Long COVID Symptoms Reported by 6% of Pediatric Patients

Tara Haelle

July 13, 2021

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Persistent long COVID symptoms affect approximately 6% of children 3 months after infection with SARS-CoV-2, according to new research.

The prevalence of long COVID in children has been unclear, and is complicated by the lack of a consistent definition, said Anna Funk, PhD, an epidemiologist at the University of Calgary in Alberta, Canada, during her online presentation of the findings at the 31st European Congress of Clinical Microbiology & Infectious Diseases.

In the several small studies conducted to date, rates range from 0% to 67% 2 to 4 months after infection, Funk reported.

To examine prevalence, she and her colleagues, as part of the Pediatric Emergency Research Network (PERN) global research consortium, assessed more than 10,500 children who were screened for SARS-CoV-2 when they presented to the emergency department at one of 41 study sites in 10 countries — Australia, Canada, Indonesia, the United States, plus three countries in Latin America and three in Western Europe — from March 2020 to June 15, 2021.

PERN researchers are following up with the more than 3100 children who tested positive 14, 30, and 90 days after testing, tracking respiratory, neurologic, and psychobehavioral sequelae.

Funk presented data on the 1884 children who tested positive for SARS-CoV-2 before January 20, 2021 and who had completed 90-day follow-up; 447 of those children were hospitalized and 1437 were not.

Symptoms were reported more often by children admitted to the hospital than not admitted (9.8% vs 4.6%). Common persistent symptoms were respiratory in 2% of cases, systemic (such as fatigue and fever) in 2%, neurologic (such as headache, seizures, and continued loss of taste or smell) in 1%, and psychological (such as new-onset depression and anxiety) in 1%.

"This study provides the first good epidemiological data on persistent symptoms among SARS-CoV-2-infected children, regardless of severity," said Kevin Messacar, MD, a pediatric infectious disease clinician and researcher at Children's Hospital Colorado in Aurora, who was not involved in the study.

And the findings show that although severe COVID and chronic symptoms are less common in children than in adults, they are "not nonexistent and need to be taken seriously," he told Medscape Medical News.

After adjustment for country of enrollment, children 10 to 17 years of age were more likely to experience persistent symptoms than children younger than 1 year (odds ratio [OR], 2.4; = .002).

Hospitalized children were more than twice as likely to experience persistent symptoms as nonhospitalized children (OR, 2.5; < .001). And children who presented to the emergency department with at least seven symptoms were four times more likely to have long-term symptoms than those who presented with fewer symptoms (OR, 4.02; = .01).

"Some Reassurance"

"Given that COVID is new and is known to have acute cardiac and neurologic effects, particularly in children with MIS-C, there were initially concerns about persistent cardiovascular and neurologic effects in any infected child," Messacar explained. "These data provide some reassurance that this is uncommon among children with mild or moderate infections who are not hospitalized."

But "the risk is not zero," he added. "Getting children vaccinated when it is available to them and taking precautions to prevent unvaccinated children getting COVID is the best way to reduce the risk of severe disease or persistent symptoms."

The study was limited by its lack of data on variants, reliance on self-reported symptoms, and a population drawn solely from emergency departments, Funk acknowledged.

No external funding source was noted. Messacar and Funk have disclosed no relevant financial relationships.

31st European Congress of Clinical Microbiology & Infectious Diseases (ECCMID): Abstract 3456. Presented July 11, 2021.

Tara Haelle is an independent science/health journalist based in Dallas.

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