Clinical features of pediatric post-acute COVID-19: a descriptive retrospective follow-up study

Smane, Liene; Roģe, Ieva; Pučuka, Zanda; Pavāre, Jana

doi:10.1186/s13052-021-01127-z

Cited by 32 publications

(40 citation statements)

References 10 publications

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“…For example, given the known effect of chronological age on acute COVID-19 severity (1), we believe this information should be present in methods of articles included in this review, although this was not always the case. On the topic of age, there is now some emerging evidence that children may experience similar long-term effects to adults after COVID-19 infection (80)(81)(82)(83). Whilst we did not specifically exclude studies on the basis of age, it is evident from Table 1 that few studies were conducted in children.…”

Section: Recommendations For the Advancement Of The Investigative Areamentioning

confidence: 99%

More Than 100 Persistent Symptoms of SARS-CoV-2 (Long COVID): A Scoping Review

2021

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Background: Persistent coronavirus disease 2019 (COVID-19) symptoms are increasingly well-reported in cohort studies and case series. Given the spread of the pandemic, number of individuals suffering from persistent symptoms, termed ‘long COVID', are significant. However, type and prevalence of symptoms are not well reported using systematic literature reviews.Objectives: In this scoping review of the literature, we aggregated type and prevalence of symptoms in people with long COVID.Eligibility Criteria: Original investigations concerning the name and prevalence of symptoms were considered in participants ≥4-weeks post-infection.Sources of Evidence: Four electronic databases [Medline, Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL)] were searched.Methods: A scoping review was conducted using the Arksey and O'Malley framework. Review selection and characterisation was performed by three independent reviewers using pretested forms.Results: Authors reviewed 2,711 titles and abstracts for inclusion with 152 selected for full-text review. 102 articles were subsequently removed as this did not meet inclusion criteria. Thus, fifty studies were analysed, 34 of which were described as cohort studies or prospective cohort studies, 14 were described as cross-sectional studies, one was described as a case control study, and one was described as a retrospective observational study. In total, >100 symptoms were identified and there was considerable heterogeneity in symptom prevalence and setting of study. Ten studies reported cardiovascular symptoms, four examined pulmonary symptoms, 25 reported respiratory symptoms, 24 reported pain-related symptoms, 21 reported fatigue, 16 reported general infection symptoms, 10 reported symptoms of psychological disorders, nine reported cognitive impairment, 31 reported a sensory impairment, seven reported a dermatological complaint, 11 reported a functional impairment, and 18 reported a symptom which did not fit into any of the above categories.Conclusion: Most studies report symptoms analogous to those apparent in acute COVID-19 infection (i.e., sensory impairment and respiratory symptoms). Yet, our data suggest a larger spectrum of symptoms, evidenced by >100 reported symptoms. Symptom prevalence varied significantly and was not explained by data collection approaches, study design or other methodological approaches, and may be related to unknown cohort-specific factors.

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Section: Recommendations For the Advancement Of The Investigative Areamentioning

confidence: 99%

More Than 100 Persistent Symptoms of SARS-CoV-2 (Long COVID): A Scoping Review

2021

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“…Similar to physical fatigue and PEM, cognitive difficulties or “brain fog” can also be exacerbated by mental exertion, such as schoolwork or studying for examinations. Headaches are also commonly reported both in the acute and post-acute phase of COVID in children [ 10 , 11 •, 17 •, 19 – 22 , 23 ••, 26 ]. Additional studies are needed to characterize the nature and specific types of headaches experienced, as well as the best treatment options.…”

Section: Long Covid Symptomsmentioning

confidence: 99%

“… Changes in taste and smell including anosmia, ageusia, parosmia, and dysgeusia are reported with acute SARS-CoV-2 infection in children [ 20 ] and adults [ 33 ]. Some children with long COVID also experience persistent alterations to taste and smell, impacting appetite and potentially leading to weight loss [ 10 , 21 , 23 ••, 26 , 34 ]. These sensory alterations tend to cluster closer to the earlier phase of the illness.…”

Section: Long Covid Symptomsmentioning

confidence: 99%

“…Headaches are also commonly reported both in the acute and post-acute phase of COVID in children [ 10 , 11 •, 17 •, 19 – 22 , 23 ••, 26 ]. Additional studies are needed to characterize the nature and specific types of headaches experienced, as well as the best treatment options.…”

Section: Long Covid Symptomsmentioning

confidence: 99%

“…Although lightheadedness/dizziness has been ascertained in some long COVID studies [ 10 , 26 ], OI is not ascertained in a consistent manner in the majority of the pediatric long COVID literature. It is important to ask about specific conditions that can provoke orthostatic symptoms, and not simply to ask about lightheadedness, as adolescent patients may not be aware that what they experience is abnormal.…”

Section: Managementmentioning

confidence: 99%

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Long-Term COVID 19 Sequelae in Adolescents: the Overlap with Orthostatic Intolerance and ME/CFS

et al. 2022

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Purpose of Review To discuss emerging understandings of adolescent long COVID or post-COVID-19 conditions, including proposed clinical definitions, common symptoms, epidemiology, overlaps with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and orthostatic intolerance, and preliminary guidance on management. Recent Findings The recent World Health Organization clinical case definition of post-COVID-19 condition requires a history of probable or confirmed SARS-CoV-2 infection, with symptoms starting within 3 months of the onset of COVID-19. Symptoms must last for at least 2 months and cannot be explained by an alternative diagnosis. Common symptoms of the post-COVID-19 condition include, but are not limited to, fatigue, shortness of breath, and cognitive dysfunction. These symptoms generally have an impact on everyday functioning. The incidence of prolonged symptoms following SARS-CoV-2 infection has proven challenging to define, but it is now clear that those with relatively mild initial infections, without severe initial respiratory disease or end-organ injury, can still develop chronic impairments, with symptoms that overlap with conditions like ME/CFS (profound fatigue, unrefreshing sleep, post-exertional malaise, cognitive dysfunction, and orthostatic intolerance). Summary We do not yet have a clear understanding of the mechanisms by which individuals develop post-COVID-19 conditions. There may be several distinct types of long COVID that require different treatments. At this point, there is no single pharmacologic agent to effectively treat all symptoms. Because some presentations of post-COVID-19 conditions mimic disorders such as ME/CFS, treatment guidelines for this and related conditions can be helpful for managing post-COVID-19 symptoms. Supplementary Information The online version contains supplementary material available at 10.1007/s40124-022-00261-4.

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Association of SARS-CoV-2 Seropositivity and Symptomatic Reinfection in Children in Nicaragua

Kubale

Balmaseda²,

Frutos

et al. 2022

JAMA Netw Open

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IMPORTANCEThe impact of the SARS-CoV-2 pandemic on children remains unclear. Better understanding of the burden of COVID-19 among children and their risk of reinfection is crucial, as they will be among the last groups vaccinated. OBJECTIVETo characterize the burden of COVID-19 and assess how risk of symptomatic reinfection may vary by age among children. DESIGN, SETTING, AND PARTICIPANTS In this prospective, community-based pediatric cohort study conducted from March 1, 2020, to October 15, 2021, 1964 nonimmunocompromised children aged 0 to 14 years were enrolled by random selection from the Nicaraguan Pediatric Influenza Cohort, a community-based cohort in District 2 of Managua, Nicaragua. Additional newborn infants aged 4 weeks or younger were randomly selected and enrolled monthly via home visits. EXPOSURES Prior COVID-19 infection as confirmed by positive anti-SARS-CoV-2 antibodies (receptor binding domain and spike protein) or real-time reverse transcriptase-polymerase chain reaction (RT-PCR)-confirmed COVID-19 infection at least 60 days before current COVID-19 infection. MAIN OUTCOMES AND MEASURES Symptomatic COVID-19 cases confirmed by real-time RT-PCR and hospitalization within 28 days of symptom onset of a confirmed COVID-19 case. RESULTS This cohort study assessed 1964 children (mean [SD] age, 6.9 [4.4] years; 985 [50.2%]male). Of 1824 children who were tested, 908 (49.8%; 95% CI, 47.5%-52.1%) were seropositive during the study. There were also 207 PCR-confirmed COVID-19 cases, 12 (5.8%) of which were severe enough to require hospitalization. Incidence of COVID-19 was highest among children younger than 2 years (16.1 cases per 100 person-years; 95% CI, 12.5-20.5 cases per 100 person-years), which was approximately 3 times the incidence rate in any other child age group assessed. In addition, 41 symptomatic SARS-CoV-2 episodes (19.8%; 95% CI, 14.4%-25.2%) were reinfections. CONCLUSIONS AND RELEVANCEIn this prospective, community-based pediatric cohort study, rates of symptomatic and severe COVID-19 were highest among the youngest participants, with rates stabilizing at approximately 5 years of age. In addition, symptomatic reinfections represented a large proportion of symptomatic COVID-19 cases.

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Clinical features of pediatric post-acute COVID-19: a descriptive retrospective follow-up study

Cited by 32 publications

References 10 publications

More Than 100 Persistent Symptoms of SARS-CoV-2 (Long COVID): A Scoping Review

More Than 100 Persistent Symptoms of SARS-CoV-2 (Long COVID): A Scoping Review

Long-Term COVID 19 Sequelae in Adolescents: the Overlap with Orthostatic Intolerance and ME/CFS

Association of SARS-CoV-2 Seropositivity and Symptomatic Reinfection in Children in Nicaragua

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