Interdisciplinary Pediatric Long-COVID Care: A Descriptive Study of Interventions and Health-Related Quality of Life

Abstract Objectives Data on pediatric long-COVID is limited to descriptive reports of symptom prevalence and incidence, with few studies describing integrative care or including patient-reported quality of life. This study describes demographic, clinical, symptom severity, and intervention characteristics within a pediatric long-COVID clinic involving collaboration between infectious disease and integrative medicine physicians. Methods Clinical data were extracted from the electronic health records for patients aged 4–25 with long-COVID seen within this clinic. A subset of patients completed validated PROs of wellbeing, fatigue, sleep-related impairment and disturbance, depression, and anxiety. Results A cohort of 214 patients (mean age 14.7, 61% female, 83% White) were seen between March 2021 and June 2023, with 39.7% providing Pediatric Quality of Life Inventory (PedsQL) and 30.3% providing Patient-Reported Outcomes Measurement Information System (PROMIS) measures. Common documented conditions included fatigue (85%), headache (75.2%), dizziness (64.5%), anxiety (62.1%), and nausea (59.3%). Common interventions included diet changes (81.8%), pacing (65.9%), sleep hygiene (61.2%), and other self-care techniques (46.7%). The long-COVID cohort reported elevated PROMIS sleep disturbance (61.79), sleep-related impairment (63.9), anxiety (58.1), and depression (58.1) as well as PedsQL total fatigue (40.19). These scores were more severe than national norms as well as compared with other pediatric chronic disease cohorts (eg, chronic pain, cancer, sickle cell disease, autism). Conclusions Pediatric patients with long-COVID report high symptom burden. This study describes patient characteristics, care delivered and provides a novel description of symptom severity. Future research among more diverse populations is needed to evaluate outcomes of this integrative care.