Persistent respiratory symptoms associated with post-Covid condition (Long Covid) in children: a systematic review and analysis of current gaps and future perspectives

Martino, Laura; Morello, Rosa; De Rose, Cristina; Buonsenso, Danilo

doi:10.1080/17476348.2023.2271836

Cited by 2 publications

(1 citation statement)

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“…These studies included mostly children with asymptomatic mild acute COVID-19 infection, with a follow-up of up to 8 months post infection, and showed mixed results, ranging from no abnormalities to an obstructive pattern seen in a large proportion of patients. In a systemic review and meta-analysis by Martino et al the [16] authors have found that children can develop persistent respiratory symptoms after SARS-CoV-2 infection; however, the methodological variabilities of the analyzed studies did not allow them to provide firm conclusions about the rate, type and best diagnostics for children with persistent respiratory symptoms. Furthermore, long-term follow-up data on children are scarce and guidelines regarding the management of these cases are lacking.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary Evaluation in Children with Post-COVID-19 Condition Respiratory Symptoms: A Prospective Cohort Study

Shmueli,

Bar-On,

Amir

et al. 2023

JCM

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Background: Studies on post-COVID-19 condition (PCC) in adults have shown deterioration in pulmonary function tests (PFTs), mainly a diffusion limitation. Among the pediatric population, data are scarce. Aim: To characterize PFTs in children with PCC, including changes over time. Methods: A prospective longitudinal study of children with defined PCC and respiratory complaints who were referred to a designated multidisciplinary clinic from 11/2020 to 12/2022. Results: Altogether, 184 children with a mean age of 12.4 years (SD 4.06) were included. A mild obstructive pattern was demonstrated in 19/170 (11%) at presentation, as indicated by spirometry and/or positive exercise challenge test and/or reversibility post bronchodilators, only three had a previous diagnosis of asthma. Lung volumes and diffusion were normal in all but one patient (1/134, 0.7%). Exhaled nitric oxide levels were elevated in 32/144 (22%). A total of 33 children who had repeated PFTs had normal or near-normal PFTs on follow-up testing, including seven (21.2%) who had mild obstructive PFTs at presentation. Multivariate analysis identified older age [OR 1.36 (95% CI:1.07–1.75)], specific imaging findings (prominent bronchovascular markings (OR 43.28 (95% CI: 4.50–416.49)), and hyperinflation (OR 28.42, 95% CI: 2.18–370.84)] as significant predictors of an obstructive pattern on PFTs. Conclusions: In children with PCC and respiratory symptoms, the most common impairment was a mild obstructive pattern; most were without a history of asthma. Improvement was witnessed in long-term follow-up. In contrast to the adult population, no diffusion limitation was found. Empirical periodic inhaler therapy may be considered in children with factors associated with PFT abnormalities.

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Section: Introductionmentioning

confidence: 99%