Prevalence of long-COVID in children and adolescents

Recent studies published in Scientific Reports The journal assessed the incidence of long coronavirus disease (COVID) between adolescents and children.

Background

The acute phase of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been the main focus of healthcare up to this point. Nevertheless, many people develop COVID 2019 (COVID-19) symptoms that incapacitate after a few months and require additional medical care and follow-up.

Severe SARS-CoV-2 infections are less common in children than in adults. Nevertheless, COVID-19 in children has at least two long-term effects. Long-term COVID and multisystem inflammatory syndrome (MIS-C).

Most of the long-term COVID studies published so far have focused primarily on the adult population, with little data on the pediatric population. Moreover, it is not yet known how often and how often children and adolescents may experience it for a long time.COVID symptoms..

Overall, establishing awareness among parents, researchers and physicians about the post-SARS-CoV-2 infection and providing a deep understanding of the sequelae of the medical system to provide personalized care and treatment for adolescents and children. Is required.

About research

In current systematic reviews and meta-analyses, researchers aimed to determine the prevalence of long-term COVID in adolescents and children and to delineate the full range of symptoms after acute SARS-CoV-2 infection.

The team used Embase and PubMed to publish before February 10, 2022, with at least 30 patients aged 0 to 18 and a long-COVID from the National Institute for Healthcare Excellence (NICE). I found an observational study that complies with the standard. NICE classifies long-COVID as a symptom of SARS-CoV-2 infection. These symptoms are continuous, that is, last for 4 to 12 weeks, and after COVID-19, that is, for more than 12 weeks.

A random effects meta-analysis was performed to calculate the prevalence pooled in the 95% confidence interval (CI) using MetaXL software. In addition, I2 statistics were used to assess non-uniformity. The authors followed the priority reporting items of the systematic reviewers and meta-analysis (PRISMA) reporting guidelines for this study.

result

In summary, the study results showed that the literature search provided 8373 publications, of which 21 studies met the requirements for inclusion, including a total of 80,071 adolescents and children. The authors found a long-term COVID prevalence of 25.24% in adolescents and children. In addition, the five most common clinical symptoms of long-COVID in the current population are headache (7.84%), sleep disorders (8.42%), respiratory symptoms (7.62%), and fatigue (9.66%). , And mood symptoms (16.50%). ).

Only 13 symptoms could be studied using a meta-analysis of odds ratios (OR) consistent with the case and control. Compared to controls, children with SARS-CoV-2 infection were more likely to develop persistent ageusia / anosmia, dyspnea, and fever.

Interestingly, some long COVID symptoms reported in current meta-analysis, such as dysphagia, orthostatic intolerance, malaise, mood disorders, sleep disorders, diminished attention, memory loss, and disorientation. Was frequently seen in autonomic dysfunction. Dysfunction of the parasympathetic and / or autonomic nervous system of the sympathetic nervous system is known as autonomic dysfunction. Nevertheless, whether autonomic imbalance was directly associated with SARS-CoV-2 infection, how it interacts with other viruses, or immunity such as cytokines, which are well-known inflammatory response mediators. The intervening mechanism remains unknown.

The team mentioned protective factors that reduce the severity and duration of SARS-CoV-2 infections and possibly increase the COVID of children. It consists of several comorbidities, a strong innate immune response, and a decrease in angiotensin converting enzyme 2 (ACE2) receptors. Expression, and active thymic function, leads to reduced T cell depletion and increased presence.

Notably, the shortcomings of the studies analyzed include lack of recall, standardized definitions, misclassification, selection, untraceable, unresponsiveness, and a high degree of non-uniformity.

Conclusion

Overall, the current meta-analysis provides all relevant control cohorts and factors to understand the need to regularly monitor the effects of long-COVID in children and adolescents, and the actual long-term burden of children. It provides additional evidence of the need to be included in the study. COVID.

Long COVIDs pose significant public health risks. Moreover, there are no recommendations for the diagnosis or treatment of long-term COVID.

Researchers emphasized that protective intervention is important to prevent long-term COVID in children. Understanding the etiology and symptoms of long-COVID is needed to support clinical management strategies, set rehabilitation initiatives, develop guidelines, and conduct therapeutic studies.

The team stated that future studies need to stratify participants by age, given that the severity and likelihood of duration of COVID-19 increases with age. In addition, self-reported symptom assessments can be significantly distorted with age, as younger children may not be able to adequately explain their emotional and functional status after COVID. Therefore, further research focused on different age groups is needed.