Features of post-infectious asthenic syndrome and neurocognitive status associated with previous coronavirus infection (COVID- 19) in children

Introduction. Post-infectious asthenic syndrome (PAS) and cognitive impairments are well-documented consequences of COVID-19 in adults; however, their characteristics in children remain insufficiently studied. Aim. To characterize the features of asthenic syndrome and neurocognitive status in children following SARS-CoV-2 infection. Materials and methods. A prospective single-center study included 209 children with confirmed COVID-19. Assessment was performed through medical record review, the Multidimensional Fatigue Inventory (MFI-20), and 6-month dynamic follow-up. Neurocognitive testing (assessing memory, attention, and executive function) was conducted in 46 children with PAS (main group) and compared with 12 apparently healthy children (control group). Results. PAS was diagnosed in 31.6 % (n = 66) of children, with a median duration of 2 months. The predominant symptoms were generalized physical weakness (69.7 %) and increased mental fatigue (36.4 %). Statistical analysis revealed no significant association between the severity of acute COVID-19 and subsequent PAS development. Neurocognitive evaluation demonstrated significantly lower scores (p < 0.05) in motor-auditory and visual-auditory-motor memory domains in the main group compared to controls. Conclusion. Previous COVID-19 infection in children is associated with a distinct post-infectious asthenic syndrome characterized by physical weakness, reduced tolerance to physical and mental exertion, excessive fatigue, impaired mnemonic functions, emotional lability, headache, dizziness, and specific memory deficits. These findings underscore the necessity for long-term monitoring and the development of targeted rehabilitation programs for pediatric patients recovering from COVID-19.