Prevalence and associating factors of long COVID in pediatric patients during the Delta and the Omicron variants
Frontiers in Pediatrics, doi:10.3389/fped.2023.1127582
Introduction: The number of pediatric COVID-19 infections is increasing; however, the data on long COVID conditions in children is still limited. Our study aimed to find the prevalence of long COVID in children during the Delta and Omicron waves, as well as associated factors. Methods: A single-center prospective cohort study was conducted. We included 802 RT-PCR-confirmed COVID-19 pediatric patients in the Delta and Omicron periods. Long COVID was defined as having symptoms for ≥3 months after infection. Parents and/or patients were interviewed by phone. Multivariable logistic regression was performed to find associated factors with long COVID. Results: The overall prevalence of long COVID was 30.2%. The Delta period had more prevalence than the Omicron (36.3% vs. 23.9%). Common symptoms for patients 0-3 years' old were loss of appetite, rhinorrhea, and nasal congestion. Conversely, patients 3-18 years' old had hair loss, dyspnea on exertion, rhinorrhea, and nasal congestion. However, there was no significant negative impact on daily life. Most symptoms improved after a 6-month follow-up. Factors associated with long COVID-19 conditions were infection during the Omicron period (adjusted OR: 0.54; 95% CI: 0.39-0.74, P < 0.001), fever (adjusted OR: 1.49, 95% CI: 1.01-2.20, P = 0.04) and rhinorrhea (adjusted OR: 1.47, 95% CI: 1.06-2.02, P = 0.02). Conclusion: Infection during the Omicron wave has a lower prevalence of long COVID. The prognosis is often favorable, and most symptoms gradually become less. However, pediatricians may schedule appointments to surveil long COVID in children with fever or rhinorrhea as an initial symptom.
Ethics statement The studies involving human participants were reviewed and approved by The Human Research Ethics Committee of Thammasat University No 1 (Faculty of Medicine). Written informed consent to participate in this study was provided by the participants' legal guardian/next of kin.
Author contributions All authors made substantial contributions to the study and manuscript and met the criteria for authorship defined in the author instruction: TL designed the study, collected data, interpreted the results, drafted and revised the manuscript, and approved the final version of the manuscript. AS designed the study, collected data, interpreted the results, revised the manuscript, and approved the final version of the manuscript. AT designed the study, interpreted the results, revised the manuscript, and approved the final version of the manuscript. PB designed the study, interpreted the results, revised the manuscript, and approved the final version of the manuscript. PSi designed the study, collected data, interpreted the results, revised the manuscript, and approved the final version of the manuscript. CC collected data, designed the study, interpreted the results, revised the manuscript, and approved the final version of the manuscript. PSr designed the study, collected data, interpreted the results, revised the manuscript, and approved the final version of the manuscript. PT designed the study, analyzed data, interpreted the results, drafted and revised the..
Afrin, Weinstock, Molderings, COVID-19 hyperinflammation and post-COVID-19 illness may be rooted in mast cell activation syndrome, Int J Infect Dis, doi:10.1016/j.ijid.2020.09.016
Borch, Holm, Knudsen, Ellermann-Eriksen, Hagstroem, Long COVID symptoms and duration in SARS-CoV-2 positive children -a nationwide cohort study
Buonsenso, Morello, Mariani, Rose, Mastrantoni et al., Risk factors for post-COVID-19 condition in previously hospitalised children using the ISARIC global follow-up protocol: a prospective cohort study, Acta Paediatr, doi:10.1183/13993003.01341-2021
Buonsenso, Munblit, Rose, Sinatti, Ricchiuto et al., Preliminary evidence on long COVID in children, Acta Paediatr, doi:10.1111/apa.15870
Byambasuren, Stehlik, Clark, Alcorn, Glasziou, Effect of COVID-19 vaccination on long COVID: systematic review, BMJ Med, doi:10.1136/bmjmed-2022-000385
Clements, Joseph, Koukounaras, UK NICE guidelines for EVAR: cost implications for post-COVID Australian public health, J Vasc Interv Radiol, doi:10.1007/s00270-021-02832-2
Harris, Taylor, Minor, Elliott, Fernandez et al., The REDCap consortium: building an international community of software platform partners, J Biomed Inform, doi:10.1016/j.jbi.2019.103208
Harris, Taylor, Thielke, Payne, Gonzalez et al., Research electronic data capture (REDCap)-a metadata-driven methodology and workflow process for providing translational research informatics support, J Biomed Inform, doi:10.1016/j.jbi.2008.08.010
Khemiri, Ayouni, Triki, Haddad-Boubaker, SARS-CoV-2 infection in pediatric population before and during the Delta (B.1.617.2) and omicron (B.1.1.529) variants era, Virol J, doi:10.1186/s12985-022-01873-4
Lopez-Leon, Wegman-Ostrosky, Del Valle, Perelman, Sepulveda et al., Long-COVID in children and adolescents: a systematic review and meta-analyses, Sci Rep, doi:10.1038/s41598-022-13495-5
Molteni, Sudre, Canas, Bhopal, Hughes et al., Illness duration and symptom profile in symptomatic UK school-aged children tested for SARS-CoV-2. Lancet Child Adolesc Health, Eur J Pediatr, doi:10.1016/S2352-4642(21)00198-X
Notarte, Catahay, Velasco, Pastrana, Ver et al., Impact of COVID-19 vaccination on the risk of developing long-COVID and on existing long-COVID symptoms: a systematic review, EClinicalMedicine, doi:10.1016/j.eclinm.2022.101624
Satdhabudha, Chaiyakulsil, Sritipsukho, Sinlapamongkolkul, Chaumrattanakul et al., Epidemiological and clinical characteristics of pediatric COVID-19 in the tertiary care system in Thailand: comparative Delta and pre-Delta era, Mediterr J Hematol Infect Dis, doi:10.4084/MJHID.2022.044
Say, Crawford, Mcnab, Wurzel, Steer et al., Post-acute COVID-19 outcomes in children with mild and asymptomatic disease, Lancet Child Adolesc Health, doi:10.1016/S2352-4642(21)00124-3
She, Liu, Liu, COVID-19 epidemic: disease characteristics in children, J Med Virol, doi:10.1002/jmv.25807
Smane, Roge, Pucuka, Pavare, Clinical features of pediatric post-acute COVID-19: a descriptive retrospective follow-up study, Ital J Pediatr, doi:10.1186/s13052-021-01127-z
Torjesen, COVID-19: omicron variant is linked to steep rise in hospital admissions of very young children, Br Med J, doi:10.1136/bmj.—o110
Wise, COVID-19: long COVID risk is lower with omicron than delta, researchers find, Br Med J, doi:10.1136/bmj.o1500
Wise, Long, one in seven children may still have symptoms 15 weeks after infection, data show, Br Med J, doi:10.1136/bmj.n2157