Long COVID associated with SARS-CoV-2 reinfection among children and adolescents in the Omicron era – original study and commentary

Background Post-acute sequelae of SARS-CoV-2 infection (PASC), commonly termed “long COVID,” continue to impose significant burdens on affected individuals and healthcare systems. While previous studies have clarified persistent sequelae in adults, the risk and mechanisms in pediatric cohorts—especially following reinfection with Omicron lineages—remain poorly quantified. Earlier, smaller datasets suggested a low risk in reinfected children, but methodological weaknesses limited inference. The RECOVER-EHR study aimed to determine whether reinfection with SARS-CoV-2 among children and adolescents increases the risk of long COVID diagnoses and related symptom clusters during the Omicron period. Methods This NIH-funded retrospective cohort leveraged the Researching COVID to Enhance Recovery (RECOVER) Initiative, aggregating electronic health record (EHR) data from 40 pediatric health institutions across the United States. Participants (<21 years) had laboratory-confirmed or clinician-coded SARS-CoV-2 infections between January 1, 2022, and October 13, 2023, reflecting Omicron predominance. Eligible cases require at least one healthcare encounter within two years before infection to ensure...