Long COVID in children: frequency and diagnostic challenges
DOI:
https://doi.org/10.15574/PP.2023.95.101Keywords:
COVID-19, long COVID, post-COVID period, children, adolescentsAbstract
Purpose - to analyze the prevalence of symptoms of long COVID-19 in the pediatric population and the methods of their diagnosis.
Electronic search of scientific research using known databases from PubMed, SCOPUS, ResearchGate, Wiley Online Library and Google Scholar from 2019 to February 2023.
The keywords for this review: long COVID, post COVID, COVID-19, pediatrics, children, adolescents, post-acute sequelae of SARS‐CoV‐2 infection (PASC). Exclusion criteria were: duplicated, dedicated exclusively to adults, analyzed only acute COVID-19. In the analysis were included research from the post-Covid period in children and adolescents, which contained the results of the assessment of their state of health and displayed certain clinical manifestations that remained after the end of the acute infection within 4-12 weeks.
Optimistic forecasts regarding the course of SARS-CoV-2 infection in the child population at the beginning of the pandemic quite quickly passed into the stage of uncertainty in forecasts of the course of the post-Covid period and the consequences of the transferred disease. Most children infected with COVID-19 recover, but some of them have persistent symptoms after an infection. The true prevalence of “long-term COVID” is under investigation study. Reports on the range of its manifestations are very diverse and differ in conclusions about the intensity of their impact on the quality of children’s life. Hence, there is an obvious need for long-term clinical observations with a mandatory comparison with the data of control groups appropriate age. Because this category of convalescents will need of a multidisciplinary approach in monitoring them, and therefore they will bear a significant burden on the health care system.
No conflict of interests was declared by the authors.
References
Ballering AV, van Zon SKR, Olde Hartman TC, Rosmalen JGM. (2022, Aug 6). Lifelines Corona Research Initiative. Persistence of somatic symptoms after COVID-19 in the Netherlands: an observational cohort study. Lancet. 400 (10350): 452-461. https://doi.org/10.1016/S0140-6736(22)01214-4; PMid:35934007
Behnood SA, Shafran R, Bennett SD et al. (2022, Feb). Persistent symptoms following SARS-CoV-2 infection amongst children and young people: A meta-analysis of controlled and uncontrolled studies. J Infect. 84 (2): 158-170. https://doi.org/10.1016/j.jinf.2021.11.011; PMid:34813820 PMCid:PMC8604800
Blankenburg J, Wekenborg MK, Reichert J et al. (2021, May 11). Mental health of adolescents in the pandemic: long-COVID-19 or long-pandemic syndrome? medRxiv [Preprint]. https://doi.org/10.1101/2021.05.11.21257037
Borch L, Holm M, Knudsen M, Ellermann-Eriksen S, Hagstroem S. (2022, Apr). Long COVID symptoms and duration in SARS-CoV-2 positive children - a nationwide cohort study. Eur J Pediatr. 181 (4): 1597-1607. https://doi.org/10.1007/s00431-021-04345-z; PMid:35000003 PMCid:PMC8742700
Boyarchuk O, Mudryk U, Borys Z, Volianska L. (2021). Hyperkalemia in newborn: case report. Pharmacology OnLine. 2: 73-79.
Boyarchuk O, Predyk L, Yuryk I. (2021). COVID-19 in patients with juvenile idiopathic arthritis: frequency and severity. Reumatologia. 59 (3): 197-199. https://doi.org/10.5114/reum.2021.107590; PMid:34538947 PMCid:PMC8436806
Boyarchuk OR, Nykytyuk SO, Borys ZYa, Levenets SS, Shylo OR. (2022). Hepatic vein thrombosis in a child with COVID-19: clinical case. Modern Pediatrics. Ukraine. 3 (123): 94-99. https://doi.org/10.15574/SP.2022.123.94
Buonsenso D, Di Giuda D, Sigfrid L et al. (2021, Sep). Evidence of lung perfusion defects and ongoing inflammation in an adolescent with post-acute sequelae of SARS-CoV-2 infection. Lancet Child Adolesc Health. 5 (9): 677-680. https://doi.org/10.1016/S2352-4642(21)00196-6; PMid:34339624
Buonsenso D, Munblit D, De Rose C et al. (2021, Jul). Preliminary evidence on long COVID in children. Acta Paediatr. 110 (7): 2208-2211. https://doi.org/10.1111/apa.15870; PMid:33835507 PMCid:PMC8251440
Buonsenso D, Pujol FE, Munblit D, Pata D, McFarland S, Simpson FK. (2022, May). Clinical characteristics, activity levels and mental health problems in children with long coronavirus disease: a survey of 510 children. Future Microbiol. 17(8): 577-588. https://doi.org/10.2217/fmb-2021-0285; PMid:35360923 PMCid:PMC9248023
Charfeddine S, Ibn Hadj Amor H, Jdidi J et al. (2021, Nov 30). Long COVID 19 Syndrome: Is It Related to Microcirculation and Endothelial Dysfunction? Insights From TUN-EndCOV Study. Front Cardiovasc Med. 8: 745758. https://doi.org/10.3389/fcvm.2021.745758; PMid:34917659 PMCid:PMC8670225
Cooper S, Tobar A, Konen O et al. (2022, Sep 1). Long COVID-19 Liver Manifestation in Children. J Pediatr Gastroenterol Nutr. 75 (3): 244-251. https://doi.org/10.1097/MPG.0000000000003521; PMid:35687535
Crook H, Raza S, Nowell J, Young M, Edison P. (2021). Long COVID - mechanisms, risk factors, and management. BMJ. 374: n1648. https://doi.org/10.1136/bmj.n1648; PMid:34312178
Datta SD, Talwar A, Lee JT. (2020, Dec 8). A proposed framework and timeline of the spectrum of disease due to SARS-CoV-2 infection: illness beyond acute infection and public health implications. JAMA. 324 (22): 2251-2252. https://doi.org/10.1001/jama.2020.22717; PMid:33206133
Davis HE, Assaf GS, McCorkell L et al. (2021, Aug). Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. EClinicalMedicine. 38: 101019. https://doi.org/10.1016/j.eclinm.2021.101019; PMid:34308300 PMCid:PMC8280690
Davis HE, McCorkell L, Vogel JM, Topol EJ. (2023, Mar). Long COVID: major findings, mechanisms and recommendations. Nat Rev Microbiol. 21 (3): 133-146. https://doi.org/10.1038/s41579-022-00846-2; PMid:36639608 PMCid:PMC9839201
De Almeida VM, Engel DF, Ricci MF et al. (2022, Jun 22). Gut microbiota from patients with mild COVID-19 cause alterations in mice that resemble post-COVID syndrome. Res. Sq. [Preprint]. https://doi.org/10.21203/rs.3.rs-1756189/v1
Debski M, Tsampasian V, Haney S et al. (2022). Post-COVID-19 syndrome risk factors and further use of health services in East England. PLOS Glob Public Health. 2 (11): e0001188. https://doi.org/10.1371/journal.pgph.0001188; PMid:36962824 PMCid:PMC10022108
Du W, Yu J, Wang H, Zhang X, Zhang S, Li Q, Zhang Z. (2020, Jun). Clinical characteristics of COVID-19 in children compared with adults in Shandong Province, China. Infection. 48 (3): 445-452. https://doi.org/10.1007/s15010-020-01427-2; PMid:32301099 PMCid:PMC7161094
Esposito S, Marchetti F, Lanari M et al. (2021, Apr 8). COVID-19 Management in the Pediatric Age: Consensus Document of the COVID-19 Working Group in Paediatrics of the Emilia-Romagna Region (RE-CO-Ped). Italy. Int J Environ Res Public Health. 18 (8): 3919. https://doi.org/10.3390/ijerph18083919; PMid:33917940 PMCid:PMC8068343
Fainardi V, Meoli A, Chiopris G et al. (2022, Feb 14). Long COVID in Children and Adolescents. Life (Basel). 12 (2): 285. https://doi.org/10.3390/life12020285; PMid:35207572 PMCid:PMC8876679
Fashina TA, Miller CM, Paintsil E, Niccolai LM, Brandt C, Oliveira CR. (2023, Feb 27). Computable Clinical Phenotyping of Postacute Sequelae of COVID-19 in Pediatrics Using Real-World Data. J Pediatric Infect Dis Soc. 12 (2): 113-116. https://doi.org/10.1093/jpids/piac132; PMid:36548966
Glynne P, Tahmasebi N, Gant V, Gupta R. (2022, Jan). Long COVID following mild SARS-CoV-2 infection: characteristic T cell alterations and response to antihistamines. J Investig Med. 70 (1): 61-67. https://doi.org/10.1136/jim-2021-002051; PMid:34611034 PMCid:PMC8494538
Haffke M, Freitag H, Rudolf G et al. (2022, Mar 22). Endothelial dysfunction and altered endothelial biomarkers in patients with post-COVID-19 syndrome and chronic fatigue syndrome (ME/CFS). J Transl Med. 20(1): 138. https://doi.org/10.1186/s12967-022-03346-2; PMid:35317812 PMCid:PMC8938726
Hageman JR. (2021, Jun). Long COVID-19 or Post-Acute Sequelae of SARS-CoV-2 Infection in Children, Adolescents, and Young Adults. Pediatr Ann. 50 (6): e232-e233. https://doi.org/10.3928/19382359-20210519-02
ISARIC Clinical Characterisation Group. (2021, Oct). COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study. Infection. 49 (5): 889-905. https://doi.org/10.1007/s15010-021-01599-5; PMid:34170486 PMCid:PMC8231091
Kompaniyets L, Bull-Otterson L, Boehmer TK et al. (2022, Aug 5). Post-COVID-19 Symptoms and Conditions Among Children and Adolescents - United States, March 1, 2020-January 31, 2022. MMWR Morb Mortal Wkly Rep. 71 (31): 993-999. https://doi.org/10.15585/mmwr.mm7131a3; PMid:35925799 PMCid:PMC9368731
Liu Q, Mak JWY, Su Q et al. (2022, Mar). Gut microbiota dynamics in a prospective cohort of patients with post-acute COVID-19 syndrome. Gut. 71 (3): 544-552. https://doi.org/10.1136/gutjnl-2021-325989; PMid:35082169
Logue JK, Franko NM, McCulloch DJ et al. (2021, Feb 1). Sequelae in Adults at 6 Months After COVID-19 Infection. JAMA Netw Open. 4 (2): e210830. https://doi.org/10.1001/jamanetworkopen.2021.0830; PMid:33606031 PMCid:PMC7896197
Lorman V, Rao S, Jhaveri R et al. (2022). Understanding pediatric long COVID using a tree-based scan statistic approach: An EHR-based cohort study from the RECOVER Program. medRxiv [Preprint]. 2022.12.08.22283158. doi: 10.1101/ 2022.12.08.22283158.
Malone LA, Morrow A, Chen Y et al. (2022, Oct). Multi-disciplinary collaborative consensus guidance statement on the assessment and treatment of postacute sequelae of SARS-CoV-2 infection (PASC) in children and adolescents. PMR. 14 (10): 1241-1269. https://doi.org/10.1002/pmrj.12890; PMid:36169159 PMCid:PMC9538628
Matviyenko IM, Ignatova TB. (2023). Long-term consequences of the coronavirus infection: review of scientific sources. Ukrainian Journal of Perinatology and Pediatrics. 1 (93): 118-122. https://doi.org/10.15574/PP.2023.93.118
Miller F, Nguyen DV, Navaratnam AM et al. (2022, Dec 1). Prevalence and Characteristics of Persistent Symptoms in Children During the COVID-19 Pandemic: Evidence From a Household Cohort Study in England and Wales. Pediatr Infect Dis J. 41 (12): 979-984. https://doi.org/10.1097/INF.0000000000003715; PMid:36375098 PMCid:PMC9645448
Molteni E, Sudre CH, Canas LS et al. (2021, Oct). Illness duration and symptom profile in symptomatic UK school-aged children tested for SARS-CoV-2. Lancet Child Adolesc Health. 5 (10): 708-718. https://doi.org/10.1016/S2352-4642(21)00198-X; PMid:34358472
Nasserie T, Hittle M, Goodman SN. (2021, May 3). Assessment of the Frequency and Variety of Persistent Symptoms Among Patients With COVID-19: A Systematic Review. JAMA NetwOpen. 4(5): e2111417. https://doi.org/10.1001/jamanetworkopen.2021.11417; PMid:34037731 PMCid:PMC8155823
NICE. (2020, Dec 18). COVID-19 rapid guideline: managing the long-term effects of COVID-19. London: National Institute for Health and Care Excellence (NICE). PMID: 33555768.
Nikolopoulou GB, Maltezou HC. (2022, Jan). COVID-19 in Children: Where do we Stand? Arch Med Res. 53 (1): 1-8. https://doi.org/10.1016/j.arcmed.2021.07.002; PMid:34311990 PMCid:PMC8257427
Nurek M, Rayner C, Freyer A, Taylor S, Järte L, MacDermott N, Delaney BC. (2021, Oct 28). Delphipanellists. Recommendations for the recognition, diagnosis, and management of long COVID: a Delphi study. Br J GenPract. 71 (712): e815-e825. https://doi.org/10.3399/BJGP.2021.0265; PMid:34607799 PMCid:PMC8510689
Office for National Statistics. (2021). Prevalence of ongoing symptoms following coronavirus (COVID-19) infection in the UK: 1 April 2021. Statistical bulletin [Internet]. London: ONS: 16. URL: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/prevalenceofongoingsymptomsfollowingcoronaviruscovid19infectionintheuk/1april2021.
Paalanne N, Honkila M, Mattila S, Pokka T, Renko M, Tapiainen T. (2023, Apr). Duration of clinical symptoms in children with acute respiratory infection. Acta Paediatr. 112(4): 813-819. Epub 2022 Dec 2. https://doi.org/10.1111/apa.16607; PMid:36427274
Page MJ, Moher D, Bossuyt PM et al. (2021, Mar 29). PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ. 372: n160. https://doi.org/10.1136/bmj.n160; PMid:33781993 PMCid:PMC8005925
Palacios S, Krivchenia K, Eisner M, Young B, Ramilo O, Mejias A et al. (2022, Oct). Long-term pulmonary sequelae in adolescents post-SARS-CoV-2 infection. Pediatr Pulmonol. 57 (10): 2455-2463. Epub 2022 Jul 8. https://doi.org/10.1002/ppul.26059; PMid:35775163 PMCid:PMC9349789
Peluso MJ, Deveau TM, Munter SE et al. (2022, Jul 22). Impact of Pre-Existing Chronic Viral Infection and Reactivation on the Development of Long COVID. medRxiv [Preprint]. 2022.06.21.22276660. https://doi.org/10.1101/2022.06.21.22276660
Phetsouphanh C, Darley DR, Wilson DB et al. (2022, Feb). Immunological dysfunction persists for 8 months following initial mild-to-moderate SARS-CoV-2 infection. Nat Immunol. 23 (2): 210-216. https://doi.org/10.1038/s41590-021-01113-x; PMid:35027728
Pretorius E, Venter C, Laubscher GJ et al. (2022, Aug 6). Prevalence of symptoms, comorbidities, fibrin amyloid microclots and platelet pathology in individuals with Long COVID/Post-Acute Sequelae of COVID-19 (PASC). Cardiovasc Diabetol. 21 (1): 148. https://doi.org/10.1186/s12933-022-01579-5; PMid:35933347 PMCid:PMC9356426
Principi N, Esposito S. (2021, Sep 18). Are we sure that the neurological impact of COVID 19 in childhood has not been underestimated? Ital J Pediatr. 47 (1): 191. https://doi.org/10.1186/s13052-021-01144-y; PMid:34537061 PMCid:PMC8449691
Proal AD, VanElzakker MB. (2021, Jun 23). Long COVID or Post-acute Sequelae of COVID-19 (PASC): An Overview of Biological Factors That May Contribute to Persistent Symptoms. Front Microbiol. 12: 698169. https://doi.org/10.3389/fmicb.2021.698169; PMid:34248921 PMCid:PMC8260991
Radtke T, Ulyte A, Puhan MA, Kriemler S. (2021, Jul 15). Long-term Symptoms After SARS-CoV-2 Infection in Children and Adolescents. JAMA. 326 (9): 869-871. https://doi.org/10.1001/jama.2021.11880; PMid:34264266 PMCid:PMC8283661
Rao S, Lee GM, Razzaghi H et al. (2022, Oct 1). Clinical Features and Burden of Postacute Sequelae of SARS-CoV-2 Infection in Children and Adolescents. JAMA Pediatr. 176 (10): 1000-1009. https://doi.org/10.1001/jamapediatrics.2022.2800; PMid:35994282 PMCid:PMC9396470
Roessler M, Tesch F, Batram M et al. (2022, Nov 10). Post-COVID-19-associated morbidity in children, adolescents, and adults: A matched cohort study including more than 157,000 individuals with COVID-19 in Germany. PLoS Med. 19 (11): e1004122. https://doi.org/10.1371/journal.pmed.1004122; PMid:36355754 PMCid:PMC9648706
Spudich S, Nath A. (2022, Jan 21). Nervous system consequences of COVID-19. Science. 375 (6578): 267-269. https://doi.org/10.1126/science.abm2052; PMid:35050660
Stephenson T, Pinto Pereira SM et al. (2022, Apr). Physical and mental health 3 months after SARS-CoV-2 infection (long COVID) among adolescents in England (CLoCk): a national matched cohort study. Lancet Child Adolesc Health. 6(4): 230-239. https://doi.org/10.1016/S2352-4642(22)00022-0; PMid:35143770
Stephenson T, Shafran R, Ladhani SN. (2022, Oct 1). Long COVID in children and adolescents. Curr Opin Infect Dis. 35 (5): 461-467. https://doi.org/10.1097/QCO.0000000000000854; PMid:36098262 PMCid:PMC9553244
Su Y, Yuan D, Chen DG et al. (2022, Mar 3). Multiple early factors anticipate post-acute COVID-19 sequelae. Cell. 185 (5): 881-895.e20. https://doi.org/10.1016/j.cell.2022.01.014; PMid:35216672 PMCid:PMC8786632
Subbaraman N. (2021, Mar). US health agency will invest $1 billion to investigate 'long COVID'. Nature. 591 (7850): 356. https://doi.org/10.1038/d41586-021-00586-y; PMid:33664445
Zimmermann P, Pittet LF, Curtis N. (2022, Jan 20). Long COVID in children and adolescents BMJ. 376: o143. https://doi.org/10.1136/bmj.o143
Zubchenko S, Kril I, Nadizhko O, Matsyura O, Chopyak V. (2022, Sep). Herpesvirus infections and post-COVID-19 manifestations: a pilot observational study. Rheumatol Int. 42 (9): 1523-1530. https://doi.org/10.1007/s00296-022-05146-9; PMid:35650445 PMCid:PMC9159383
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Ukrainian Journal of Perinatology and Pediatrics
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The policy of the Journal “Ukrainian Journal of Perinatology and Pediatrics” is compatible with the vast majority of funders' of open access and self-archiving policies. The journal provides immediate open access route being convinced that everyone – not only scientists - can benefit from research results, and publishes articles exclusively under open access distribution, with a Creative Commons Attribution-Noncommercial 4.0 international license(СС BY-NC).
Authors transfer the copyright to the Journal “MODERN PEDIATRICS. UKRAINE” when the manuscript is accepted for publication. Authors declare that this manuscript has not been published nor is under simultaneous consideration for publication elsewhere. After publication, the articles become freely available on-line to the public.
Readers have the right to use, distribute, and reproduce articles in any medium, provided the articles and the journal are properly cited.
The use of published materials for commercial purposes is strongly prohibited.
