Physicians and other healthcare providers should be aware that the symptoms of long COVID in children and teenagers can evolve over time, according to a study in The Lancet Regional Health – Europe.
The key to getting a handle on just what healthcare professionals confront in long COVID, according to the researchers who tracked children and young people in the U.K., is to measure data from the same patients over an extended period of time.
“If we had simply looked at cross-sectional prevalence of adverse symptoms at testing, 6-months and 12-months, as is commonly done in other studies, it would have appeared as if the prevalence of specific common post-COVID-symptoms stayed largely stable, or increased, over time,” the study said. “However, we show that this is not the case. The new-onset adverse symptoms arising 6- or 12-months after initial viral infection should not exclusively be viewed as new long COVID symptoms as a consequence of the initial SARS-COV-2 infection.”
Researchers with various institutions in the U.K. asked children 11 to 17 years old about their health six months and a year after taking a PCR test between September 2020 and March 2021. The dates rule out that the effects were caused by the delta or omicron variants. Data were taken from 5,086 children, 2,909 of whom tested positive for COVID-19 and 2,277 who tested negative.
The study found that adverse symptoms should be evaluated with the health and well-being of the general child and youth population in mind.
“Recent reviews of long COVID in [children] indicate that higher quality studies are needed and that a consistent definition of long COVID is required; our research goes one step further and indicates that studies with repeat measurement on the same [children are needed to track individual trajectories and not simply report repeat cross-sectional prevalence’s of symptoms over time,” the study found.
The patients were asked to note what afflicted them out of a list of 21 symptoms. The list included shortness of breath and tiredness. The researchers were also evaluating quality of life, mental health, well-being and fatigue.
Health problems were more prominent in children and young people who’d tested positive for COVID-19 than in those who’d tested negative, and this was the case at the six-month and one-year marks as well. Among those who’d tested positive, 10.9% complained about fatigue at all three testing points while only 1.2% of those who tested negative did.
“For two symptoms, (shortness of breath and tiredness) as well as measures of poor quality of life (in particular having pain and problems doing usual activities), poor well-being and fatigue, the overall prevalence in test-positives increased over time. Importantly, our within-individual exploration demonstrates that the prevalence actually declined in those who first described these adverse symptoms at either baseline or 6 months," according to the study.
A majority of study participants who’d tested positive for COVID-19 and complained about a particular symptom at initial testing were free of that problem at the six-month and one-year marks, the study states.
“Additionally, most [children] who first developed a particular symptom 6 months after their positive (or negative) PCR-test did not report that symptom at 12-months,” the study states. “We also found in the sub-sample with data collected at 3-, 6- and 12-months post-test, broadly similar patterns and results.”