#15,767
While most people appear to recover completely from COVID-19, for a significant percentage of patients, the end of the infection doesn't necessarily signal the end of their illness. Some are left with various degrees of lung, kidney, heart, or liver damage while others are left with an array of neurological manifestations (see CDC Late Sequelae of COVID-19).
A few (of many) studies we've looked at include:
Frequent Neurologic Manifestations & Encephalopathy‐Associated Morbidity in Covid‐19 patients
J. Neurology: COVID-19 As A Potential Risk Factor For Chronic Neurological. Disorders
JASN: Acute Kidney Injury In Hospitalized Patients With COVID-19
JAMA: Two Studies Linking SARS-CoV-2 Infection To Cardiac Injury
Some COVID patients continue to report ongoing, and often debilitating symptoms, months after they should have recovered from their infection, which are not as easily classified; fatigue, mental `fog', shortness of breath, joint pain, etc. which have been dubbed as `Long COVID'.
Last October, in UK NIHR: Living With COVID-19 (Long COVID), we looked at the potential for many patients to develop what appears to be a Post Viral Fatigue syndrome - similar to ME/CFS - that could cause permanent disability.
The CDC describes these cases in:
Updated Nov. 10, 2020CDC is actively working to learn more about the whole range of short- and long-term health effects associated with COVID-19. As the pandemic unfolds, we are learning that many organs besides the lungs are affected by COVID-19 and there are many ways the infection can affect someone’s health.While most persons with COVID-19 recover and return to normal health, some patients can have symptoms that can last for weeks or even months after recovery from acute illness. Even people who are not hospitalized and who have mild illness can experience persistent or late symptoms.
Multi-year studies are underway to further investigate. CDC continues to work to identify how common these symptoms are, who is most likely to get them, and whether these symptoms eventually resolve.
Last week (Thurs Jan 28th) the CDC held a COCA (Clinician Outreach & Communication Activity) Call on clinician's experiences with `Long COVID' cases, which is now archived for viewing.
Up until now, most of the data we've seen on `Long COVID' has involved adults, who are generally far more affected by COVID-19 than are adolescents and children. But as we've seen, not all young patients come away unscathed (see MMWR: COVID-19–Associated Multisystem Inflammatory Syndrome in Children — U.S., March–July 2020)
Today we've a preprint study out of Italy, published last week, that looks at the prevalence of `Long COVID' among a relatively small (n=129) cohort of children and adolescents diagnosed with COVID.
This study is limited by its small size and single-center design - and so it may not be fully representative of the larger picture - but it does provide us with some preliminary data on what has been a little studied cohort of `recovered' COVID cases.
Follow the link to read the report in its entirety.
Preliminary Evidence on Long COVID in children
Danilo Buonsenso, Daniel Munblit, Cristina De Rose, Dario Sinatti, Antonia Ricchiuto, Angelo Carfi, Piero Valentini
doi: https://doi.org/10.1101/2021.01.23.21250375
This article is a preprint and has not been peer-reviewed [what does this mean?].
Preview PDF
Abstract
There is increasing evidence that adult patients diagnosed with acute COVID-19 suffer from Long COVID initially described in Italy.
To date, data on Long COVID in children are lacking.
We assessed persistent symptoms in pediatric patients previously diagnosed with COVID-19. More than a half reported at least one persisting symptom even after 120 days since COVID-19, with 42.6% being impaired by these symptoms during daily activities. Symptoms like fatigue, muscle and joint pain, headache, insomnia, respiratory problems and palpitations were particularly frequent, as also described in adults.
The evidence that COVID-19 can have long-term impact children as well, including those with asymptomatic/paucisymptomatic COVID-19, highlight the need for pediatricians, mental health experts and policy makers of implementing measures to reduce impact of the pandemic on child’s health.
Background
There is increasing evidence that adult patients diagnosed with acute COVID-19 suffer from Long COVID initially described in Italy (1). A recent large cohort of 1733 patients from Wuhan found persistent symptoms in 76% of patients 6 months after initial diagnosis (2). To date, data on Long COVID in children are lacking. We assessed persistent symptoms in pediatric patients previously diagnosed with COVID-19.
Methods
This cross-sectional study included all children ≤18 year-old diagnosed with microbiologically-confirmed COVID-19 in Fondazione Policlinico Univeersitario A. Gemelli IRCCS (Rome, Italy). Patients > 18 years-old or with severe disability were excluded. Caregivers were interviewed about their child’s health using a questionnaire (supplementary material) developed by the Long Covid ISARIC study group (3), for evaluation of persisting symptoms.
Participants were interviewed by two pediatricians, either online or in the outpatient department, from September 1st to January 1st. Participants were categorized into groups according to symptoms status during the acute phase (symptomatic/asymptomatic), need for hospitalization and time from COVID-19 diagnosis to follow-up evaluation (<60, 60-120, > 120 days). Numerical variables were compared using t-test or ANOVA, and categorical variables with χ2 or Fisher’s exact test where appropriate. All analyses were performed using R version 4.0.3 (R Foundation). This study was approved by the Institutional Ethics Committee and all participants consented to participate.
Results
129 children diagnosed with COVID-19 between March and November, 2020 were enrolled (mean age of 11 ± 4.4 years, 62 (48.1%) female). Subsequently, three developed Multisystem Inflammatory Syndrome (2.3%) and two myocarditis (1.6%). Patients were assessed on average 162.5 ± 113.7 days after COVID-19 microbiological diagnosis. 41.8% completely recovered, 35.7% had 1 or 2 symptoms and 22.5% had 3 or more. 52.7% had at least one symptom 120 days or more after diagnosis (Table 1).
Table 2 provides details about persistence of symptoms according to severity and length of followup. Insomnia (18.6%), respiratory symptoms (including pain and chest tightness) (14.7%), nasal congestion (12.4%), fatigue (10.8%), muscle (10.1%) and joint pain (6.9%), and concentration difficulties (10.1), were the most frequently reported symptoms. Although they were more common in symptomatic or hospitalized children, they were also described in those individuals who were asymptomatic during acute phase. 29 out of the 68 (42.6%) children assessed ≥120 days from diagnosis were still distressed by these symptoms.
