Long-term physical, mental and social health effects of COVID-19 in the pediatric population: a scoping review

Abstract

Background The majority of coronavirus disease 2019 (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, which raises questions about the 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) severe acute respiratory syndrome coronavirus 2 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. In addition, 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.

Neurocognitive and Psychosocial Characteristics of Pediatric Patients With Post-Acute/Long-COVID: A Retrospective Clinical Case Series

“…Given the assorted symptoms associated with long COVID, which may represent multisystemic effects, partnerships between medical and mental health disciplines (e.g., neurology, rehabilitation medicine, neuropsychology), and across settings (e.g., medical, mental health, and school teams) will likely be integral in supporting patients’ symptom management, well-being, and return to day-to-day functioning. Cognitive difficulties such as concentration difficulties are very commonly reported long after COVID illness as shown in our clinical sample and in prior case studies with children ( Berg et al., 2022 ; Borch et al., 2022 ; Borel et al., 2022 ; Brackel et al., 2021 ; Ludvigsson, 2021 ). Because of their training in both the medical/neurological and psychological fields, neuropsychologists are uniquely poised to understand the many factors that might be contributing to these cognitive difficulties; communicate the identified brain–behavior relationships to patients, families, school personnel, and other providers; and tailor treatment and educational plans as appropriate.…”

“…It was suggested that adults with prolonged symptoms may experience a constellation of physical and cognitive symptoms similar to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) or mild traumatic brain injury (mTBI). At present, the neurological and cognitive sequelae of children remain largely unknown, although recent case reports suggest affected youth and their parents similarly endorse complaints of fatigue, labored breathing, and attention/concentration difficulties ( Brackel et al., 2021 ; Ludvigsson, 2021 ) in addition to sleep disturbances and memory difficulties ( Borel et al., 2022 ). To our knowledge, most of these studies rely on self or parent report and there are no existing investigations on the cognitive sequelae of long COVID in youth based on objective cognitive test measures.…”

Long-Term Health Symptoms and Sequelae Following SARS-CoV-2 Infection: An Evidence Map

“…This approach, however, relies on multiple low-quality systematic reviews, which usually fail on the definition of their methods (protocol), the rigour of their search, and the ambiguity in their inclusion criteria. Nevertheless, existing reviews highlighted similar findings to our evidence map, including the lack of controlled studies, the need for prospective studies with long-term follow-up and focus on overall recovery and health-related quality of life, and a paucity of research in children and in vaccinated people [ 31 , 32 , 33 ].…”

The Impact of the COVID-19 Outbreak on Mental Wellbeing in Children with a Chronic Condition Compared to Healthy Peers

“…At-risk individuals may experience new onset of mental health problems, while those with pre-existing mental health problems may experience symptomatic exacerbation—especially if access to mental health services is impeded due to COVID-19 regulations [ 21 , 22 ]. To date, empirical studies of the mental wellbeing burden of the pandemic are scarce in this vulnerable population—particularly longitudinal studies [ 23 ]. A better understanding is of clinical relevance, since this enables health professionals to incorporate pandemic-related effects into their care for their patients.…”