Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2022 Feb 1;5(2):e2147053.
doi: 10.1001/jamanetworkopen.2021.47053.

Prevalence of Select New Symptoms and Conditions Among Persons Aged Younger Than 20 Years and 20 Years or Older at 31 to 150 Days After Testing Positive or Negative for SARS-CoV-2

Alfonso C Hernandez-Romieu  1   2 , Thomas W Carton  3 , Sharon Saydah  2 , Eduardo Azziz-Baumgartner  2 , Tegan K Boehmer  2 , Nedra Y Garret  2 , L Charles Bailey  4 , Lindsay G Cowell  5 , Christine Draper  6 , Kenneth H Mayer  7 , Kshema Nagavedu  6 , Jon E Puro  8 , Sonja A Rasmussen  9 , William E Trick  10 , Valentine Wanga  1   2 , Jennifer R Chevinsky  1   2 , Brendan R Jackson  2 , Alyson B Goodman  2 , Jennifer R Cope  2 , Adi V Gundlapalli  2 , Jason P Block  6
Affiliations
Comparative Study

Prevalence of Select New Symptoms and Conditions Among Persons Aged Younger Than 20 Years and 20 Years or Older at 31 to 150 Days After Testing Positive or Negative for SARS-CoV-2

Alfonso C Hernandez-Romieu et al. JAMA Netw Open. .

Abstract

Importance: New symptoms and conditions can develop following SARS-CoV-2 infection. Whether they occur more frequently among persons with SARS-CoV-2 infection compared with those without is unclear.

Objective: To compare the prevalence of new diagnoses of select symptoms and conditions between 31 and 150 days after testing among persons who tested positive vs negative for SARS-CoV-2.

Design, setting, and participants: This cohort study analyzed aggregated electronic health record data from 40 health care systems, including 338 024 persons younger than 20 years and 1 790 886 persons aged 20 years or older who were tested for SARS-CoV-2 during March to December 2020 and who had medical encounters between 31 and 150 days after testing.

Main outcomes and measures: International Statistical Classification of Diseases, Tenth Revision, Clinical Modification codes were used to capture new symptoms and conditions that were recorded 31 to 150 days after a SARS-CoV-2 test but absent in the 18 months to 7 days prior to testing. The prevalence of new symptoms and conditions was compared between persons with positive and negative SARS-CoV-2 tests stratified by age (20 years or older and young than 20 years) and care setting (nonhospitalized, hospitalized, or hospitalized and ventilated).

Results: A total of 168 701 persons aged 20 years or older and 26 665 younger than 20 years tested positive for SARS-CoV-2, and 1 622 185 persons aged 20 years or older and 311 359 younger than 20 years tested negative. Shortness of breath was more common among persons with a positive vs negative test result among hospitalized patients (≥20 years: prevalence ratio [PR], 1.89 [99% CI, 1.79-2.01]; <20 years: PR, 1.72 [99% CI, 1.17-2.51]). Shortness of breath was also more common among nonhospitalized patients aged 20 years or older with a positive vs negative test result (PR, 1.09 [99% CI, 1.05-1.13]). Among hospitalized persons aged 20 years or older, the prevalence of new fatigue (PR, 1.35 [99% CI, 1.27-1.44]) and type 2 diabetes (PR, 2.03 [99% CI, 1.87-2.19]) was higher among those with a positive vs a negative test result. Among hospitalized persons younger than 20 years, the prevalence of type 2 diabetes (PR, 2.14 [99% CI, 1.13-4.06]) was higher among those with a positive vs a negative test result; however, the prevalence difference was less than 1%.

Conclusions and relevance: In this cohort study, among persons hospitalized after a positive SARS-CoV-2 test result, diagnoses of certain symptoms and conditions were higher than among those with a negative test result. Health care professionals should be aware of symptoms and conditions that may develop after SARS-CoV-2 infection, particularly among those hospitalized after diagnosis.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosures: Dr Trick reported receiving grants from the Centers for Disease Control and Prevention (CDC) during the conduct of the study. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. Flow Diagram
Flow diagram of prevalence of new symptoms and conditions 31 to 150 days after SARS-CoV-2 infection between March and December 2020. Adults and children and young adults with positive and negative SARS-CoV-2 test results were stratified by care setting, and those with medical encounters 31 to 150 days after SARS-CoV-2 testing were analyzed. We compared prevalence of new symptoms and conditions between adults and children and young adults with positive and negative SARS-CoV-2 test results by care setting. aIncluded all individuals with polymerase chain reaction (99%) or antigen (1%) testing. bPatients never had a positive test result during the entire study period (ie, up to 150 days after SARS-CoV-2 test). cOwing to the small sample of mechanically ventilated children with a positive SARS-CoV-2 test result, we did not assess new symptoms and conditions for this group. dTo ensure data completeness for symptoms and conditions, we restricted the analysis to patients who had at least 1 medical encounter in any care setting recorded 3 years to 1 month before and 31 to 150 days after SARS-CoV-2 testing. PCORnet indicates the National Patient-Centered Clinical Research Network.
Figure 2.
Figure 2.. Prevalence Ratios of New Symptoms Among Adults and Children and Young Adults With Medical Encounters 31 to 150 Days After a First SARS-CoV-2 Test Between March and December 2020
Mechanically ventilated children were not included owing to the small sample size of children with a positive SARS-CoV-2 test result in this group (n = 172). Prevalence ratios are calculated as the proportion patients with a symptom who had a positive SARS-CoV-2 test result divided by the proportion of patients with a symptom who had a negative test result. Point estimates and 99% CIs (indicated by whiskers) are provided.
Figure 3.
Figure 3.. Prevalence Ratios of New Conditions Among Adults and Children and Young Adults With Medical Encounters 31 to 150 Days After a First SARS-CoV-2 Test Between March and December 2020
Mechanically ventilated children were not included owing to the small sample size of children with a positive SARS-CoV-2 test result in this group (n = 172). Prevalence ratios are calculated as the proportion patients with a condition who had a positive SARS-CoV-2 test result divided by the proportion of patients with a condition who had a negative test result. Point estimates and 99% CIs (indicated by whiskers) are provided.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

  • Association between SARS-CoV-2 infection before the age of two and child development.
    Tassanakijpanich N, Chumchuen K, Worachotekamjorn J, Laoprasopwattana K. Tassanakijpanich N, et al. Pediatr Res. 2024 Oct 12. doi: 10.1038/s41390-024-03614-5. Online ahead of print. Pediatr Res. 2024. PMID: 39394427
  • Risk of New-Onset Diabetes Before and During the COVID-19 Pandemic: A Real-World Cohort Study.
    Varghese JS, Ali MK, Guo Y, Donahoo WT, Chakkalakal RJ. Varghese JS, et al. J Gen Intern Med. 2024 Sep 20. doi: 10.1007/s11606-024-09035-8. Online ahead of print. J Gen Intern Med. 2024. PMID: 39302562
  • Body mass index changes and their association with SARS-CoV-2 infection: a real-world analysis.
    Varghese JS, Guo Y, Ali MK, Donahoo WT, Chakkalakal RJ. Varghese JS, et al. Int J Obes (Lond). 2024 Sep 14. doi: 10.1038/s41366-024-01628-x. Online ahead of print. Int J Obes (Lond). 2024. PMID: 39277656
  • Characterizing Long COVID in Children and Adolescents.
    Gross RS, Thaweethai T, Kleinman LC, Snowden JN, Rosenzweig EB, Milner JD, Tantisira KG, Rhee KE, Jernigan TL, Kinser PA, Salisbury AL, Warburton D, Mohandas S, Wood JC, Newburger JW, Truong DT, Flaherman VJ, Metz TD, Karlson EW, Chibnik LB, Pant DB, Krishnamoorthy A, Gallagher R, Lamendola-Essel MF, Hasson DC, Katz SD, Yin S, Dreyer BP, Carmilani M, Coombs K, Fitzgerald ML, Güthe N, Hornig M, Letts RJ, Peddie AK, Taylor BD; RECOVER-Pediatrics Consortium; RECOVER-Pediatrics Group Authors; Balaraman V, Bogie A, Bukulmez H, Dozor AJ, Eckrich D, Elliott AJ, Evans DN, Farkas JS, Faustino EVS, Fischer L, Gaur S, Harahsheh AS, Hasan UN, Hsia DS, Huerta-Montañez G, Hummel KD, Kadish MP, Kaelber DC, Krishnan S, Kosut JS, Larrabee J, Lim PPC, Michelow IC, Oliveira CR, Raissy H, Rosario-Pabon Z, Ross JL, Sato AI, Stevenson MD, Talavera-Barber MM, Teufel RJ, Weakley KE, Zimmerman E, Bind MC, Chan J, Guan Z, Morse RE, Reeder HT, Akshoomoff N, Aschner JL, Bhattacharjee R, Cottrell LA, Cowan K, D'Sa VA, Fiks AG, Gennaro ML, Irby K, Khare M, Guttierrez JL, McCulloh RJ, Narang S, Ness-Cochinwala M, Nolan S, Palumbo P, Ryu J, Salazar JC, Selvarangan R, Stein CR, Werzberger A, Zempsky WT, Aupperle … See abstract for full author list ➔ Gross RS, et al. JAMA. 2024 Aug 21:e2412747. doi: 10.1001/jama.2024.12747. Online ahead of print. JAMA. 2024. PMID: 39196964
  • Public Health Surveillance in Electronic Health Records: Lessons From PCORnet.
    Ghildayal N, Nagavedu K, Wiltz JL, Back S, Boehmer TK, Draper C, Gundlapalli AV, Horgan C, Marsolo KA, Mazumder NR, Reynolds J, Ritchey M, Saydah S, Tedla YG, Carton TW, Block JP. Ghildayal N, et al. Prev Chronic Dis. 2024 Jul 11;21:E51. doi: 10.5888/pcd21.230417. Prev Chronic Dis. 2024. PMID: 38991533 Free PMC article.
See all "Cited by" articles

References

    1. Logue JK, Franko NM, McCulloch DJ, et al. . Sequelae in adults at 6 months after COVID-19 infection. JAMA Netw Open. 2021;4(2):e210830-e210830. doi:10.1001/jamanetworkopen.2021.0830 - DOI - PMC - PubMed
    1. Huang C, Huang L, Wang Y, et al. . 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet. 2021;397(10270):220-232. doi:10.1016/S0140-6736(20)32656-8 - DOI - PMC - PubMed
    1. Nalbandian A, Sehgal K, Gupta A, et al. . Post-acute COVID-19 syndrome. Nat Med. 2021;27(4):601-615. doi:10.1038/s41591-021-01283-z - DOI - PMC - PubMed
    1. Taquet M, Geddes JR, Husain M, Luciano S, Harrison PJ. 6-month neurological and psychiatric outcomes in 236 379 survivors of COVID-19: a retrospective cohort study using electronic health records. Lancet Psychiatry. 2021;8(5):416-427. doi:10.1016/S2215-0366(21)00084-5 - DOI - PMC - PubMed
    1. Ayoubkhani D, Khunti K, Nafilyan V, et al. . Post-covid syndrome in individuals admitted to hospital with COVID-19: retrospective cohort study. BMJ. 2021;372:n693. doi:10.1136/bmj.n693 - DOI - PMC - PubMed

Publication types

MeSH terms