Long-lasting COVID Symptoms 'Rare in Young People'

Peter Russell

August 04, 2021

Most children who have COVID-19 have few symptoms that usually do not persist for long, a study found.

Experts said the findings were reassuring for the majority of young people, and reflected what paediatricians were seeing in clinical practice.

The study, in The Lancet Child & Adolescent Health , found that symptomatic children who received a positive PCR test for COVID typically got better after 6 days, and only 4.4% experienced symptoms later than 4 weeks.

Headache and Fatigue

The research was based on data from 1734 children aged 5 to 17 reported by parents and carers via the ZOE COVID Study smartphone app between September 2020 and February 2021.

The most common symptom experienced by children who were ill for a long period of time was fatigue, affecting 84% of participants. Headache and loss of sense of smell were also common, the researchers from King's College London (KCL) found. 

Of the 1379 children who developed symptoms at least 2 months before the end of the study period, only 1.8% experienced symptoms for longer than 8 weeks. 

The study also found that older children were typically ill for longer than primary school aged children – 7 days for those aged 12 to 17 years compared with 5 days for those in primary school years.

The researchers also assessed children who tested negative for COVID-19 who could have had other childhood illnesses, such as colds and influenza. A small cohort of children with other illnesses tended to have more symptoms than those who were ill with COVID-19, averaging five symptoms in the COVID-negative group compared with two symptoms in those who tested positive.

Dr Michael Absoud/SMC

Dr Michael Absoud, a consultant and senior author of the study at KCL, said: "Our data highlight that other illnesses, such as colds and flu, can also have prolonged symptoms in children and it is important to consider this when planning for paediatric health services during the pandemic and beyond. 

"This will be particularly important given that the prevalence of these illnesses is likely to increase as physical distancing measures implemented to prevent the spread of COVID-19 are relaxed. 

"All children who have persistent symptoms – from any illness – need timely multidisciplinary support linked with education, to enable them to find their individual pathway to recovery."

'Reassuring'

Commenting on the results for the Science Media Centre, Russell Viner, professor of child and adolescent health at UCL, said:  "The most important finding is the low proportion that had persistent symptoms, the great majority of whom recovered by 2 months after illness.  This is much lower than reported in some other studies and is reassuring about the population burden of post-COVID symptoms in children and young people."

Dr Alasdair Munro, clinical research fellow in paediatric infectious diseases at University Hospital Southampton, said: "Persistent symptoms after COVID-19 in children fortunately appear uncommon, and families can be reassured that in the event of an infection in children the risk to the individual remains extremely low."

Dr Liz Whittaker, infectious disease lead at the Royal College of Paediatrics and Child Health, and senior clinical lecturer in paediatric infectious diseases and immunology at Imperial College London, said: "This study is reassuring for the majority of children and young people who develop SARS-CoV-2 infection, and reflects what paediatricians are seeing in clinical practice. 

"It is important that the small group of children who experience persistent symptoms can access the pathways for assessment that have been established across the country in a timely fashion."

Illness duration and symptom profile in symptomatic UK school-aged children tested for SARS-CoV-2. The Lancet Child & Adolescent Health. DOI:https://doi.org/10.1016/S2352-4642(21)00198-X

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