Long COVID in children and adolescents: Is it real?
DOI:
https://doi.org/10.25753/BirthGrowthMJ.v31.i3.27683Keywords:
adolescent, fatigue, Long COVID, persistent symptomsAbstract
Introduction: While acute COVID-19 symptoms are well defined and described, long-term symptoms are not. Most patients achieve full recovery within 3-4 weeks after the onset of the infection, but in some cases, symptoms persist weeks or months after recovery. Although extensively studied in adults, COVID-19 data in pediatric patients remains scarce.
Objective: To review the available literature regarding Long COVID syndrome in children and adolescents.
Methods: A brief literature review was conducted on PubMed and Google Scholar databases using the terms “Long COVID”, “post-COVID”, “persistent COVID” AND “children”, “adolescents”, “pediatric”.
Results: Seventeen articles were eligible for this review. The prevalence of Long COVID was highly variable, ranging from 2 to 66%. The most commonly reported symptoms were fatigue, shortness of breath, headache, sleep disturbance, concentration difficulties, chronic cough, dizziness, myalgia, chest pain, poor sense of smell or anosmia, abdominal pain, and loss of appetite or weight. Older age, muscle pain on admission, Intensive Care Unit admission, allergic diseases, higher body mass index, and longer duration of infection were risk factors identified for the development of Long COVID. Six studies included a control group; four reported differences between groups, with more symptoms in the group of cases, and one reported no differences between groups.
Conclusion: Long COVID represents a significant public health concern, which should be studied to enable the development of protective measures, rehabilitation programs, and specific guidelines. Appropriate case-control studies are important to better discriminate between symptoms associated with SARS-CoV-2 and those associated with the pandemic.
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References
Zhu N, Zhang D, Wang W, Xingwang L, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China. N Engl J Med. 2020;382:727–33. doi: https://doi.org/10.1056/NEJMoa2001017.
WHO. Coronavirus disease 2019 (COVID-19) Situation Report – 11 https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200131-sitrep-11-ncov.pdf?sfvrsn=de7c0f7_4 . Published 31 January 2020. Accessed March 23, 2020.
Direção-Geral da Saúde (DGS) Relatório de Situação n° 001. Available from: https://covid19.min-saude.pt/wp-content/uploads/2020/03/Relato%CC%81rio-de-Situac%CC%A7a%CC%83o-1.pdf (accessed March 03, 2020).
Ward JL, Harwood R, Smith C, Kenny S, Clark M, Davis PJ, et al. Risk factors for PICU admission and death among children and young people hospitalized with COVID-19 and PIMS-TS in England during the first pandemic year. Nat Med. 2022;28(1):193-200. doi: https://doi.org/10.1038/s41591-021-01627-9.
Michelen M, Manoharan L, Elkheir N, Cheng V, Dagens A, Hastie C, et al. Characterising long COVID: A living systematic review. BMJ Glob. Health 2021, 6, e005427. https://doi.org/doi:10.1136/bmjgh-2021-005427.
A clinical case definition of post-COVID-19 condition by a Delphi consensus. Joan B Soriano, Srinivas Murt. https://www.who.int/publications/i/item/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1.
Guidelines N. COVID-19 rapid guideline: managing the long-term effects of COVID-19. 2020 [Available from: https://www.nice.org.uk/guidance/ng188].
Asadi-Pooya AA, Nemati H, Shahisavandi M, Akbari A, Emami A, Lofti M, et al. Long COVID in children and adolescents [published correction appears in World J Pediatr. 2022 Jul 3;:]. World J Pediatr. 2021;17(5):495-9. doi: https://doi.org/10.1007/s12519-021-00457-6.
Kikkenborg Berg S, Dam Nielsen S, Nygaard U, Bundgaard H, Palm P, Rotvig C, et al. Long COVID symptoms in SARS-CoV-2-positive adolescents and matched controls (LongCOVIDKidsDK): a national, cross-sectional study. Lancet Child Adolesc Health. 2022;6(4):240-8. doi: https://doi.org/10.1016/S2352-4642(22)00004-9.
Bloise S, Isoldi S, Marcellino A, De Luca E, Dilillo A, Mallardo S, et al. Clinical picture and long-term symptoms of SARS-CoV-2 infection in an Italian pediatric population. Ital J Pediatr. 2022;48(1):79. doi: https://doi.org/10.1186/s13052-022-01270-1.
Buonsenso D, Pujol FE, Munblit D, Pata D, McFarland S, Simpson FK. Clinical characteristics, activity levels and mental health problems in children with long coronavirus disease: a survey of 510 children. Future Microbiol. 2022;17(8):577-88. doi: https://doi.org/10.2217/fmb-2021-0285.
Trapani G, Verlato G, Bertino E, Maiocco G, Vesentini R, Spadavecchia A, et al. Long COVID-19 in children: an Italian cohort study. Ital J Pediatr. 2022;48(1):83. doi: https://doi.org/10.1186/s13052-022-01282-x.
Bossley CJ, Kavaliunaite E, Harman K, Cook J, Ruiz G, Gupta A. Post-acute COVID-19 outcomes in children requiring hospitalisation. Sci Rep. 2022;12(1):8208. doi: https://doi.org/10.1038/s41598-022-12415-x.
Fink TT, Marques HHS, Gualano B, Lindoso L, Bain V, Astley C, et al. Persistent symptoms and decreased health-related quality of life after symptomatic pediatric COVID-19: A prospective study in a Latin American tertiary hospital. Clinics (Sao Paulo). 2021;76:e3511. doi: https://doi.org/10.6061/clinics/2021/e3511.
Ashkenazi-Hoffnung L, Shmueli E, Ehrlich S, Ziv A, Bar-On O, Birk E, et al. Long COVID in children: observations from a designated pediatric clinic. Pediatr Infect Dis J. 2021;40(12):e509-11. doi: https://doi.org/10.1097/INF.0000000000003285.
Molteni E, Sudre CH, Canas LS, Bhopal SS, Hughes RC, Antonelli M, et al. Illness duration and symptom profile in symptomatic UK school-aged children tested for SARS-CoV-2 Lancet Child Adolesc Health. 2021;5(10):708-18. doi: https://doi.org/10.1016/S2352-4642(21)00198-X.
Osmanov IM, Spiridonova E, Bobkova P, Gamirova A, Shikhaleva A, Andreeva M, et al. Risk factors for post-COVID-19 condition in previously hospitalised children using the ISARIC Global follow-up protocol: a prospective cohort study. Eur Respir J. 2022;59(2):2101341. doi: https://doi.org/10.1183/13993003.01341-2021.
Radtke T, Ulyte A, Puhan MA, Kriemler S. Long-term Symptoms After SARS-CoV-2 Infection in Children and Adolescents. JAMA. 2021;326(9):869-71. doi: https://doi.org/10.1001/jama.2021.11880.
Say D, Crawford N, McNab S, Wurzel D, Steer A, Tosif S. Post-acute COVID-19 outcomes in children with mild and asymptomatic disease. Lancet Child Adolesc Health. 2021;5(6):e22-3. doi: https://doi.org/10.1016/S2352-4642(21)00124-3.
Sterky E, Olsson-Åkefeldt S, Hertting O, Herlenius E, Alfven T, Rinder MR, et al. Persistent symptoms in Swedish children after hospitalisation due to COVID-19. Acta Paediatr. 2021;110(9):2578-80. doi: https://doi.org/10.1111/apa.15999.
Stephenson T, Shafran R, De Stavola B, Rojas N, Aiano F, Amin-Chowdhury, et al. Long COVID and the mental and physical health of children and young people: national matched cohort study protocol (the CLoCk study). BMJ Open. 2021;11(8):e052838. doi: https://doi.org/10.1136/bmjopen-2021-052838.
Borch L, Holm M, Knudsen M, Ellermann-Eriksen S, Hagstroem S. Long COVID symptoms and duration in SARS-CoV-2 positive children - a nationwide cohort study. Eur J Pediatr. 2022;181(4):1597-607. doi: https://doi.org/10.1007/s00431-021-04345-z.
Smane L, Roge I, Pucuka Z, Pavare J. Clinical features of pediatric post-acute COVID-19: a descriptive retrospective follow-up study. Ital J Pediatr. 2021;47(1):177. doi: https://doi.org/10.1186/s13052-021-01127-z.
Zavala M, Ireland G, Amin-Chowdhury Z, Ramsay ME, Ladhani SN. Acute and persistent symptoms in children with PCR-confirmed SARS-CoV-2 infection compared to test-negative children in England: active, prospective, national surveillance. Clin Infect Dis. 2021;ciab991. doi: https://doi.org/10.1093/cid/ciab991.
Varsavsky T, Graham MS, Canas LS, Ganesh S, Pujol JC, Sudre CH, et al. Detecting COVID-19 infection hotspots in England using large-scale self-reported data from a mobile application: a prospective, observational study. Lancet Public Health. 2021;6(1):e21-9. doi: https://doi.org/10.1016/S2468-2667(20)30269-3.
Fumagalli C, Zocchi C, Tassetti L, Silverii MV, Amato C, Livi L, et al. Factors associated with persistence of symptoms 1 year after COVID-19: A longitudinal, prospective phone-based interview follow-up cohort study. Eur J Intern Med. 2022;97:36-41. doi: https://doi.org/10.1016/j.ejim.2021.11.018.
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