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Review finds quarter of children develop long COVID

A meta-analysis has identified how approximately a quarter of children and adolescents are likely to experience long COVID symptoms

The World Health Organization uses the term post COVID-19 conditions (i.e., long COVID), to define a condition that occurs among individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms and that last for at least 2 months and cannot be explained by an alternative diagnosis.

To date, the currently available literature on long covid relates to the symptoms developed in adults, although one recent analysis that specifically focused on children and young people and who were followed-up for a median of 125 days, observed a range of symptoms including a higher incidence of diarrhoea and fatigue.

Nevertheless, the complete range and frequency of long Covid symptoms that develop in children and adolescents remains unclear and was the subject of the current study by the Mexican and US team.

The researchers looked for any type of study that included children and discussed long COVID, which they defined as the presence of one or more symptoms for longer than 4 weeks after the acute infection.

Children and long covid

The search identified a total of 21 eligible studies with 80,071 children and adolescents and which were included in the meta-analyses. The number of patients in each of the studies ranged from 53 to 57,763 and the participant ages from 0 to 18 years and the authors identified more than 40 long-term clinical manifestations of long Covid.

The overall prevalence of long Covid in children and adolescents was 25.2% (95% CI 18.2 –33.0) although among children who had been hospitalised, this increased to 29.2% (95% CI 17.8–41.9).

A wide range of symptoms were detected, with the most common (16.5%) being mood symptoms (e.g., sadness, tension, anger, depression, and anxiety) fatigue (9.7%), sleep disorders (8.4%) which encompassed insomnia, hypersomnia, and poor sleep quality. Other symptoms included headache (7.8%) and respiratory symptoms (7.6%).

The authors calculated that in comparison to controls, children with long COVID had a higher risk of persistent dyspnoea (OR 2.69, 95% CI 2.3 – 3.1), anosmia/ageusia (OR 10.7, 95% CI 2.5 – 46.0), and/or fever (OR 2.2, 95% CI 1.2 – 4.1).

Based on their findings, they concluded that the results of the meta-analysis supported the continued monitoring of the impact of long Covid on children and adolescents.

Lopez-Leon S et al. Long-COVID in children and adolescents: a systematic review and meta-analysis Sci Rep 2022