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Long COVID-19 in children: an Italian cohort study
Gianfranco Trapani1, Giuseppe Verlato2, Enrico Bertino3
1Alfred Nobel International Association Studies Center, Sanremo, Italy.
Insights
Long COVID-19 affects children, with higher prevalence in hospitalized cases. Even mild or asymptomatic infections can lead to persistent symptoms, highlighting the need for monitoring and vaccination.
Area of Science:
- Pediatric infectious diseases
- Public health
- Epidemiology
Background:
- Long COVID-19 syndrome, characterized by persistent symptoms post-SARS-CoV-2 infection, lacks extensive research in pediatric populations.
- Existing studies on pediatric Long COVID-19 are heterogeneous, making prevalence assessment challenging.
Purpose of the Study:
- To determine the prevalence of Long COVID-19 syndrome in Italian pediatric primary care patients.
- To compare Long COVID-19 prevalence between primary care and hospitalized pediatric cohorts.
Main Methods:
- A questionnaire-based study involving 629 primary care pediatric patients observed 8-36 weeks post-infection.
- Clinical document review for 60 hospitalized pediatric patients with prior SARS-CoV-2 infection.
- Data collected by 18 Primary Care Pediatricians across 8 Italian regions.
Main Results:
- Cumulative incidence of Long COVID-19 was 24.3% in primary care and 58% in hospitalized children.
- Common symptoms included fatigue, neurological, and respiratory issues in primary care; psychological and cardiac issues in hospitalized patients.
- Prevalence was higher in children symptomatic during acute infection (46.5%) versus asymptomatic (11.5%).
- Younger children (0-5 years) were at higher risk for respiratory symptoms; adolescents (11-16 years) for neurological and psychological symptoms.
Conclusions:
- Long COVID-19 is a significant concern in pediatric populations, affecting even those with mild or no acute symptoms.
- Monitoring pediatric patients post-COVID-19 infection is crucial.
- Vaccination programs in children are recommended to mitigate Long COVID-19 consequences.
Background:
Long COVID-19 syndrome is a complex of symptoms that occurs after the acute SARS-CoV-2 infection, in the absence of other possible diagnoses. Studies on Long COVID-19 in pediatric population are scanty and heterogeneous in design, inclusion criteria, outcomes, and follow-up time. The objective of the present study is to assess the prevalence of Long COVID-19 syndrome in a cohort of Italian pediatric primary care patients, observed for a period of time of 8 to 36 weeks from healing. Prevalence was also assessed in a cohort of pediatric patients hospitalized during acute infection.
Methods:
Data concerning 629 primary care patients with previous acute SARS-CoV-2 infection were collected by a questionnaire filled in by Primary Care Pediatrician (PCP). The questionnaire was administrated to patients by 18 PCPs based in 8 different Italian regions from June to August 2021. Data concerning 60 hospitalized patients were also collected by consultation of clinical documents.
Results:
Cumulative incidence of Long COVID-19 resulted to be 24.3% in primary care patients and 58% in hospitalized patients. The most frequently reported symptoms were abnormal fatigue (7%), neurological (6.8%), and respiratory disorders (6%) for the primary care cohort. Hospitalized patients displayed more frequently psychological symptoms (36.7%), cardiac involvement (23.3%), and respiratory disorders (18.3%). No difference was observed in cumulative incidence in males and females in both cohorts. Previous diseases did not influence the probability to develop Long COVID-19. The prevalence of Long COVID-19 was 46.5% in children who were symptomatic during acute infection and 11.5% in asymptomatic ones. Children aged 0 to 5 years had a greater risk to develop respiratory symptoms, while adolescents (aged 11-16 years) had a greater risk to develop neurological and psychological Long COVID-19 symptoms.
Conclusions:
Our study demonstrates that Long COVID-19 is a reality in pediatric age and could involve even patients with mild or no acute symptoms. The results stress the importance of monitoring primary care pediatric patients after acute COVID-19 infection and the relevance of vaccination programs in pediatric population, also in order to avoid the consequences of Long COVID-19 syndrome.
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