, we sought to explore diagnostic practices and preferences among clinicians.MethodsA ten-question survey assessed pediatric providers’ clinical decision making for identifying and evaluating long COVID in children. Of the 120 survey respondents, 84 (70%) were physicians, 31 (26%) nurse practitioners, and 5 (4%) physician assistants.ResultsThe most common categories of symptoms identified as raising suspicion for long COVID in children included cardiopulmonary symptoms, selected by 119 (99%) of pediatric providers, and neurocognitive symptoms, selected by 118 (98%) of providers. However, there was more ambiguity on the primary feature of long COVID, with providers selecting a range of key symptoms. Of all physical exam findings, postural orthostatic tachycardia, was most suggestive of long COVID [identified by 49 (41%) of pediatric providers], whereas one-third of providers reported no specific identifiable exam finding.DiscussionPediatric providers report variable decision making in the clinical evaluation of long COVID, with patient demographics and clinical factors impacting whether a diagnosis of long COVID is considered. This variation in diagnosing pediatric long COVID reflects ambiguity in the definition of long COVID in children and the absence of clinical guidelines to support providers in the identification of disease and treatment. This study highlights an area of need for future clinical advances in pediatric long COVID.https://www.frontiersin.org/articles/10.3389/fped.2024.1484941/fullpediatricSARS-CoV-2COVID-19post-viral illnesspost-acute sequalae of COVIDPASC
spellingShingle Vivian Y. Liu
Vivian Y. Liu
Madeleine Godfrey
Matthew Dunn
Robert Fowler
Lauren Guthrie
David Dredge
David Dredge
Scott Holmes
Scott Holmes
Alicia M. Johnston
Alicia M. Johnston
Tregony Simoneau
Tregony Simoneau
Alessio Fasano
Alessio Fasano
Dawn Ericson
Dawn Ericson
Lael M. Yonker
Lael M. Yonker
Diagnostic challenges of long COVID in children: a survey of pediatric health care providers’ preferences and practices
Frontiers in Pediatrics
pediatric
SARS-CoV-2
COVID-19
post-viral illness
post-acute sequalae of COVID
PASC
title Diagnostic challenges of long COVID in children: a survey of pediatric health care providers’ preferences and practices
title_full Diagnostic challenges of long COVID in children: a survey of pediatric health care providers’ preferences and practices
title_fullStr Diagnostic challenges of long COVID in children: a survey of pediatric health care providers’ preferences and practices
title_full_unstemmed Diagnostic challenges of long COVID in children: a survey of pediatric health care providers’ preferences and practices
title_short Diagnostic challenges of long COVID in children: a survey of pediatric health care providers’ preferences and practices
title_sort diagnostic challenges of long covid in children a survey of pediatric health care providers preferences and practices
topic pediatric
SARS-CoV-2
COVID-19
post-viral illness
post-acute sequalae of COVID
PASC
url https://www.frontiersin.org/articles/10.3389/fped.2024.1484941/full
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