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Current state of COVID-19 in children: 4 years on
Annabel A Powell1, Alexander C Dowell2, Paul Moss2
1Public Health Programmes, UK Health Security Agency, London, UK.
Insights
Children experienced significant pandemic impacts despite low severe disease risk. This review details UK childhood COVID-19, covering infection, vaccination, PIMS-TS, and long COVID, informing future public health strategies.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Children faced disproportionate impacts from COVID-19 pandemic measures like lockdowns and school closures.
- Despite low severe disease risk, mitigation strategies were widely implemented globally to control SARS-CoV-2 spread.
Purpose of the Study:
- To review the UK's experience with COVID-19 in children over four years.
- To consolidate knowledge on childhood COVID-19, including infection, immunity, transmission, severity, outcomes, vaccination, PIMS-TS, and long COVID.
Main Methods:
- Comprehensive literature review of COVID-19 in children within the UK context.
- Analysis of data on infection risks, disease severity, and post-infection syndromes.
- Assessment of vaccination impact and public health policy effectiveness.
Main Results:
- Children experienced significant disruption from mitigation measures despite low severe disease risk.
- Paediatric Inflammatory Multisystem Syndrome temporally associated with SARS-CoV-2 (PIMS-TS) emerged and subsequently declined.
- Understanding of long COVID in children continues to evolve.
Conclusions:
- Continued research is crucial for evidence-based public health actions and policy decisions regarding childhood COVID-19.
- Future strategies must consider new variants and vaccine development for children.
- A balanced approach is needed to mitigate risks while minimizing disruption to child well-being.
Abstract:
Children have been disproportionately affected by the COVID-19 pandemic. Despite evidence of a very low risk of severe disease, children were subjected to extensive lockdown, restriction and mitigation measures, including school closures, to control the rapid spread of SARS-CoV-2 in most parts of the world. In this review we summarise the UK experience of COVID-19 in children four years into the largest and longest pandemic of this century. We address the risks of SARS-CoV-2 infection, immunity, transmission, severity and outcomes in children. We also assess the implementation, uptake, effectiveness and impact of COVID-19 vaccination, as well as the emergence, evolution and near disappearance of PIMS-TS (paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2) and current understanding of long COVID in children. This review consolidates current knowledge on childhood COVID-19 and emphasises the importance of continued research and the need for research-driven public health actions and policy decisions, especially in the context of new variants and future vaccines.
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