Mental health of Adolescents in the Pandemic: Long-COVID19 or Long-Pandemic Syndrome?

Abstract

Backround Post-COVID19 complications such as pediatric inflammatory multisystem syndrome (PIMS) and Long-COVID19 move increasingly into focus, potentially causing more harm in this age group than the acute infection. To better understand the symptoms of long-COVID19 in adolescents and to distinguish infection-associated symptoms from pandemic-associated symptoms, we conducted a Long-COVID19 survey, comparing responses from seropositive and seronegative adolescents. To our knowledge, data of Long-COVID19 surveys with seronegative control groups have not been published yet. Methods Since May 2020 students grade 8-12 in fourteen secondary schools in Eastern Saxony were enrolled in the SchoolCovid19 study. Seroprevalence was assessed via serial SARS-CoV-2 antibody testing in all participants. Furthermore, during the March/April 2021 study visit all participants were asked to complete a 12 question Long-COVID19 survey regarding the occurrence and frequency of difficulties concentrating, memory loss, listlessness, headache, abdominal pain, myalgia/ arthralgia, fatigue, insomnia and mood (sadness, anger, happiness and tenseness). Findings 1560 students with a median age of 15 years participated in this study. 1365 (88%) were seronegative, 188 (12%) were seropositive. Each symptom was present in at least 35% of the students within the last seven days before the survey. However, there was no statistical difference comparing the reported symptoms between seropositive students and seronegative students. Whether the infection was known or unknown to the participant did not influence the prevalence of symptoms. Interpretation The lack of differences comparing the reported symptoms between seropositive and seronegative students suggests that Long-COVID19 might be less common than previously thought and emphasizing the impact of pandemic-associated symptoms regarding the well-being and mental health of young adolescents. Funding This study was supported by a grant by the Federal State of Saxony. M.K.W. was supported by the Else Kroener-Fresenius Center for Digital Health (EKFZ), TU Dresden, Germany.

Italian intersociety consensus on management of long covid in children

“…However, significantly higher prevalence rates were reported by Smane et al [34], Sterky et al [37], Osmanov et al [38], and Buonsenso et al [39], and Stephenson et al [40], who diagnosed long COVID in 30, 22, 24, 22, 87.1, and 66% of the children assessed at 12 weeks or more from COVID-19 onset. Several factors could justify these differences and explain why in a recent analysis of the available data, it was indicated that definitive conclusions on the prevalence and clinical characteristics of pediatric long COVID could not be drawn [29].…”

“…Soon after, in UK, the Office for National Statistics calculated that, before February 2021, 12.9% of primary-school aged children and 15% of secondary-school aged children had had at least one symptom suggesting long COVID at 5 weeks post SARS-CoV-2 infection [32]. More recently, some studies confirmed these findings, although prevalence rates of long COVID reported by these studies varied significantly [33][34][35][36][37][38][39][40][41][42][43][44][45][46]. Low prevalence rates of long COVID were reported by Say et al [36], Miller et al [41], Radtke et al [44] and Molteni et al [45] who, examining children at 4 weeks from COVID-19 diagnosis, evidenced persisting symptoms in 8, 5, 9, and 4%, of the cases.…”

Post COVID-19 in children, adolescents, and adults: results of a matched cohort study including more than 150,000 individuals with COVID-19

“…To the extent that these results reflect a higher long-run morbidity related to SARS-CoV-2 infections, they may indicate an important public health challenge that should be considered in discussions about adequate preventive measures. Of course, these discussions must also consider harmful side effects of preventive measures [26].…”

“…Our study therefore extends previous research as it is the first that suggests relevant post COVID-19 healthcare utilization and new-onset morbidity patterns documented by physicians in children and adolescents following COVID-19 disease in a large sample of patients with confirmed COVID-19 compared to a matched control group. Previous studies among children and adolescents, which did not observe significant group differences between children and adolescents with COVID-19 and controls were limited by restrictions to hospitalized patients [10], high drop-out rates and/or high risk of selection bias [10,23], self-reported outcome assessment [5,10,19,24,25], lack of a control group [10], insufficiently long follow-up time to assess post COVID-19 outcomes [23,26], and low sample size resulting in low statistical power [26,27].…”

COVID-19 and mental health in children and adolescents: a diagnostic panel to map psycho-social consequences in the pandemic context

“…But in addition to the organic effects of potential viral diseases, the pandemic also has a psychological impact independent of the question of whether a child itself was infected. Emotions such as fear, anxiety, loneliness as well as boredom are reinforced by various pandemic measures [ 1 , 21 , 22 , 49 , 51 , 52 , 76 , 77 ]. This has also led to an increased incidence of mental illness in children and adolescents during the Corona period [ 24 , 52 ].…”