Diagnosis and management of post-COVID (Long COVID) in children: a moving target

Morello, Rosa; Martino, Laura; Buonsenso, Danilo

doi:10.1097/mop.0000000000001221

Cited by 25 publications

(40 citation statements)

References 66 publications

(120 reference statements)

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“…hypertophy of the right ventricle, tricuspid insufficiency or abnormal shape of the pulmonary doppler curve) and, in case of abnormal findings, ruling out ongoing thrombotic processes with laboratory measurement of d ‐Dimers. 99m Tc‐MAA SPECT/CT may be considered as a third‐step test in children with abnormal findings at noninvasive tests (eg echocardiography and/or CPET) or those with severe persisting cardiorespiratory symptoms (this is currently also our approach 35 . Given the small number of patients in our cohort, we were not able to perform statistical analyses to understand the risk factors for having an abnormal 99m Tc‐MAA SPECT/CT.…”

Section: Discussionmentioning

confidence: 99%

“…99m Tc-MAA SPECT/CT may be considered as a third-step test in children with abnormal findings at noninvasive tests (eg echocardiography and/or CPET) or those with severe persisting cardiorespiratory symptoms (this is currently also our approach. 35 Given the small number of patients in our cohort, we were not able to perform statistical analyses to understand the risk factors for having an abnormal 99m Tc-MAA SPECT/CT.…”

Section: This Is the Largest Study Showing Details Of Lung Perfusion ...mentioning

confidence: 99%

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Lung perfusion assessment in children with long‐COVID: A pilot study

Buonsenso

Morello

et al. 2023

Pediatric Pulmonology

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Background: There is increasing evidence that chronic endotheliopathy can play a role in patients with Post-Covid Condition (PCC, or Long Covid) by affecting peripheral vascularization. This pilot study aimed at assessing lung perfusion in children with Long-COVID with 99m Tc-MAA SPECT/CT. Materials and Methods: lung 99m Tc-MAA SPECT/CT was performed in children with Long-COVID and a pathological cardiopulmonary exercise testing (CPET). Intravenous injections were performed on patients in the supine position immediately before the planar scan according to the EANM guidelines for lung scintigraphy in children, followed by lung SPECT/CT acquisition. Reconstructed studies were visually analyzed.Results: Clinical and biochemical data were collected during acute infection and follow-up in 14 children (6 females, mean age: 12.6 years) fulfilling Long-COVID diagnostic criteria and complaining of chronic fatigue and postexertional malaise after mild efforts, documented by CPET. Imaging results were compared with clinical scenarios during acute infection and follow-up. Six out of 14 (42.8%) children showed perfusion defects on 99m Tc-MAA SPECT/CT scan, without morphological alterations on coregistered CT.Conclusions: This pilot investigation confirmed previous data suggesting that a small subgroup of children can develop lung perfusion defects after severe acute respiratory syndrome coronavirus 2 infection. Larger cohort studies are needed to confirm these preliminary results, providing also a better understanding of which children may deserve this test and how to manage those with lung perfusion defects.

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Section: Discussionmentioning

confidence: 99%

Section: This Is the Largest Study Showing Details Of Lung Perfusion ...mentioning

confidence: 99%

Lung perfusion assessment in children with long‐COVID: A pilot study

Buonsenso

Morello

et al. 2023

Pediatric Pulmonology

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“…Most studies without control groups were retrospective and have suggested rates of up to 40%. 2 Our hypothesis was that selfreported studies could have overestimated symptoms at specific timepoints, in both cases and controls, and that observational studies without control groups could have underestimated the risk.…”

Section: B R I E F R E P O R T Paediatric Long Covid Studies Should F...mentioning

confidence: 95%

Paediatric long COVID studies should focus on clinical evaluations that examine the impact on daily life not just self‐reported symptoms

Buonsenso,

Camporesi,

Morello

et al. 2024

Acta Paediatrica

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“…The physical symptoms, to which the definition refers, subsist mainly of chronic fatigue and neuropsychiatric, cardiovascular, pulmonary, hematologic, gastrointestinal, renal, endocrine, dermatologic, and musculoskeletal sequelae. Currently, there is increasing evidence that persistent olfactory dysfunction (anosmia) and taste dysfunction (dysgeusia) are frequent complications of acute SARS-CoV-2 infection in children [ 4 ]. Despite the growing impact of the latter two dysfunctions, not much is yet known about the pathophysiology underlying them.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Persistent Anosmia and Dysgeusia in Children with SARS-CoV-2 Infection: A Retrospective Study

et al. 2023

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Background: Olfactory and gustative dysfunctions are two of the most common post-acute sequelae of SARS-CoV-2 infection in children, which can have a negative impact on the routines of children and families. As several children have had COVID-19 since the Omicron variant, it is important to investigate if this increase in infections is reflected in higher olfactory/taste disfunctions. The primary aim of this study was to characterize the presence of olfactory/gustative problems in a cohort of children, its evolution, and its association with risk factors such as COVID-19 variant, hospitalization, presence of olfactory/gustative dysfunction during the acute phase, and vaccination. Methods: This was a retrospective analysis of children with microbiologically confirmed SARS-CoV-2 infection evaluated in person at a referral pediatric post-COVID-19 clinic in Rome, Italy. We included children younger than 19 years old, evaluated from the beginning of the pandemic up to October 2022. At specific timepoints, we investigated the presence of olfactory/taste disfunctions and evaluated them according to the SARS-CoV-2 variants circulating at the time of infection. Results: A total of 1250 children (650 females; 52.0%) with a mean age of 6.77 (±4.12) years were included in the study. At 3, 6, 12, and 18 months, 12 (9.6%), 7 (5.6%), 2 (1.6%), and 1 (0.8%) of the children reported anosmia and dysgeusia post-COVID-19 infection, respectively. The presence of anosmia and dysgeusia during the acute phase of infection and being infected with a pre-Omicron variant were found to be significant risk factors for persistent olfactory and gustatory dysfunction during all follow-up periods. Conclusions: anosmia and dysgeusia symptoms tended to decrease gradually over time, but not all children recovered quickly.

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Diagnosis and management of post-COVID (Long COVID) in children: a moving target

Cited by 25 publications

References 66 publications

Lung perfusion assessment in children with long‐COVID: A pilot study

Lung perfusion assessment in children with long‐COVID: A pilot study

Paediatric long COVID studies should focus on clinical evaluations that examine the impact on daily life not just self‐reported symptoms

Risk Factors for Persistent Anosmia and Dysgeusia in Children with SARS-CoV-2 Infection: A Retrospective Study

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