Pediatric long‐COVID: An overlooked phenomenon?

Abstract

Background Long‐COVID is a well‐documented multisystem disease in adults. Far less is known about long‐term sequelae of COVID in children. Here, we report on the occurrence of long‐COVID in Dutch children. Patients and Methods We conducted a national survey asking Dutch pediatricians to share their experiences on long‐COVID in children. We furthermore describe a case series of six children with long‐COVID to explore the clinical features in greater detail. Results With a response rate of 78% of Dutch pediatric departments, we identified 89 children, aged 2–18 years, suspected of long‐COVID with various complaints. Of these children, 36% experienced severe limitations in daily function. The most common complaints were fatigue, dyspnea, and concentration difficulties with 87%, 55%, and 45% respectively. Our case series emphasizes the nonspecific and broad clinical manifestations seen in post‐COVID complaints. Conclusion Our study shows that long‐COVID is also present in the pediatric population. The main symptoms resemble those previously described in adults. This novel condition demands a multidisciplinary approach with international awareness and consensus to aid early detection and effective management.

Cross-Sectional Survey on Long Term Sequelae of Pediatric COVID-19 among Italian Pediatricians

“…According to a Dutch survey involving 78% of national pediatric departments, 89 children had clinical characteristics attributable to long-covid. Specifically, the main complaints were fatigue, dyspnea and difficulty concentrating [9]. Molteni et al evaluated symptom prevalence, burden and illness duration in 1734 children with COVID-19.…”

“…In fact, it is known that the course of COVID-19 in children is much less severe than in adults, and more serious complications, such as pneumonia, are less frequent [4][5][6]. However, recent evidence seems to show that long-COVID symptoms also affect younger patients [7][8][9][10].…”

Vaccinating Adolescents and Children Significantly Reduces COVID-19 Morbidity and Mortality across All Ages: A Population-Based Modeling Study Using the UK as an Example

“…Although COVID-19 illness is generally milder in children when compared with adults, with low risks of hospitalization and death [ 17 , 18 , 19 ], a small number of children present with a multisystem inflammatory state with an associated mortality rate of 1–2% [ 20 , 21 , 22 ]. Furthermore, evidence is emerging that children may experience long COVID symptoms, similar to adults, which can lead to high morbidity and limitations in daily functioning [ 23 , 24 , 25 ]. In adults, there is clear evidence of post-COVID damage to the lung, heart, kidneys, and brain.…”

Pathogenesis, Symptomatology, and Transmission of SARS-CoV-2 through Analysis of Viral Genomics and Structure

“…However, not all cases of severe COVID-19 in children are characterizable as MIS-C. A recent study ( 132 ) described demographic and clinical variables associated with MIS-C in comparison with non-MIS-C severe acute COVID-19 in young people in the United States. Efforts to characterize long-term sequelae of SARS-CoV-2 infection in children face the same challenges as in adults, but long-term effects remain a concern in pediatric patients ( 105 , 133 , 134 ), although some early studies have suggested that they may be less of a concern than in adults ( 135 – 137 ). Research is ongoing into the differences between the pediatric and adult immune responses to SARS-CoV-2, and future research may shed light on the factors that lead to MIS-C; it is also unknown whether the relative advantages of children against severe COVID-19 will remain in the face of current and future variants ( 138 ).…”