Logo image
Back
Ethnic and racial differences in children and young people with respiratory and neurological post-acute sequelae of SARS-CoV-2: an electronic health record-based cohort study from the RECOVER Initiative
Journal article   Peer reviewed

Ethnic and racial differences in children and young people with respiratory and neurological post-acute sequelae of SARS-CoV-2: an electronic health record-based cohort study from the RECOVER Initiative

Suchitra Rao, Rodrigo Azuero-Dajud, Vitaly Lorman, Jeremy Landeo-Gutierrez, Kyung E. Rhee, Julie Ryu, C. Kim, Megan Carmilani, Rachel S. Gross, Sindhu Mohandas, …
EClinicalMedicine, Vol.80, 103042
02/2025
DOI: 10.1016/j.eclinm.2024.103042
PMCID: PMC11753962
PMID: 39850015

View Online

Abstract

Summary Background Children from racial and ethnic minority groups are at greater risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, but it is unclear whether they have increased risk for post-acute sequelae of SARS-CoV-2 (PASC). Our objectives were to assess whether the risk of respiratory and neurologic PASC differs by race/ethnicity and social drivers of health. Methods We conducted a retrospective cohort study of individuals <21 years seeking care at 24 health systems across the U.S, using electronic health record (EHR) data. Our cohort included those with a positive SARS-CoV-2 molecular, serology or antigen test, or with a COVID-19, multisystem inflammatory disease in children, or PASC diagnosis from February 29, 2020 to August 1, 2022. We identified children/youth with at least 2 codes associated with respiratory and neurologic PASC. We measured associations between sociodemographic and clinical characteristics and respiratory and neurologic PASC using odds ratios and 95% confidence intervals estimated from multivariable logistic regression models adjusted for other sociodemographic characteristics, social vulnerability index or area deprivation index, time period of cohort entry, presence and complexity of chronic respiratory (respectively, neurologic) condition and healthcare utilization. Findings Among 771,725 children in the cohort, 203,365 (26.3%) had SARS-CoV-2 infection. Among children with documented infection, 3217 children had respiratory PASC and 2009 children/youth had neurologic PASC. In logistic regression models, children <5 years (Odds Ratio [OR] 1.78, 95% CI 1.62–1.97), and of Hispanic White descent (OR 1.19, 95% CI 1.05–1.35) had higher odds of having respiratory PASC. Children/youth living in regions with higher area deprivation indices (OR 1.25, 95% CI 1.10–1.420 for 60–79th percentile) and with chronic complex respiratory conditions (OR 3.28, 95% CI 2.91–3.70) also had higher odds of respiratory PASC. In contrast, older (OR 1.57, 95% CI 1.40–1.77 for those aged 12–17 years), non-Hispanic White individuals and those with chronic pre-existing neurologic conditions (OR 2.04, 95% CI 1.78–2.35) were more likely to have a neurologic PASC diagnosis. Interpretation Racial and ethnic differences in healthcare utilization for neurologic and respiratory PASC may reflect social drivers of health and inequities in access to care.
 PEDSnet PCORnet Long COVID Chronic COVID-19 syndrome Late sequelae of COVID-19 Long-haul COVID Long-term COVID-19 Post-COVID syndrome Post-acute COVID-19 Post-acute sequelae of SARS-CoV-2 infection Post-COVID condition Ethnicity Race Social determinants of health

Details

Metrics

7 Record Views
2 Times Cited - Web of Science
Logo image