A literature review by researchers in Australia suggests long COVID is rare in children, but more double-blind studies are urgently required to investigate the long-term risks and impact of SARS-CoV-2 infection on young people.
Long COVID refers to a range of new or ongoing symptoms that can last weeks, months or possibly even years after first being infected with the virus that causes COVID-19. The symptoms are wide ranging and present in different combinations, but difficulty breathing, fatigue, headache and “brain fog” seem to be the most common.
Thus far, long COVID has been seen mostly in adults, but that was prior to the significant recent uptick in pediatric cases of COVID-19. Since July, pediatric cases have risen by about 240 percent as the Delta variant spreads, children return to school and mask mandates and social distancing measures become voluntary.
The review, published in Pediatric Infectious Disease Journal, examined 14 existing studies on long COVID in a total of 19,426 children. Children were evaluated for persistent symptoms for varying durations from over 4 weeks to more than 12 weeks, as well as arbitrary time points.
The prevalence of long COVID symptoms varied considerably between the studies from 4% to 66%. While limitations are present in nearly every study, the review acknowledges a glaring one here—only 5 of the 14 studies included a control group. Still, even with the vacillating data, the most commonly reported pediatric symptoms line up with what we know of long COVID in adults: fatigue (up to 87%), concentration difficulties or brain fog (up to 81%) and headaches (up to 80%).
That’s where the commonalities appear to halt, however. The Australian researchers say, with all the studies taken together, there is little evidence that the reported long COVID symptoms persist beyond 12 weeks in pediatric patients.
“One study that did find a difference between cases and controls in persisting symptoms at 4 weeks post-COVID reported that by 8 weeks, most symptoms had resolved, suggesting long COVID might be less of a concern in children and adolescents than in adults,” conclude the researchers. “However, in light of the large number of children and adolescents infected with SARS-CoV-2, the impact of even a low prevalence of persisting symptoms will be considerable.”
Doctors at Kennedy Krieger Institute in Baltimore are echoing that concern as they man one of the only pediatric long COVID units in the nation. Brad Schlaggar, CEO and president of Kennedy Krieger Institute, told Fox News the hospital is seeing lingering symptoms in about 10% of pediatric patients recently.
"We presently have around 40 patients, but the referrals are increasing with the increased numbers of pediatric cases throughout the country,” said Schlaggar.
That’s why the Australian researchers repeatedly emphasize the need for further studies in their published review.
“The low risk posed by acute disease means that one of the key benefits of COVID-19 vaccination of children and adolescents might be to protect them from long COVID,” says Nigel Curtis, co-author of the review and professor at Murdoch Children’s Research Institute. “An accurate determination of the risk of long COVID in this age group is therefore crucial in the debate about the risks and benefits of vaccination.”
Last week, the National Institutes of Health awarded $470 million to NYU Langone Health to support the agency’s REsearching COVID to Enhance Recovery (RECOVER) initiative. NYU will make multiple sub-awards to more than 100 researchers at over 30 institutions. This award supports new studies of COVID-19 survivors and leverages existing long-running large cohort studies with an expansion of their research focus.
Researchers, those affected by long COVID, and representatives from advocacy organizations worked together to develop the RECOVER master protocols that are standardized across three populations: adult, pregnant and pediatric volunteers.
With immediate access to data from existing study populations, it is anticipated researchers will be able to accelerate the timeline of this project, providing insights over the coming months, including the incidence and prevalence of long-term effects from SARS-CoV-2 infection, the range of symptoms, underlying causes, risk factors, outcomes and potential strategies for treatment and prevention.