• Crawley, Esther
• Mcowat, Kelsey
• Pereira, Snehal M. Pinto
• Dalrymple, Emma
• Shafran, Roz
• Rojas, Natalia
• Stephenson, Terence
• Stavola, Bianca L. De
• Cheung, Emily Y.
• Ladhani, Shamez N.
• Nugawela, Manjula D.
• Simmons, Ruth
• Ford, Tamsin
• Heyman, Isobel

Abstract

<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>To update and internally validate a model to predict children and young people (CYP) most likely to experience long COVID (i.e. at least one impairing symptom) 3 months after SARS-CoV-2 PCR testing and to determine whether the impact of predictors differed by SARS-CoV-2 status.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Data from a nationally matched cohort of SARS-CoV-2 test-positive and test-negative CYP aged 11–17 years was used. The main outcome measure, long COVID, was defined as one or more impairing symptoms 3 months after PCR testing. Potential pre-specified predictors included SARS-CoV-2 status, sex, age, ethnicity, deprivation, quality of life/functioning (five EQ-5D-Y items), physical and mental health and loneliness (prior to testing) and number of symptoms at testing. The model was developed using logistic regression; performance was assessed using calibration and discrimination measures; internal validation was performed via bootstrapping and the final model was adjusted for overfitting.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>A total of 7139 (3246 test-positives, 3893 test-negatives) completing a questionnaire 3 months post-test were included. 25.2% (817/3246) of SARS-CoV-2 PCR-positives and 18.5% (719/3893) of SARS-CoV-2 PCR-negatives had one or more impairing symptoms 3 months post-test. The final model contained SARS-CoV-2 status, number of symptoms at testing, sex, age, ethnicity, physical and mental health, loneliness and four EQ-5D-Y items before testing. Internal validation showed minimal overfitting with excellent calibration and discrimination measures (optimism-adjusted calibration slope: 0.96575; C-statistic: 0.83130).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>We updated a risk prediction equation to identify those most at risk of long COVID 3 months after a SARS-CoV-2 PCR test which could serve as a useful triage and management tool for CYP during the ongoing pandemic. External validation is required before large-scale implementation.</jats:p></jats:sec>

Topics

• impedance spectroscopy
• size-exclusion chromatography