AUTHOR=Esposito Susanna , Puntoni Matteo , Deolmi Michela , Ramundo Greta , Maglietta Giuseppe , Poeta Marco , Zampogna Stefania , Colomba Claudia , Suppiej Agnese , Cardinale Fabio , Bosis Samantha , Castagnola Elio , Midulla Fabio , Giaquinto Carlo , Giordano Paola , Biasucci Giacomo , Fainardi Valentina , Nunziata Francesco , Grandinetti Roberto , Condemi Anna , Raiola Giuseppe , Guarino Alfredo , Caminiti Caterina ,  Long-Covid-Ped Italian Study Group 

TITLE=Long COVID in pediatric age: an observational, prospective, longitudinal, multicenter study in Italy

JOURNAL=Frontiers in Immunology

VOLUME=Volume 16 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2025.1466201

DOI=10.3389/fimmu.2025.1466201

ISSN=1664-3224

ABSTRACT=IntroductionThis observational prospective longitudinal multicenter study examines the occurrence and characteristics of long COVID (LC) in the Italian pediatric population.MethodsConducted across 12 Pediatric Units in Italy from January to March 2022, the study involved 1129 children diagnosed with SARS-CoV-2 infection. Data were collected via self-administered questionnaires at 1-3 months, 3-6 months, and 6-12 months post-infection, with LC defined as symptoms persisting for at least 2 months and occurring 3 months post-diagnosis.ResultsResults revealed that 68.6% of children reported at least one post-COVID symptom, with 16.2% experiencing LC. The most frequent symptoms included respiratory issues (43.4%), neurological and cognitive dysfunction (27.7%), gastrointestinal symptoms (22.1%), fatigue (21.6%), and sleep disturbances (18.8%). Age and gender differences were significant, with older children and females more prone to cardiovascular and neurological & cognitive dysfunction.DiscussionThe study highlights that LC in children presents similarly to adults, though less frequently. The occurrence of LC was lower compared to adult populations, likely due to the generally milder course of COVID-19 in children. The findings underscore the need for targeted follow-up and support for affected children, especially considering the long-term persistence of symptoms. Further research is necessary to explore the impact of COVID-19 vaccines on pediatric LC and the effects of different SARS-CoV-2 variants. These insights are crucial for developing strategies to manage and mitigate long-term impacts in children recovering from COVID-19.