LAUSR

Background There is limited research on children infected with Covid-19 after initial diagnosis. The aim of this study was to describe changes in symptoms in children infected by Covid-19 after 1st and 3rd months of diagnosis. Methods Covid-19 patients age under 18 admitted to the Dokuz Eylul University Hospital, Izmir, Turkey during December 2020 (n = 144) and completed three months follow-up (n = 123) were included in this prospective cohort study. Data on age, sex, parents' educational status, perceived economic status, presence of Covid-19 patient at household, chronic diseases history, initial and existing symptoms and perception of recovery were collected via telephone interviews. Persistent symptom was defined as any symptom reported within a week of the interview. Chi-square and Mann-Whitney U Test were used for univariate analyses. Results Out of 124 patients, 89.3% reported a symptom at time of diagnosis, 21.0% at 1st month and 11.4% at the 3rd-month follow-up. Median number of symptoms was 2 at diagnosis, 0 at 1st and the 3rd month. The most common initial symptoms were fever (52.4%), weakness (40.3%), flu like symptoms (25.8%) and cough (24.4%). The most common persistent symptoms by the 1st month were fatigue (5.7%), cough (4.1%) and gastrointestinal symptoms (4.1%), and by the 3rd month were fatigue (2.4%), weakness (2.4%), respiratory symptoms and chest pain (2.4%). 10.6% of the patients were not fully recovered by the 3rd month. Persistent symptoms at the end of 1st month were more common in children with chronic diseases (36.6% vs 13.3%, p = 0.003) and who were not recovered fully (63.6% vs 15.5%, p = 0.001). Parents' education level, perceived economic status, and presence of Covid-19 patients at household were not associated with persisting symptoms. Conclusions COVID-19 symptoms may persist by three months of infection, especially in children with chronic conditions. Health care providers should consider following up those children with special care. Key messages COVID-19 symptoms may persist by three months of infection, especially in children with chronic conditions. Health care providers should consider following up those children with special care.