Prolonged COVID-19 in Children and Adolescents: Science Reviews Facts and Doubts

In the kidsAnd The risk of severe coronavirus disease (COVID) is low. but nevertheless, Risk of persistent symptoms after SARS-CoV-2 infection is uncertain in this age group, and long-term characteristics of COVID are poorly characterized.According to a series of specialists from the Faculty of Science and Medicine, University of Freiburg, who encountered a review published in the Pediatric Infections Disease Journal.

We reviewed – notes author Petra Zimmermann – 14 studies to date report persistent symptoms after COVID in children and adolescents. Almost all studies have important limitations, including lack of clear case definition, variable follow-up times, inclusion of children without confirmed SARS-CoV-2 infection, dependence on self-reported or parental-reported symptoms without clinical evaluation, lack of response, other biases, and absence of control group.

subordinate 5 studies which included uninfected children and adolescents with SARS-CoV-2 infection as controls, 2 did not find that persistent symptoms were more prevalent in children and adolescents with evidence of SARS-CoV-2 infection. This highlights the difficulty in distinguishing symptoms associated with long-standing SARS-CoV-2 infection from those associated with a pandemic.

Children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) They are usually asymptomatic or have mild coronavirus disease (COVID) with lower rates of hospitalization (2%) or death (0.03%). 1-9

Reported hospitalization rates can overestimate severity, as many studies do not determine whether children are hospitalized for COVID or because of COVID. The burden of disease is greater in adolescents, who become infected and hospitalized more often than in younger children.

Measure the real danger

Although the risks posed by acute coronavirus to children are low in the short term, there are two long-term consequences of infection that are of concern. The first is Pediatric Multisystem Inflammatory Syndrome Temporarily Associated with SARS-CoV-2 (SIMP-AT) or Pediatric Multisystem Inflammatory Syndrome (SIM-N)And Immune-mediated disease occurs in a small percentage (0.1%) of children 2 to 6 weeks after infection with SARS-CoV-2.11–20

The second is the prolonged COVID, also called Post-COVID syndrome or postoperative sequelae Dell SARS-CoV-2 (SPAC). These terms describe persistent symptoms after COVID, described primarily in adults, that affect the sensory, nervous, respiratory, and heart systems, as well as mental health.

To date, there is no clear definition of this syndrome and there is no agreement on the duration of symptoms that justify the diagnosis, which ranges from 4 to 12 weeks after acute infection. More than 200 shows attributed to COVID for prolonged periods, Many of them are nonspecific and widely prevalent in the general population, Such as fatigue, sleep disturbances, difficulty concentrating, loss of appetite, and muscle or joint pain.

And therefore, Accurate determination of the risk of prolonged infection with COVID is critical to the debate about the risks and benefits of vaccination in this age group.

“Evidence for prolonged COVID in children and adolescents is limited – says Zimmermann – and All studies performed to date have significant limitations or do not show a difference between children who have been infected with SARS-CoV-2 and those who have not. The lack of a control group in most studies makes it difficult to separate symptoms attributable to COVID for prolonged periods from those associated with the epidemic.”

Given the large number of children and adolescents infected with SARS-CoV-2, the impact of a reduced prevalence of persistent symptoms would be significant. but nevertheless, In most studies, symptoms did not last more than 12 weeks. Consistent with this, one study that found a difference between cases and controls in persistent symptoms (at 4 weeks after COVID) reported that by 8 weeks, most symptoms had resolved, suggesting that prolonged COVID may be less worrying in children and adolescents than in adults.

Interestingly, Zimmerman says, in one study, more than half of the teens in the uninfected control group reported symptoms at 12 weeks even though only 8% reported symptoms at the time of SARS-CoV testing. -two “.

“The relative paucity of studies on prolonged COVID and the limitations of those reported to date mean that the true incidence of this syndrome in children and adolescents remains uncertain,” According to the report. The effect of age, severity and duration of illness, virus strain, and other factors on the risk of prolonged COVID infection in this age group also remains to be determined.

In light of the importance of prolonged COVID in the risk-benefit equation for policy decisions regarding COVID vaccines for children and adolescents, More studies are urgently needed to accurately determine the risks of prolonged COVID-19. These should include strict control groups, children with other infections, and those admitted to hospital or intensive care for other reasons.

“Longitudinal cohort studies should include regular testing for SARS-CoV-2 to confirm infection, accurate identification of symptoms, and consistent and sufficiently long follow-up times. To account for intermittent symptoms and to record pre-existing medical conditions. More research is also needed to determine the immune mechanisms underlying prolonged COVID,” Zimmermann cites in the conclusion.

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