Long Term Physical, Mental and Social Health Effects of COVID-19 in the Pediatric Population: A Scoping Review

Abstract

Background. The majority of COVID-19 symptom presentations in adults and children appear to run their course within a couple of weeks. However, a subgroup of adults has started to emerge with effects lasting several months or more after initial infection. However, little is known about long term physical, mental and social health effects of COVID-19 in the pediatric population. The purpose of this review was to determine these impacts well into the second year of the pandemic. Methods. A search was conducted using PUBMED, Web of Science, Science Direct, and COCHRANE between 11/1/2019 and 9/1/2021. Search inclusion criteria were as follows: (1) COVID-19 illness and symptoms in children; (2) SARS-COv2 in children; (3) English language; and (4) human studies only. Results. The few studies that have documented long-term physical symptoms in children show that fatigue, difficulty in concentrating (brain fog), sleep disturbances, and sensory problems are the most reported outcomes. Most studies examining the impact of COVID-19 in pediatric populations have focused on initial clinical presentation, and symptoms, which are similar to those in adult populations. Additionally, COVID-19 has had a moderate impact on children and adolescents social environment, which may exacerbate current and future physiological, psychological, behavioral, and academic outcomes. Conclusions. There are limited studies reporting long physical symptoms of COVID-19 in the pediatric population. However, pediatric COVID-19 cases are underreported due to low rates of testing and symptomatic infection, which calls for more longitudinal studies. Children who have experienced COVID-19 illness should be monitored for long physiological, psychological, behavioral, and academic outcomes.

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

“…7,8 Events such as school closures, lack of resources to support remote learning and social isolation can also negatively impact the child and their family's quality of life. 9 Thus, one of the major challenges of reporting accurate persistent COVID symptom prevalence estimates in the nonhospitalized pediatric population has been the absence of a control or comparison group. 10 In 1 recent report summarizing 14 studies in the literature, 10 5 studies included children and adolescents without severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection as controls and of these 2 did not find persistent symptoms to be more prevalent in children and adolescents with evidence of SARS-CoV-2 infection.…”

“…These inconsistent findings are also supported in other studies that report a low prevalence of persistent symptoms in children (1.8%-4%), 2,12 while others report much higher estimates (24% to >30%) 13,14 and with multisystem involvement. 14 Both previously mentioned reviews 9,10 included only 2 studies with children, 15,16 and 1 study that included children from the United States, 7 respectively, neither of which included exclusively nonhospitalized children and adolescents. Therefore, we report here the prevalence of persistent symptoms in a population-based sample of ≤19 years old in the United States with known SARS-CoV-2 antibody status.…”