Which healthcare services did children and adolescents use before presentation at specialised outpatient clinics for post-COVID-19 condition? Descriptive findings from the Post-COVID Kids Bavaria study.

Clinical Snapshot

Key Findings

• P Value: Not applicable (descriptive study)

• Effect Size: Median 6.5 physician contacts per patient

• Primary Outcome: Healthcare utilisation patterns before specialised care

• Nnt Or Sensitivity: 72.6% consulted paediatricians, 46.2% general practitioners

• Confidence Interval: Q1-Q3: 3.8-11.5 contacts

Clinical Application

Findings suggest need for clearer care pathways and better primary care education about post-COVID condition Relevant for Australian paediatricians and GPs; highlights importance of Medicare-funded specialist referral pathways and potential role for telehealth initiatives Children and adolescents with suspected post-COVID condition in developed healthcare systems

Abstract

OBJECTIVE: Measuring the utilisation of healthcare services in children and adolescents with symptoms suggesting post-COVID-19 condition (PCC) until their presentation at specialised outpatient clinics (SOC). METHODS: 117 patients (aged 4-17 years) with symptoms suggesting PCC were recruited for study participation in SOCs of the comprehensive care network 'Post-COVID Kids Bavaria' for children and adolescents with PCC in Bavaria, Germany. Information on healthcare utilisation from their initial SARS-CoV-2 infection until presentation at an SOC was collected via telephone interviews with parents. RESULTS: Participants had a median of 6.5 physician contacts (Q1-Q3: 3.8-11.5), mainly in person (99.1%, n=116) and rarely used telemedicine (21.4%, n=25). Contacts were mainly with paediatricians (72.6%, n=85), followed by general practitioners (46.2%, n=50). Non-pharmacological measures were used by 56 participants (47.9 %), with therapies by Heilpraktiker and osteopaths being used most commonly (30.8%, n=36). 76 participants (65.0%) were prescribed medications, and 71 (60.7%) used non-prescribed medications or supplements. CONCLUSIONS: Children and adolescents with PCC symptoms frequently consult healthcare services, often self-initiated measures provided by Heilpraktiker and osteopaths, until their presentation at an SOC. This may be due to unclear care pathways. Paediatricians and general practitioners are key providers, making their expertise and strong connections with SOCs essential for early diagnosis and appropriate treatment.

References

1. 1.Koenig, M., Rathgeb, C., Pawellek, M., Bauer, T., Alberer, M., Stojanov, S., Warlitz, C., Behrends, U., Kabesch, M., Gerling, S., Apfelbacher, C., & Brandstetter, S. (2026). Which healthcare services did children and adolescents use before presentation at specialised outpatient clinics for post-COVID-19 condition? Descriptive findings from the Post-COVID Kids Bavaria study. BMJ Paediatrics Open. https://doi.org/10.1136/bmjpo-2025-004184