Abstract
Introduction: The data on long COVID in children is scarce since children and adolescents are typically less severely affected by acute COVID-19. This study aimed to identify the long-term consequences of SARS-CoV-2 infection in children, and to compare the persistent symptom spectrum between COVID-19 and community-acquired infections of other etiologies.Methods: This was an ambidirectional cohort study conducted at the Children's Clinical University Hospital in Latvia. The study population of pediatric COVID-19 patients and children with other non-SARS-CoV-2-community-acquired infections were invited to participate between July 1, 2020, and April 30, 2021.Results: In total, 236 pediatric COVID-19 patients were enrolled in the study. Additionally, 142 comparison group patients were also enrolled. Median follow-up time from acute symptom onset was 73.5 days (IQR; 43–110 days) in the COVID-19 patient group and 69 days (IQR, 58–84 days) in the comparison group. Most pediatric COVID-19 survivors (70%, N = 152) reported at least one persistent symptom, but more than half of the patients (53%, N = 117) noted two or more long-lasting symptoms. The most commonly reported complaints among COVID-19 patients included persistent fatigue (25.2%), cognitive sequelae, such as irritability (24.3%), and mood changes (23.3%), as well as headaches (16.9%), rhinorrhea (16.1%), coughing (14.4%), and anosmia/dysgeusia (12.3%). In addition, 105 (44.5%) COVID patients had persistent symptoms after the 12-week cut-off point, with irritability (27.6%, N = 29), mood changes (26.7%, N = 28), and fatigue (19.2%, N = 20) being the most commonly reported ones. Differences in symptom spectrum among the various age groups were seen. Logistic regression analysis showed that long-term persistent symptoms as fever, fatigue, rhinorrhea, loss of taste and/or smell, headaches, cognitive sequelae, and nocturnal sweating were significantly associated with the COVID-19 experience when compared with the controls.Conclusions: We found that at the time of interview almost three-quarters of children reported at least one persistent symptom, but the majority of patients (53%) had two or more concurrent symptoms. The comparison group's inclusion in the study allowed us to identify that symptom persistence is more apparent with COVID-19 than any other non-SARS-CoV-2 infection. More research is needed to distinguish the symptoms of long COVID from pandemic-associated complaints. Each persistent symptom is important in terms of child well-being during COVID-19 recovery.
Highlights
The data on long COVID in children is scarce since children and adolescents are typically less severely affected by acute COVID-19
Research into long COVID among pediatric population is ongoing, and new information is published at tremendous speed all the time, our research has identified the significant number of children who experience long COVID
We believe that this assumption could be representative, since our hospital is the only tertiary-level pediatric medical institution in Latvia in which a post-acute outpatient service for children recovering from COVID-19 could be established, and most children with long COVID are believed to have responded to our call to participate in the study
Summary
The data on long COVID in children is scarce since children and adolescents are typically less severely affected by acute COVID-19. If symptoms extend beyond 12 weeks, post-COVID-19 syndrome can be diagnosed [1, 2] Up to this point, there has been no consensus on a definition of long COVID, so timeframe, terminology, and classification can vary from one publication to another. It has been suggested that the definition could be adapted for different COVID-19 patient groups, taking into consideration length of hospitalization, predisposing intrinsic (age, gender, and comorbidities) and extrinsic (biological, psychological, and social) factors [2,3,4]. At this point, there is no clear case-definition for long COVID among the pediatric population
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