Long COVID and COVID-19 in children

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This wiki is intended for healthcare professionals and should not be considered medical advice.

General

Dyani Lewis (14 July 2021) Long COVID and kids: scientists race to find answers. Nature 595, 482-483 (2021) doi: https://doi.org/10.1038/d41586-021-01935-7

Stephen TJ Ray et al. (14 July 2021) Neurological manifestations of SARS-CoV-2 infection in hospitalised children and adolescents in the UK: a prospective national cohort study The Lancet Child & Adolescent Health https://doi.org/10.1016/S2352-4642(21)00193-0

Ludvigsson JF. Case report and systematic review suggest that children may experience similar long‐term effects to adults after clinical COVID‐19 Acta Paediatrica. 2020;00:1–8 doi.org/10.1111/apa.15673

Hobbs CV, Khaitan A, Kirmse BM, Borkowsky W. COVID-19 in Children: A Review and Parallels to Other Hyperinflammatory Syndromes Front Pediatr. 2020 Nov 24;8:593455. doi: 10.3389/fped.2020.593455. PMID: 33330288; PMCID: PMC7732413.

Frances Simpson and Amali Lokugamage (Oct 2020). Counting long covid in children. BMJ Opinion.

Danilo Buonsenso, Daniel Munblit, Cristina De Rose, Dario Sinatti, Antonia Ricchiuto, Angelo Carfi, Piero Valentini Preliminary Evidence on Long COVID in children medRxiv January 26, 2021 doi: https://doi.org/10.1101/2021.01.23.21250375

Abstract

There is increasing evidence that adult patients diagnosed with acute COVID-19 suffer from Long COVID initially described in Italy.

To date, data on Long COVID in children are lacking.

We assessed persistent symptoms in pediatric patients previously diagnosed with COVID-19. More than a half reported at least one persisting symptom even after 120 days since COVID-19, with 42.6% being impaired by these symptoms during daily activities. Symptoms like fatigue, muscle and joint pain, headache, insomnia, respiratory problems and palpitations were particularly frequent, as also described in adults.

The evidence that COVID-19 can have long-term impact children as well, including those with asymptomatic/paucisymptomatic COVID-19, highlight the need for pediatricians, mental health experts and policy makers of implementing measures to reduce impact of the pandemic on child’s health.

Useful Organisations

MIRS

Bautista-Rodriguez C. et al. (Nov 2020) Multisystem Inflammatory Syndrome in Children: An International Survey Pediatrics, e2020024554; DOI: https://doi.org/10.1542/peds.2020-024554

ABSTRACT Objective. To describe presentation, hospital course and predictors of bad outcome in Multisystem Inflammatory Syndrome in Children (MIS-C).
Methods. Retrospective data review of a case series of children meeting published definition for MIS-C discharged/died between March 1st and June 15th, 2020, from 33 participating European, Asian and American hospitals. Data was collected through a web-based survey and included clinical, laboratory, electrocardiographic and echocardiographic findings and treatment management.
Results. We included 183 patients (109 males [59.6%]; mean age 7.0±4.7 years; black race, 56[30.6%]; obesity, 48[26.2%]) with MIS-C. Overall, 114/183(62.3%) had evidence of SARSCoV-2 infection. All presented with fever, 117/183 (63.9%) with gastrointestinal symptoms and 79/183 (43.2%) with shock, that was associated with black race, higher inflammation and imaging abnormalities. Twenty-seven patients (14.7%) fulfilled criteria for Kawasaki disease. They were younger with no shock, fewer gastrointestinal, cardio-respiratory and neurological symptoms. The remaining 77 patients (49.3%) had mainly fever and inflammation. Inotropic support, mechanical ventilation and ECMO were indicated in 72 (39.3%), 43 (23.5%) and 4 (2.2%) patients, respectively. A shorter duration of symptoms prior to admission was found to be associated with poor patient outcome and for ECMO/death, with 72.3% (95% CI 0.56-0.90, p=0.006) increased risk per day reduction and with 63.3% (95% CI 0.47-0.82, p<0.0001) increased risk per day reduction respectively.
Conclusion. In this case series, children with MIS-C presented with a wide clinical spectrum, including KD-like, life-threatening shock and milder forms with mainly fever and inflammation. A shorter duration of symptoms prior to admission was associated with worse outcome.