Post-acute COVID-19 outcomes in children with mild and asymptomatic disease

Say, Daniela F; Crawford, Nigel; McNab, Sarah; Wurzel, Danielle; Steer, Andrew C.; Tosif, Shidan

doi:10.1016/s2352-4642(21)00124-3

Cited by 168 publications

(255 citation statements)

References 3 publications

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“…Our data concords with a small Australian study reporting 171 young children testing positive for SARS-CoV-2 (median age three years [IQR 1;8]), 151 of whom were followed for 3-6 months: twelve (8%) children (median age, two years) had symptoms 3-8 weeks after initial presentation (most commonly, cough and/or fatigue); all returned to baseline health by study end. 36 Our study is part of one of the largest citizen-scientist initiatives ever in the UK. We leveraged our previously published methodologies assessing illness duration and symptom profiling, including long COVID assessment.…”

Section: Lack Of Contemporaneous Data Comparing Illness Duration and Symptom Profiles Aftermentioning

confidence: 99%

Illness duration and symptom profile in a large cohort of symptomatic UK school-aged children tested for SARS-CoV-2

Molteni

Sudre

Canas

et al. 2021

Preprint

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Background In children, SARS-CoV-2 is usually asymptomatic or causes a mild illness of short duration. Persistent illness has been reported; however, its prevalence and characteristics are unclear. We aimed to determine illness duration and characteristics in symptomatic UK school-aged children tested for SARS-CoV-2 using data from the COVID Symptom Study, the largest citizen participatory epidemiological study to date. Methods Data from 258,790 children aged 5-17 years were reported by an adult proxy between 24 March 2020 and 22 February 2021. Illness duration and symptom profiles were analysed for all children testing positive for SARS-CoV-2 for whom illness duration could be determined, considered overall and within younger (5-11 years) and older (12-17 years) age groups. Data from symptomatic children testing negative for SARS-CoV-2, matched 1:1 for age, gender, and week of testing, were also assessed. Findings 1,734 children (588 younger children, 1,146 older children) had a positive SARS-CoV-2 test result and calculable duration of illness with the study time frame. The commonest symptoms were headache (62.2%) and fatigue (55.0%). Median illness duration was six days (vs. three days in children testing negative); and was positively associated with age (rs 0.19, p<1.e-4) with median duration seven days in older vs. five days in younger children. Seventy-seven (4.4%) children had illness duration =>28 days (LC28); LC28 was more common in older compared with younger children (59 (5.1%) vs. 18 (3.1%), p=0.046). The commonest symptoms experienced by children with LC28 were fatigue (84.4%), headache and anosmia (both 77.9%); however, by day 28 the median symptom burden was two. Only 25 (1.8%) of 1,379 children experienced symptoms for ≥56 days. Few children (15 children, 0.9%) in the negatively-tested cohort experienced prolonged symptom duration; however, these children experienced greater symptom burden (both throughout their illness and at day 28) than children positive for SARS-CoV-2. Interpretation Some children with COVID-19 experience prolonged illness duration; reassuringly, symptom burden in these children did not increase with time, and most recovered by day 56. Some children who tested negative for SARS-CoV-2 also had persistent and burdensome illness. Thus, a holistic approach for all children with persistent illness during the pandemic is required.

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Section: Lack Of Contemporaneous Data Comparing Illness Duration and Symptom Profiles Aftermentioning

confidence: 99%

Illness duration and symptom profile in a large cohort of symptomatic UK school-aged children tested for SARS-CoV-2

Molteni

Sudre

Canas

et al. 2021

Preprint

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“…8 This is in accord with the most recent study from Australia, which followed 151 children (median age 3 years) for 3-6 months who predominantly had mild or asymptomatic infection followed in only 8% with ongoing symptoms. 9 However, evidence from other small long-term outcome studies in children suggests that more than a half having at least one persisting symptom 4 months after COVID-19. 10 Our experience is that preschool children rarely have long-COVID symptoms but those in the 6-18 age groups are significantly more frequently affected.…”

Section: Long-covidmentioning

confidence: 98%

Legacy of COVID-19 infection in children: long-COVID will have a lifelong health/economic impact

Munblit

Simpson

Mabbitt³

et al. 2021

Arch Dis Child

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“…or to full recovery in all children with predominantly mild disease5 . Initial SARS-CoV-2 infection severity, different methodological approaches (clinical assessment versus self-report), definition of cases (diagnosed versus suspected cases), variable follow-up times, and prevalence of pre-existing clinical conditions likely contribute to the variability of long COVID reported in children.…”

mentioning

confidence: 91%

“…The copyright holder for this preprint this version posted May 18, 2021. ; https://doi.org/10.1101/2021.05.16.21257255 doi: medRxiv preprint 3 limited to selective -mostly clinical -populations without control groups [2][3][4][5] , which do not allow estimating the overall prevalence and burden in a general pediatric population. In this study, we compared long COVID related symptoms in children and adolescents (hereafter referred to as children) with 6-months follow-up according to their SARS-CoV-2 serology.…”

Section: Introductionmentioning

confidence: 99%

Long-term symptoms after SARS-CoV-2 infection in school children: population-based cohort with 6-months follow-up

Radtke

Ulytė

Puhan

et al. 2021

Preprint

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Although nobody doubts the existence of long COVID in children, it is still unclear to what extent children are affected. The Ciao Corona study is a longitudinal cohort investigating SARS-CoV-2 seroprevalence and clustering of cases among around 2500 children from 55 randomly selected primary and secondary schools in the canton of Zurich in Switzerland. Between June 2020 and April 2021, we completed three testing phases where we collected venous blood for serological analysis (ABCORA 2.0 test) and asked about symptoms with online questionnaires. We compared children who tested positive for SARS-CoV-2 antibodies in October/November 2020 with those who tested negative. Children who were seronegative in October/November 2020 and seroconverted or were not retested by March/April 2021 were excluded from the analysis (n=256). In March-May 2021 we assessed the presence of symptoms occurring since October 2020, lasting for at least 4 weeks, and persisting for either >4 weeks or >12 weeks. Overall, 1355 of 2503 children with a serology result in October/November 2020 and follow up questionnaire in March/April 2021 were included. Among seropositive and seronegative 6- to 16-year-old children and adolescents, 9% versus 10% reported at least one symptom beyond 4 weeks, and 4% versus 2% at least one symptom beyond 12 weeks. None of the seropositive children reported hospitalization after October 2020. This study suggests a very low prevalence of long COVID in a randomly selected population-based cohort of children followed over 6 months after serological testing. Importantly, seropositive children, all with a history of pauci-symptomatic SARS-CoV-2 infection, did not report long COVID more frequently than seronegative children.

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Post-acute COVID-19 outcomes in children with mild and asymptomatic disease

Cited by 168 publications

References 3 publications

Illness duration and symptom profile in a large cohort of symptomatic UK school-aged children tested for SARS-CoV-2

Illness duration and symptom profile in a large cohort of symptomatic UK school-aged children tested for SARS-CoV-2

Legacy of COVID-19 infection in children: long-COVID will have a lifelong health/economic impact

Long-term symptoms after SARS-CoV-2 infection in school children: population-based cohort with 6-months follow-up

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