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Post COVID-19 conditions in an Australian pediatric cohort, 3 months following a Delta outbreak
Philip N Britton1,2,3, Rebecca Burrell4,5, Emily Chapman6
1The Children's Hospital at Westmead Clinical School, Sydney Medical School, the University of Sydney, Westmead, NSW, Australia. philip.britton@health.nsw.gov.au.
Insights
Pediatric Long COVID is infrequent in Australian children, with most recovering within 12 weeks. However, a minority experience persistent symptoms, highlighting the need for ongoing attention to post-COVID conditions.
Area of Science:
- Pediatric infectious diseases
- Public health surveillance
- Clinical immunology
Background:
- Pediatric long COVID remains poorly understood, with limited Australian data.
- The 2021 Delta variant outbreak provided a specific cohort for study.
Purpose of the Study:
- To assess symptoms and functional impairment 12 weeks post-infection in Australian children and adolescents.
- To evaluate the impact of the SARS-CoV-2 Delta variant on pediatric recovery.
Main Methods:
- Online survey distributed to parents/carers of 11,864 PCR-confirmed SARS-CoV-2 cases.
- Assessment of symptoms and functional impairment at 12 weeks post-infection.
- Clinical review for patients reporting non-recovery.
Main Results:
- 17.6% of invited parents responded to the survey.
- 11.7% reported persistent symptoms or functional impairment.
- Of those reviewed, 37.3% had Post COVID Conditions (PCC), and 12.4% met Long COVID criteria.
Conclusions:
- Self-reported non-recovery in children is infrequent but warrants attention.
- Long COVID is a subset of non-recovery cases, affecting a minority of pediatric patients.
- Risk factors for pediatric post-COVID conditions include age over 11 and pre-existing comorbidities.
Background:
Pediatric long COVID remains incompletely understood with scant Australian data available. We aimed to assess the impacts of the 2021 Delta variant of SARS-CoV-2 outbreak on symptoms and functioning 12 weeks post-acute infection in a cohort of children and adolescents.
Methods:
The parents/carers of 11,864 patients with PCR-confirmed SARS-CoV-2 were invited, via email or text message, to complete an online survey assessing symptoms and functional impairment.
Findings:
1731 (17.6%) responded to the survey. 203 (11.7%) reported continued symptoms and/or functional impairment which were flagged for clinical review, all others reported recovery. Of the 169 subsequently clinically reviewed, 63 had already recovered (37.3%) and 17 had exacerbation of pre-existing condition(s) (10.1%); 63 (37.3%) were diagnosed with a Post COVID Condition (PCC). Of these, 21 (12.4%) were considered to have features compatible with the United Kingdom consensus cases definition for Long COVID.
Interpretation:
During an outbreak of SARS-CoV-2 an online questionnaire with subsequent clinical review revealed self-reported non-recovery at 12 weeks in a minority of cases, with a spectrum of features. Long COVID comprised only a subset of cases with self-reported non-recovery, and is infrequent in children and adolescents, but still comprises a likely significant burden that warrants attention.
Impact:
Our study provides the only comprehensive estimate of the frequency and spectrum of post-COVID conditions in children from Australia. The high frequency of self-reported recovery, and low frequency of Long COVID compatible illness adds to the literature from other settings. Risk factors for post-COVID conditions in children are identified and include: age >11 year, and previous medical co-morbidity.
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