The impact of pediatric post-COVID-19 condition Navigating the long and winding road

Five years after the start of the COVID-19 pandemic, many children continue to experience long-term effects of SARS-CoV-2 infection. This thesis explores the impact of Pediatric Post-COVID-19 Condition (PPCC) at global, national, and individual levels.
Part I examines pediatric post-COVID-19 care programs internationally, highlighting challenges, multidisciplinary approaches, and the need for standardized guidelines. The International Post-COVID-Condition in Children Collaboration (IP4C) revealed a high burden of symptoms such as fatigue and cognitive difficulties globally, yet few objective abnormalities in diagnostic testing were found. Treatment is primarily focused on rehabilitation and symptom management.
Part II investigates PPCC in the Netherlands, analyzing prevalence, risk factors, and other clinical outcomes. A nationwide study found that PPCC was more common after severe COVID-19, and is associated with reduced physical health-related quality of life. Further research into children hospitalized for severe COVID-19 or Multisystem Inflammatory Syndrome in Children (MIS-C) revealed long-term respiratory impairments in symptomatology and functional tests, emphasizing the need for tailored follow-up care. The role of multidisciplinary clinics in providing individualized treatment is also explored.
Part III assesses the impact of PPCC on children’s daily lives. Three clinical phenotypes were identified, offering insights into the large variability in symptoms and patient characteristics. Additionally, children with PPCC demonstrated significantly lower quality of life and increased risks of anxiety, depression, and sleep-related impairments compared to children with chronic health conditions and healthy peers.
This thesis underscores the need for standardized healthcare and research protocols, and individualized, multidisciplinary care strategies to improve outcomes for children with PPCC.