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Impact of War-Related Internal Displacement on the Course and Consequences of COVID-19 in Ukrainian Children

Turk Arch Pediatr. 2026 May 21;61(6):531-542. doi: 10.65717/TurkArchPediatr.2026.25353.

ABSTRACT

OBJECTIVE: The aim of the study was to compare the key clinical features and course of SARS-CoV-2 infection between the local population of the Ternopil region and internally displaced persons (IDPs), to analyze the quality of life in both participant groups, and to determine the frequency and symptoms of long COVID.

METHODS: A cross-sectional study was conducted involving children with confirmed COVID-19 from September 2022 to May 2024. Clinical symptoms, COVID-19 severity, 25(OH)D and zinc levels, long COVID symptoms, and quality of life were compared between internally displaced and local populations using structured questionnaires and medical records.

RESULTS: A total of 299 children with COVID-19 were included, consisting of 29 IDPs and 270 local population. Gastrointestinal symptoms were significantly more common among IDPs (P<.0001), while respiratory symptoms and severe fatigue predominated in the local population (P < .0001 and P=.0229, respectively). The IDPs experienced a more severe course of COVID-19 (P=.0141) and had a longer duration of hospital stay (P < .0001). Serum zinc levels were significantly lower in IDPs compared to local population (P=.0229). Assessment of quality of life demonstrated higher total, physical, psychosocial, and school functioning scores among IDPs, indicating a statistically better perceived health status. The overall frequency of long COVID did not differ between groups; however, its distribution varied by age: it was significantly higher in IDPs under 6 years (P=.0062), whereas among children ≥6 years, it was more common in the local population (P=.0092). Age-specific differences in long COVID symptom patterns were also observed between IDPs and local children.

CONCLUSION: This study highlights the need to consider the impact of war, displacement, and chronic stress on the clinical presentation, timeliness of seeking care, and symptom reporting among children with COVID-19. Future efforts should focus on improving access to healthcare, health education, nutritional, and psychosocial support for displaced children to mitigate the combined negative effects of COVID-19 and war.

PMID:42228823 | DOI:10.65717/TurkArchPediatr.2026.25353

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