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VERIFIED CONTENTConsultation: Piotr Rzymski - Polish medical and environmental biologist, dr hab. medical sciences, popularizer of science

Recent studies show that children experience the symptoms of so-called long COVID. Studies on school-aged children in the UK have shown that the disease is mild. What do we know at the moment about long COVID in children?

It is worth noting that the research was carried out before the Delta variant became popular. In addition, the findings may not take into account a dangerous syndrome called multi-system inflammatory syndrome that appeared weeks to months after a child was initially diagnosed with COVID-19.

A new study from the UK provides a detailed account of the course of COVID-19 in children between the ages of 5 and 17. Data were collected from people who tested positive for the PCR test at the time of symptom onset. The accompanying symptoms were regularly monitored and reported by the caregivers until the children fully recovered.

The results, which were based on information provided via smartphone applications by parents and guardians, indicate that the most common symptoms in children were fever, headache, fatigue, sore throat and loss of smell.

According to Michael Grosso, chief physician and director of pediatrics at Huntington Northwell He alth Hospital in Long Island, New York, research like this is extremely important in informing the medical community about the progress of COVID in children.

Long COVID in children - research

The researchers used data collected from September 1, 2022 to February 22, 2022, before the Delta variant became the dominant strain of the pandemic. The study found that 1,734 children developed symptoms typical of COVID-19 and tested positive for PCR during the symptom period.

According to the information received, it was found that the children were ill for 6 days on average.

They also allowed to establish that the local version of SARS-CoV-2 showed a mild course of the disease with a short duration.

However, about 4.5 percent of children experienced symptoms for more than 4 weeks - researchers attributed these symptoms to what is known as long COVID.

The children were also comparedinfected with COVID with children experiencing other diseases and found that those with COVID-19 were more likely to be sick for more than 4 weeks.

Children with other illnesses only had more symptoms after 4 weeks.

Researchers wonder if the results would have been the same if this study had been conducted in a different patient population - would they have looked similar or different for children infected with newer variants such as Delta? Additional research will be needed to find out.

The study has limitations

Recall that the analyzes were based on data collected up to February 2022, and they do not include infections caused by the Delta variant, which appeared in the UK only in May.

The authors of the study admitted that it is not possible to verify the symptoms reported by parents and guardians, which may result in inconsistencies in the interpretation of these symptoms in children.

Importantly, the researchers noted that their findings on the number of children experiencing long-term symptoms are lower than official UK figures.

Children with interruptions in symptoms lasting longer than 1 week were also excluded from the study, but as the researchers point out - prolonged COVID-19 symptoms may have a relapsing-remitting form.

It is worth adding that the study was conducted on a small population, and the method of reporting symptoms may not be reliable.

Consequences of COVID-19 in childhood can be serious inflammation of the brain, skin, eyes or gastrointestinal organs.

The multi-system inflammatory syndrome can occur weeks to months after being diagnosed with COVID-19.

Although MIS-C is a serious and potentially fatal condition, the CDC states that it is not a risk in most children diagnosed with it.

Symptoms of MIS-C are fever. Other symptoms may include:

  • stomach ache
  • vomiting
  • bloodshot eyes
  • pressure or pain in the chest
  • extreme fatigue

The CDC points out that it still keeps an eye on MIS-C and how it affects children, and still doesn't know why some of them get MIS-C and others don't.

Researchers admit that MIS-C tends to occur during periods of acute infection. While the risk of children hospitalizing for COVID-19 is low, a recent study published in The Lancet Child and Adolescent He alth concludes thatAbout 1 in 20 children hospitalized for COVID-19 develop brain or neural complications from a viral infection.

Between April 2022 and January 2022, researchers identified 52 cases of children under the age of 18 with neurological complications among 1,334 children hospitalized for COVID-19.

According to the study, the estimated prevalence in children was almost 4 percent, compared to just 0.9 percent of adults admitted with COVID-19.

Children who were also diagnosed with MIS-C exhibited multiple neurological conditions, including encephalopathy, stroke, behavior change, and hallucinations. They also required intensive care more often.

New UK research shows that children experience much less

symptoms of long COVID. However, these results do not agree with UK government reported data on children experiencing long-term symptoms after COVID-19.

The study used information provided by caregivers in a phone app, and experts say this could significantly distort the results. More research will be needed to come to clear conclusions.

Other recent studies have also found that children hospitalized for COVID-19 have a significantly increased risk of COVID-related inflammatory disease (MIS-C), which is linked to organ damage and neurological problems.

We asked dr hab. Peter of Rome:

“The UK study is another one whose results show that for most children between the ages of 5 and 17, symptoms of COVID-19 pass quickly, and that is very good news.

Of course, there is a small percentage who struggle longer with the symptoms of the disease. Approx. 4.5 percent children reported symptoms for at least four weeks, and about 2% reported symptoms for at least eight weeks. It was loss of smell, pain in the head and throat, and fatigue. This is not very surprising, because we know from other studies that in the case of SARS-CoV-2 infection, children generally have a lower viral load than adults.

In a British study, the group of children who required hospitalization for COVID-19 was small. From research conducted by the PERN research consortium, covering more than 40 hospitals in different countries, we know that persistent COVID-19 symptoms persist twice as often in children whose condition requires hospitalization.

The more different symptoms a child had, the greater the chance that one of them would persistlong, sometimes even up to 3 months. Interestingly, it was also noticed that the problem of long COVID significantly more often affects older children (aged 10 years and over) than very young children (up to 1 year old).

Nevertheless, symptoms disappeared quickly in 94% of patients. study participants. This does not mean, of course, that we can ignore these observations. On the contrary - from a medical point of view, we must be aware that some young patients may struggle with the symptoms of COVID longer and try to help them.

Especially that the PERN study shows that the persistent symptoms included not only loss of smell and taste, headache and fatigue, but also affective disorders, such as the initial phases of anxiety and depression. Importantly, at the moment we do not know how the delta variant may affect the frequency of long COVID in children, which in adults leads to a greater viremia than previously dominant variants "

ExpertPiotr Rzymski - Polish medical and environmental biologist, dr hab. medical sciences, popularizer of scienceMedical and environmental biologist, co-author of over 150 scientific publications, academic lecturer, science promoter, science journalist. Scholarship holder of the Foundation for Polish Science and the Ministry of Science and Higher Education, expert of the EU Research Executive Agency, ambassador of the international scientific network Universal Scientific Education and Research Network (USERN), member of the Program Council of the "Science Against Pandemic" initiative

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