Pulmonary sequelae in children after severe COVID-19 or multisystem inflammatory syndrome

<bold>Background:</bold> Severe manifestations in children infected with SARS-CoV-2 vary from predominantly respiratory symptoms, to Multisystem Inflammatory Syndrome (MIS-C). It is unclear whether severe, acute illness due to Sars-CoV-2 is associated with long-term respiratory sequelae. <bold>Aim:</bold> To evaluate long-term respiratory symptoms and lung function in children severely affected with acute COVID-19 or MIS-C. <bold>Methods:</bold> This multicenter, observational study included children with severe COVID-19 or MIS-C from the COPP cohort (Tulling et al, 2023). Respiratory symptoms and lung function were assessed after 6-12 months follow up. Statistical analysis: ANOVA or Mann-Whitney U test for differences in between presentation groups; logistic regression adjusted for age and previous respiratory diseases for associations between acute presentation and long-term respiratory symptoms. <bold>Results:</bold> 24% of 84 children reported respiratory symptoms 8.3 (SD±2.7) months after acute disease [Table 1]. Children with acute respiratory COVID-19 had more long-term respiratory symptoms (45%), OR 6.36 (95%CI 1.77, 22.9) and lower pre-bronchodilator FEV1 (p=0.04) than children with MIS-C or other presentations. <bold>Conclusion:</bold> Children with severe respiratory acute COVID-19 are at increased risk for developing persistent respiratory sequelae, highlighting the need for a thorough follow-up assessment of respiratory complaints and lung function in this population. <fig><object-id>erj;64/suppl_68/PA1396/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>