Long COVID symptoms and duration in SARS-CoV-2 positive children — a nationwide cohort study

Borch, Luise; Holm, Mette; Knudsen, Maria; Ellermann-Eriksen, Svend; Hagstrøm, Søren

doi:10.1007/s00431-021-04345-z

Cited by 215 publications

(244 citation statements)

References 35 publications

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“…It would be instructive to determine if these same predictors identified those predisposed to severe COVID-19 and/or “long-haul” COVID as well. Youth infected with SARS-CoV-2 do report more symptoms than controls at follow up 28 , and in a recent study dealing with recovery from COVID, reactivation of latent EBV and SARS-CoV-2 RNAemia were predictors of post-acute sequelae of covid-19 (PASC), and those reporting gastrointestinal PASC, SARS-CoV-2-specific and CMV-specific CD8+ T cells exhibited unique dynamics 29 .…”

Section: Discussionmentioning

confidence: 99%

Predictors for Developing Severe Myalgic Encephalomyelitis/Chronic Fatigue Syndrome following Infectious Mononucleosis

Jason¹,

Cotler²,

Islam³

et al. 2022

J Rehab Therapy

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Background: About 10% of individuals who contract infectious mononucleosis (IM) have symptoms 6 months later that meet criteria for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Our study for the first time examined whether it is possible to predict who will develop ME/CFS following IM. Methods: We have reported on a prospectively recruited cohort of 4,501 college students, of which 238 (5.3%) developed IM. Those who developed IM were followed-up at six months to determine whether they recovered or met criteria for ME/CFS. The present study focuses on 48 students who after six months had a diagnosis of ME/CFS, and a matched control group of 58 students who had no further symptoms after their IM. All of these 106 students had data at baseline (at least 6 weeks prior to the development of IM), when experiencing IM, and 6 months following IM. Of those who did not recover from IM, there were two groups: 30 were classified as ME/CFS and 18 were classified as severe ME/CFS. We measured the results of 7 questionnaires, physical examination findings, the severity of mononucleosis and cytokine analyses at baseline (pre-illness) and at the time of IM. We examined predictors (e.g., pre-illness variables as well as variables at onset of IM) of those who developed ME/CFS and severe ME/CFS following IM. Results: From analyses using receiver operating characteristic statistics, the students who had had severe gastrointestinal symptoms of stomach pain, bloating, and an irritable bowel at baseline and who also had abnormally low levels of the immune markers IL-13 and/or IL-5 at baseline, as well as severe gastrointestinal symptoms when then contracted IM, were found to have a nearly 80% chance of having severe ME/CFS persisting six months following IM. Conclusions: Our findings are consistent with emerging literature that gastrointestinal distress and autonomic symptoms, along with several immune markers, may be implicated in the development of severe ME/CFS. Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating illness affecting over a million people in the US1. Six months after having had Infectious Mononucleosis (IM), about 9-12% of individuals are diagnosed with this syndrome. For example, Hickie et al.2 showed an 11% rate of ME/CFS six months following acute infection with Epstein-Barr virus as well as following two other similar systemic infections. Katz et al.3 found similar outcomes following IM in youth. In a recent prospective, longitudinal study, university students were assessed prior to IM, at the time of IM, and at a six-month follow-up. Those who developed severe ME/CFS had differences in several pre-illness domains compared to those who recovered from IM without further symptoms4. In addition, Katz et al.5 found that the severity of IM was predictive of severe ME/CFS 6 months following IM. We have used these baseline pre-illness behavioral and immune data along with severity of IM data to predict who will develop severe ME/CFS six months following IM.

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Section: Discussionmentioning

confidence: 99%

Predictors for Developing Severe Myalgic Encephalomyelitis/Chronic Fatigue Syndrome following Infectious Mononucleosis

Jason¹,

Cotler²,

Islam³

et al. 2022

J Rehab Therapy

View full text Add to dashboard Cite

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“…Schools can help in this process through the reinforcement of ritualization and normalization of hygiene habits [ 131 , 132 ]. Moreover, even though “long covid” (e.g., manifestation of persistent long-term symptoms after the acute infection) has been more frequently reported among adult patients, in children the disease could affect their cognitive development, which has been already compromised during the pandemic due to delayed education, isolation, increase in poverty and food security, among other factors [ 133 , 134 ]. In that sense, the provision of hygiene infrastructure in schools should not be overlooked.…”

Section: Discussionmentioning

confidence: 99%

Water, Sanitation and Hygiene in Schools in Low- and Middle-Income Countries: A Systematic Review and Implications for the COVID-19 Pandemic

Poague

Blanford

Anthonj

2022

IJERPH

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The global COVID-19 pandemic has revealed the extent to which schools are struggling with the provision of safe drinking water, sanitation and hygiene (WASH). To describe the WASH conditions in schools and discuss the implications for the safe reopening of schools during the ongoing COVID-19 pandemic, a systematic review of peer-reviewed literature on WASH in schools in low- and middle-income countries was performed. In April 2021, five databases, including MEDLINE (via PubMed), Web of Science, Scopus, AJOL, and LILACS, were used to identify studies. Sixty-five papers met the inclusion criteria. We extracted and analyzed data considering the Joint Monitoring Programme (JMP) definitions and the normative contents of Human Rights to safe drinking water and sanitation. Publications included in this systematic review considered 18,465 schools, across 30 different countries. Results indicate a lack of adequate WASH conditions and menstrual hygiene management requirements in all countries. The largely insufficient and inadequate school infrastructure hampers students to practice healthy hygiene habits and handwashing in particular. In the context of the COVID-19 pandemic, being hindered to implement such a key strategy to contain the spread of SARS-CoV-2 in the school environment is of major concern.

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“…The prevalence of at least one symptom at 3 months of follow-up was 66.5% in test-positives versus 53.4% in test-negatives and 30.3% versus 16.2% respectively for three or more symptoms. These results must be interpreted with appropriate caution, as only 13% of the eligible test-positive and test-negative population responded to the survey, a limitation that also complicates interpretation of the incidence data from a nationwide study in Denmark [ 35 ].…”

Section: Epidemiologymentioning

confidence: 99%

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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Long COVID symptoms and duration in SARS-CoV-2 positive children — a nationwide cohort study

Cited by 215 publications

References 35 publications

Predictors for Developing Severe Myalgic Encephalomyelitis/Chronic Fatigue Syndrome following Infectious Mononucleosis

Predictors for Developing Severe Myalgic Encephalomyelitis/Chronic Fatigue Syndrome following Infectious Mononucleosis

Water, Sanitation and Hygiene in Schools in Low- and Middle-Income Countries: A Systematic Review and Implications for the COVID-19 Pandemic

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

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