Long COVID in Children and Adolescents

Abstract

Severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) has caused significant mortality and morbidity worldwide. In children, the acute SARS-CoV-2 infection is often asymptomatic or paucisymptomatic, and life-threatening complications are rare. Nevertheless, there are two long-term consequences of SARS-CoV-2 infection in children that raise concern: multisystem inflammatory syndrome in children (MIS-C) and long COVID. While the understanding and the experience regarding the acute phase of SARS-CoV-2 infection have remarkably increased over time, scientific and clinical research is still exploring the long-term effects of COVID-19. In children, data on long COVID are scant. Reports are conflicting regarding its prevalence, duration and impact on daily life. This narrative review explored the latest literature regarding long COVID-19 in the pediatric population. We showed that long COVID in children might be a relevant clinical problem. In most cases, the prognosis is good, but some children may develop long-term symptoms with a significant impact on their daily life. The paucity of studies on long COVID, including a control group of children not infected by SARS-CoV-2, prevents us from drawing firm conclusions. Whether the neuropsychiatric symptoms widely observed in children and adolescents with long COVID are the consequence of SARS-CoV-2 infection or are due to the tremendous stress resulting from the restrictions and the pandemics is still not clear. In both cases, psychological support can play a fundamental role in managing COVID pandemics in children. More knowledge is needed to share a standardized definition of the syndrome and improve its management and treatment.

Self-Reported Long COVID in the General Population: Sociodemographic and Health Correlates in a Cross-National Sample

“…The study showed that none of the sociodemographic variables was significantly associated with long COVID. While previous research has found that the prevalence of long COVID is higher among women than among men, indicating that female gender is a sociodemographic risk factor for long COVID in adults [13] and in children and adolescents [15], this finding was not substantiated in our study. Moreover, our study cannot point in the direction of other possible risk factors among the sociodemographic variables.…”

“…However, gender moderated the effect of long COVID on psychological distress and fatigue, implying that the differences in psychological distress and fatigue between men with and without long COVID were larger than the corresponding differences between women with and without long COVID. Thus, while women are more inclined to get long COVID, as reported in the literature [13,15], men who do get long COVID appear to experience more severe symptoms. Possibly, the male participants may have been more severely ill in the acute phase.…”

COVID-19 Vaccine Acceptance Among US Parents: A Nationally Representative Survey

“…Parents may balance perceived risks of COVID-19 against perceived risks of vaccination. Although fewer children experience severe disease than adults, “long COVID” and MIS-C are important sources of morbidity in children, and parental perception that pediatric COVID-19 disease is severe was a significant positive predictor of vaccination intention for children 0–4 and 5–11 [ 28 , 30 ]. Even among respondents very likely to vaccinate children ages 0–4 and 5–11 against COVID-19, nearly one-third indicated that if side effects were more severe than those experienced with routine vaccines, they would be less likely to vaccinate their children, and baseline acceptance of other routine childhood immunizations was a significant positive predictor of parental COVID-19 vaccine acceptance across all age groups.…”

Long COVID in children

“…12 The estimated prevalence among children varies considerably. 13 The definition of the condition (especially if the need for a confirmed test of COVID-19 illness is included), the broad range of symptoms (as some may have started before COVID-19 illness), and the similarities to other conditions (eg, chronic fatigue syndrome) are some of the reasons for the diagnosis being challenging. Furthermore, studies to date have had small cohorts, suffered from the biased selection of populations or recall bias of reported symptoms, had no control groups, and had variable lengths of follow-up.…”