June 23, 2022 1:04:28 pm
The largest study to date of long Covid symptoms in children aged 0-14 years confirms that children who have received a Covid-19 diagnosis can experience symptoms of long Covid lasting at least two months.
The study, published in ‘The Lancet Child and Adolescent Health’ journal, used national level sampling of children in Denmark and matched Covid-19 positive cases with a control group of children with no prior history of a Covid-19 infection.
Most previous studies of long Covid in young people have focussed on adolescents, with infants and toddlers seldom represented. In this research, surveys were sent to the mother or guardian of children between 0-14 years who had tested positive for Covid-19 between January 2020 and July 2021. In total, responses were received for almost 11,000 children with a positive Covid-19 test result who were matched by age and sex to over 33,000 children who had never tested positive for Covid-19.
The surveys asked participants about the 23 most common symptoms of long Covid in children (identified by the Long COVID Kids Rapid Survey January 2021) and used the World Health Organization definition of long COVID as symptoms lasting more than two months.
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The most commonly reported symptoms among children 0-3 years old were mood swings, rashes, and stomach aches. In the 4-11 years age group, the most commonly reported symptoms were mood swings, trouble remembering or concentrating, and rashes, and in the 12-14-year age group, fatigue, mood swings, and trouble remembering or concentrating.
The results of the study found children diagnosed with Covid-19 in all age groups to be more likely to experience at least one symptom for two months or longer than the control group. In the 0-3 years age group, 40% of children diagnosed with Covid-19 (478 of 1,194 children) experienced symptoms for longer than two months, compared to 27% of controls (1,049 of 3,855 children). For the 4-11 years age group, the ratio was 38% (1,912 of 5,023 children) compared to 34% of controls (6,189 of 18,372 children), and for the 12-14 years age group, it was 46% (1,313 of 2,857 children) compared to 41% of controls (4,454 of 10,789 children).
When contacted via email, Professor Selina Kikkenborg Berg, Copenhagen University Hospital, Denmark told The Indian Express that the overall aim of the study was to determine the prevalence of long-lasting symptoms in children and infants, alongside quality of life, and absence from school or day care. “Very young children can have late effects after Covid-19. Around 40 percent of 0-3-year-olds who have had corona have symptoms for 8 weeks or more afterwards, their parents report. In the control group, 27 per cent have similar symptoms, and that makes a significant difference,” Prof Selina said.
“Our results reveal that although children with a positive Covid-19 diagnosis are more likely to experience long-lasting symptoms than children with no previous Covid-19 diagnosis, the pandemic has affected every aspect of all young people’s lives. Knowledge of long-term symptom burden in SARS-CoV-2 positive children is essential to guide clinical recognition, parental caregiving, and societal decisions about isolation, lockdown, non-pharmaceutical interventions, and vaccine strategies,” Prof Selina added.
The types of non-specific symptoms associated with long Covid are often experienced by otherwise healthy children: headache, mood swings, abdominal pain, and fatigue are all symptoms of common ailments that children experience which are unrelated to Covid-19. However, this study revealed that children with a positive Covid-19 diagnosis were more likely to experience long-lasting symptoms than children who had never had a positive diagnosis, suggesting that these symptoms were a presentation of long Covid. This is supported by approximately one third of children with positive Covid-19 tests experiencing symptoms that were not present before the SARS-CoV-2 infection. In addition, with increasing duration of symptoms, the proportion of children with those symptoms tended to decrease, according to the study report.
Generally, children diagnosed with Covid-19 reported less psychological and social problems than children in the control group. In older age groups, children often felt less scared, had less trouble sleeping, and felt less worried about what would happen to them. A likely explanation for this is the increased pandemic awareness in older age groups, with children in the control group experiencing fear of the unknown disease and more restricted everyday life due to protecting themselves from catching the virus.
“Our findings align with previous studies of long Covid in adolescents showing that, although the chances of children experiencing long Covid is low, especially compared to control groups, it must be recognised and treated seriously. More research will be beneficial to treat and better understand these symptoms and the long-term consequences of the pandemic on children going forward,” she said. “There is still a lot we do not know about Corona, and one should not rush to recover from an infectious disease. If you suffer from fatigue, shortness of breath, fever and other symptoms, take it a little calmly and do not stress the body. Sometimes a viral disease takes longer to recover,” she pointed out.
Dr Aarti Kinikar, chairperson of the Covid paediatric task force in Pune, said that a small telephonic feedback survey at the tertiary care B J Medical College and Sassoon General Hospital found that majority of the 250 children (0-12 years) who were Covid-positive during the first and second wave did not have significant residual post-Covid medical issues. “Perhaps there are some differences between the patients here and those in the West. However, we do need more studies on this issue,” Dr Kinikar said. Post-Covid paediatric facilities in the OPD of any hospital would benefit in recording the effects over a period of time, Dr Kinikar said.
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