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The existence of long COVID-19 in children and adolescents has been the subject of debate among scientists. Two published studies have focused on the long COVID-19 signs and symptoms of these patients.
Published by an interdisciplinary group in Mexico Scientific Reports, First study Systematic review and meta-analysis. It identified mood symptoms as the most common clinical symptoms of long COVID-19 in children and adolescents. These symptoms include sadness, tension, anger, depressionAnd anxiety (16.50%); fatigue (9.66%); and sleep disorders (8.42%).
Second study, LongCOVIDKidsDK was held in Denmark. We compared 11,000 children under the age of 14 who tested positive for COVID-19 with 33,000 children who had no history of COVID-19.The study was published in Lancet child and adolescent health.
The definition is changing
In their meta-analysis, researchers estimated long COVID-19 prevalence and counted signs and symptoms, as defined by the National Institute for Health and Care Technology. Long COVID-19 was defined as the presence of one or more symptoms more than 4 weeks after SARS-CoV-2 infection. Use “COVID-19”, “COVID”, “SARSCOV-2”, “Coronavirus”, “long COVID”, “postCOVID”, “PASC”, “long-haulers”, “longed” as search terms. Did. “Post-acute”, “persistent”, “recovery”, “sequelae”, and “post-viral infection”.
Of the 8373 citations returned by the search as of February 10, 2022, 21 prospective studies (two of which were preprint servers) met the author’s selection criteria. These studies included a total of 80,071 children and adolescents under the age of 18.
In a meta-analysis, the prevalence of long COVID-19 in children and adolescents was 25.24% (95% CI: 18.17-33.02; I2: 99.61%), regardless of whether the case was asymptomatic, mild, or moderate. Was reported to be. , Severe, or severe. The prevalence of hospitalized patients was 29.19% (95% CI: 17.83-41.98; I2: 80.84%).
According to lead author Sandra Lopez Leon, MD, associate professor of pharmacological epidemiology at Rutgers University in New Brunswick, NJ, these numbers are impressive, but not the focus of research. “It’s important not to focus on that 25%,” she said. Medscape Medical News.. “This is the disease we are learning. We are still in a period of changing definition and will be given different numbers depending on when it is measured. The message we want to convey is that. It is a long COVID. -19 is present, which is occurring in children and adolescents, and patients need this awareness, and also to show that it can affect the whole body. “
This study showed that children and adolescents with SARS-CoV-2 infection were at increased risk of subsequent long dyspnea, anosmia / ageusia, or fever compared to controls.
In total, the included studies identified over 40 long-term clinical symptoms associated with COVID-19 in the pediatric population.
The most common symptoms in children aged 0 to 3 years were mood swings, skin rashes, and abdominal pain. For ages 4-11, the most common symptoms were mood swings, difficulty remembering and concentrating, and skin rashes. At the age of 12-14, fatigue, mood swings, and difficulty remembering and concentrating. These data are based on the parent’s answer.
A list of signs and symptoms headacheRespiratory symptoms, cognitive symptoms (loss of concentration, difficulty learning, confusion, memory loss, etc.), loss of appetite, and olfactory dysfunction (hyposmia, anosmia, hyperosmia, parosmia, and hallucinogenic odor) ).
In the study, the prevalence of the following symptoms was less than 5%: HyperhidrosisChest pain, dizziness, cough, muscle / joint pain, weight change, dysgeusia, tinnitus (tinnitus, Ear painDizziness), ophthalmic symptoms (conjunctivitis, Dry eyeBlurred vision, photophobia, pain), skin symptoms (dry skin, itchy skin, rash, HivesHair loss), urinary symptoms, abdominal pain, sore throat, chest tightness, heart rate fluctuations, palpitation, constipationHoarseness, fever, diarrheaVomiting / nausea, menstrual changes, neurological abnormalities, speech disorders, and Dysphagia..
The authors show that the frequency and severity of these symptoms can vary from patient to patient.
“A meta-analysis is important for 21 studies selected from more than 8,000 articles, among which a large number of children are brought together to study the most common symptoms of long COVID-19,” Gabriela said. Ensinck, MD, the Infectious Diseases Department of Victor J. Villera Children’s Hospital in Rosario, Argentina, told Medscape. Ensinck did not participate in the study. “The important thing here is that long COVID-19 is present in pediatrics, and it is an extension of the signs and symptoms over time, there is no single definition.”
“This is a snapshot of all the symptoms that may remain after COVID-19,” explained Lopez-Leon. “The meta-analysis tries to find out if there is a link between being infected with COVID-19 and the symptoms, but never talking about the causal relationship.”
The prevalence of symptoms is highly dependent on the time since the onset of acute COVID-19. Most symptoms improve over time. In the studies included in the meta-analysis, the follow-up period varied between 1 and 13 months. It is important for the author to understand what symptoms are associated with each period after the onset of the infection.
Survey of parents in Denmark
The Danish study LongCOVIDKidsDK enrolled children and adolescents aged 0-14 years who were diagnosed with COVID-19 and experienced symptoms lasting at least 2 months, according to the World Health Organization standards for long COVID-19.
Between July 20, 2021 and September 15, 2021, questionnaires were sent to 38,152 case patients and 147,212 controls. Of this group, 10,997 (28.8%) case patients and 33,016 (22.4%) controls responded to the survey.
Children diagnosed with SARS-CoV-2 infection were more likely to experience long-term symptoms than children who had never been diagnosed. About one-third of children who test positive for SARS-CoV-2 experienced symptoms that were not present before infection. Among children who experienced long-term symptoms, 40% of children diagnosed with COVID-19, 27% of controls aged 0 to 3 years, 38% of case patients, and 34% of controls aged 4 to 11 years. , And 46% were included. 41% of patients and controls aged 12-14 years.
Interestingly, those diagnosed with COVID-19 reported less psychological and social problems than the control group. Among the oldest (ages 12-14), those who tested positive for SARS-CoV-2 had higher quality of life scores and lower anxiety scores.
Detailed information required
Given the variety of symptoms in meta-analysis and LongCOVIDKidsDK studies, an interdisciplinary approach is essential. Lopez-Leon suggests that there is a need to raise awareness among parents, clinicians, researchers, and the healthcare system about the conditions that can occur after COVID-19. Clinicians need a better understanding of sequelae in order to provide targeted care and treatment. The authors of a Danish study recommend establishing a long COVID-19 clinic with multi-specialty care.
Dr. Maren J. Heilskov Rytter, an associate professor of clinical medicine at the University of Copenhagen, Denmark, wrote: editorial About Danish research. Until it became clear whether SARS-CoV-2 actually caused persistent symptoms, she said, “It is excessive and premature for COVID-19 to establish a specific interdisciplinary clinic for long children. It seems like. “
Rytter emphasized the difficulty of interpreting LongCOVIDKidsDK data due to recall bias, failure to rule out causes of other symptoms in the analyzed cases, and the number of control symptoms. In addition, the data analyzed in Denmark have limited clinical relevance, she said. Given that there are more mild symptoms and, paradoxically, a higher quality of life.
She said, “In the majority of children who show non-specific symptoms after COVID-19, the presented symptoms are likely caused by something other than COVID-19 and are associated with COVID-19. If so, you are likely to go. ” It will move away over time. “
Ensink, co-author of the Argentine Ministry of Health’s guide on long-term COVID-19 monitoring in children and adolescents and on behalf of the Infectious Diseases Commission of the Argentine Pediatric Society, highlighted another aspect of the problem. “The thing to take into account in these data is to see how much the confinement contributed. Children are the ones who suffered the most during the school closure period. They couldn’t meet their peers. , There were sick relatives, they felt afraid … this all has to be taken into account. “
There is still no consensus on how to define and diagnose the long adult COVID-19, a more closely studied population. Part of the problem is that long COVID-19 is associated with more than 200 symptoms. These symptoms can range from inconvenient to debilitating, lasting months to years, and in some cases can recur after a clear recovery.Therefore, the basic question about still has different answers Frequency of syndrome Vaccination, reinfection, and its effect on the latest variants of SARS-CoV-2.
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This article has been translated from Medscape Spanish version..
