ORIGINAL RESEARCH article
Front. Pediatr.
Sec. General Pediatrics and Pediatric Emergency Care
Volume 13 - 2025 | doi: 10.3389/fped.2025.1628826
Evaluation of a Pediatric Post-Acute Sequelae of SARS-CoV-2 Index Score
Provisionally accepted
Frederick Dun-Dery1
Jianling Xie1
Kathleen Winston1
Brett Burstein2
Vikram Sabhaney3Jason Emsley4
Jocelyn Gravel5April Kam6Darcy Beer7
Roger Zemek8Ahmed Mater9Robert Porter10
Gabrielle Freire11Naveen Poonai12Simon Berthelot13Anne Moffatt14Andrew Dixon15
Deepti Reddy8Marina Salvadori2
Stephen Freedman1*- 1university of calgary, calgary, Canada
- 2McGill University, Montreal, Canada
- 3University of British Columbia, Vancouver, Canada
- 4Dalhousie University, Halifax, Canada
- 5Université de Montréal, Montreal, Canada
- 6McMaster University, Hamilton, Canada
- 7University of Manitoba, Winnipeg, Canada
- 8University of Ottawa, Ottawa, Canada
- 9University of Saskatchewan, Saskatoon, Canada
- 10Newfoundland and Labrador Health Services, St. John's, Canada
- 11University of Toronto, Toronto, Canada
- 12University of Western Ontario, London, Canada
- 13CHU de Québec-Université, Quebec City, Canada
- 14Queen's University, Kingston, Canada
- 15University of Alberta, Edmonton, Canada
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective: To assess the performance of the RECOVER initiative's proposed Post-Acute Sequelae of COVID-19 (PASC) index in a cohort of children evaluated for SARS-CoV-2 infection, 6 to 12 months after exposure.We conducted a multicenter, prospective cohort study with 6-and 12-month follow-up in 14 Canadian tertiary-care pediatric emergency departments (EDs) in the Pediatric Emergency Research Canada network. Eligible children were 6-<18 years who were tested for acute SARS-CoV-2 infection. We assess score validity and reliability and evaluated associations between PASC index scores dichotomized using thresholds values (≥5.5 for ages 6-<12 years; ≥5.0 for ages 12-<18 years), and SARS-CoV-2 infection.Results: Participants included 785 children, median age 9 years (IQR: 7, 13), enrolled between August 2020 and February 2022. Factor analysis identified characteristics that accounted for 32-40% of variance. Strong correlations were identified between PASC index scores and PedsQL™ and overall health status; Cronbach's α ranged from 0.49-0.67. Changes in PASC index scores across time-points, accounted for 71% (6-<12 years) and 63% (12-<18 years) of total variance. The proportion of children exceeding PASC index score thresholds did not differ between SARS-CoV-2 test-positive and negative children in the 6-<12 (25% vs 22%; aOR: 1.2; CI: 0.6, 2.54) and 12-< 18 (18% vs 10%; aOR: 2.20; CI: 0.5, 10.48.2) age groups at 6-months. Similar results were reported at 12 months.Conclusions: While scores correlated with quality of life and overall health, internal reliability was low to acceptable. The PASC index was not associated with previous SARS-CoV-2 infection.
Keywords: emergency department, Index score, Post Acute Sequelae of SARS-CoV-2, SARS-CoV-2, pediatric
Received: 14 May 2025; Accepted: 25 Jul 2025.
Copyright: © 2025 Dun-Dery, Xie, Winston, Burstein, Sabhaney, Emsley, Gravel, Kam, Beer, Zemek, Mater, Porter, Freire, Poonai, Berthelot, Moffatt, Dixon, Reddy, Salvadori and Freedman. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Stephen Freedman, university of calgary, calgary, Canada
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.