Prevalence and associating factors of long COVID in pediatric patients during the Delta and the Omicron variants

Abstract

IntroductionThe number of pediatric COVID-19 infections is increasing; however, the data on long COVID conditions in children is still limited. Our study aimed to find the prevalence of long COVID in children during the Delta and Omicron waves, as well as associated factors.MethodsA single-center prospective cohort study was conducted. We included 802 RT-PCR-confirmed COVID-19 pediatric patients in the Delta and Omicron periods. Long COVID was defined as having symptoms for ≥3 months after infection. Parents and/or patients were interviewed by phone. Multivariable logistic regression was performed to find associated factors with long COVID.ResultsThe overall prevalence of long COVID was 30.2%. The Delta period had more prevalence than the Omicron (36.3% vs. 23.9%). Common symptoms for patients 0–3 years’ old were loss of appetite, rhinorrhea, and nasal congestion. Conversely, patients 3–18 years’ old had hair loss, dyspnea on exertion, rhinorrhea, and nasal congestion. However, there was no significant negative impact on daily life. Most symptoms improved after a 6-month follow-up. Factors associated with long COVID-19 conditions were infection during the Omicron period (adjusted OR: 0.54; 95% CI: 0.39–0.74, P < 0.001), fever (adjusted OR: 1.49, 95% CI: 1.01–2.20, P = 0.04) and rhinorrhea (adjusted OR: 1.47, 95% CI: 1.06–2.02, P = 0.02).ConclusionInfection during the Omicron wave has a lower prevalence of long COVID. The prognosis is often favorable, and most symptoms gradually become less. However, pediatricians may schedule appointments to surveil long COVID in children with fever or rhinorrhea as an initial symptom.

The effectiveness of the COVID-19 vaccines in the prevention of post-COVID conditions in children and adolescents: a systematic literature review and meta-analysis

“…Eight studies met the inclusion criteria 11 , 12 , 19 – 24 and were included in the final review (Table 1 ). All studies were non-randomized; 11 , 12 , 19 – 24 of these, 5 were prospective cohort studies, 12 , 21 – 24 2 were cross-sectional studies, 19 , 20 and 1 was a retrospective cohort study. 11 Four of these studies evaluated the Pfizer/BioNTech vaccine.…”

“… 11 Four of these studies evaluated the Pfizer/BioNTech vaccine. 12 , 21 , 22 , 24 Two analyzed the Moderna vaccine, 21 , 24 1 analyzed the AstraZeneca vaccine, 12 and 1 analyzed the Sinopharm vaccine. 12 Four studies did not report the type of COVID-19 vaccine administered.…”

“… 12 , 21 , 22 , 24 Two analyzed the Moderna vaccine, 21 , 24 1 analyzed the AstraZeneca vaccine, 12 and 1 analyzed the Sinopharm vaccine. 12 Four studies did not report the type of COVID-19 vaccine administered. 11 , 19 , 20 , 23 There were no published studies that evaluated post-COVID conditions as an outcome of bivalent COVID-19 vaccines.…”

“…Two studies included in our review were conducted in the United Kingdom, 11 , 20 and 2 were conducted in Thailand. 12 , 22 One study each was performed in Israel, 19 Italy, 24 Norway, 21 and the United States. 23 All studies were performed between February 2020 and October 2022.…”

“…Eight corresponding authors were contacted for additional information, and 2 were able to provide additional information regarding the number of individuals with and without post-COVID conditions in both vaccinated and unvaccinated groups. 11 , 12 The risk of bias was assessed using the Downs and Black scale. 13 Reviewers answered all original questions from this scale except for question #27 (a single item on the Power subscale scored 0 to 5), which was changed to a yes or no.…”