Comparison of Persistent Symptoms Following SARS-CoV-2 Infection by Antibody Status in Nonhospitalized Children and Adolescents

Abstract

Background: The prevalence of long-term symptoms of coronavirus disease 2019 (COVID-19) in nonhospitalized pediatric populations in the United States is not well described. The objective of this analysis was to examine the presence of persistent COVID symptoms in children by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody status. Methods: Data were collected between October 2020 and May 2022 from the Texas Coronavirus Antibody REsponse Survey, a statewide prospective population-based survey among 5-90 years old. Serostatus was assessed by the Roche Elecsys Anti-SARS-CoV-2 Immunoassay for detection of antibodies to the SARS-CoV-2 nucleocapsid protein. Self-reported antigen/polymerase chain reaction COVID-19 test results and persistent COVID symptom status/type/duration were collected simultaneously. Risk ratios for persistent COVID symptoms were calculated versus adults and by age group, antibody status, symptom presence/severity, variant, body mass index and vaccine status. Results: A total of 82 (4.5% of the total sample [n = 1813], 8.0% pre-Delta, 3.4% Delta and beyond) participants reported persistent COVID symptoms (n = 27 [1.5%] 4–12 weeks, n = 58 [3.3%] >12 weeks). Compared with adults, all pediatric age groups had a lower risk for persistent COVID symptoms regardless of length of symptoms reported. Additional increased risk for persistent COVID symptoms >12 weeks included severe symptoms with initial infection, not being vaccinated and having unhealthy weight (body mass index ≥85th percentile for age and sex). Conclusions: These findings highlight the existence of nonhospitalized youth who may also experience persistent COVID symptoms. Children and adolescents are less likely to experience persistent COVID symptoms than adults and more likely to be symptomatic, experience severe symptoms and have unhealthy weight compared with children/adolescents without persistent COVID symptoms.

Risk factors for post-COVID-19 condition (Long Covid) in children: a prospective cohort study

“…27 A couple of adult studies have similarly identified a lower risk of developing PCC in adults infected with the Omicron variant compared to the delta variant. 28,29 In contrast, a prospective cohort study in Norway, found a similar risk of persistent post-Covid symptoms in adults infected with the delta as those infected with the omicron variant. 30 On the opposite, S. Morikota et al, 31 in Japan, did not find significant differences in the prevalence of post-COVID-19 condition between the Omicron and pre-omicron groups.…”

Risk Factors for Persistent Anosmia and Dysgeusia in Children with SARS-CoV-2 Infection: A Retrospective Study

“…There is only one other study that has addressed this issue in children. Messiah et al showed that patients who did not report vaccination information were six times more likely to develop PCC than those who were vaccinated (RR: 5.76; 95% CI: 1.18–28.06) [ 39 ]. Studies in adults have shown a stronger protective effect of vaccinations, suggesting that vaccination before SARS-CoV-2 infection could reduce, but not eliminate, the risk of PCC.…”

Long-Term Effect of COVID-19 on Lung Imaging and Function, Cardiorespiratory Symptoms, Fatigue, Exercise Capacity, and Functional Capacity in Children and Adolescents: A Systematic Review and Meta-Analysis

“…Female sex, older age, multiple symptoms during acute COVID-19 infection, longer hospital stays, and respiratory distress following acute COVID-19 were risk factors related to long COVID in children and adolescents [ 18 , 28 ]. Experiencing severe symptoms during the acute phase of infection, being unvaccinated for COVID-19, and a high body mass index (BMI) that is equal to or greater than the 85th percentile for age and sex, can also increase the risk of long-COVID in this group of patients [ 49 ]. Maddux et al [ 50 ] reported that patients under 21 years of age were more likely to experience long COVID symptoms at 2 to 4 months follow-up if they had pre-existing respiratory conditions or co-morbidities including MIS-C.…”