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Children and younger people may not be at high risk for long COVID as previous studies suggested. Stephanie Keith/Bloomberg via Getty Images
  • Children and young people often report persistent symptoms after SARS-CoV-2 infection.
  • In a systematic analysis of controlled and uncontrolled studies, researchers found similar symptoms in those who had tested positive and negative for SARS-CoV-2 infection.
  • Children who had tested positive for SARS-CoV-2 were slightly more likely to have some persistent symptoms.
  • The study suggests that long COVID might be less of a risk for young people than previously thought.

All data and statistics are based on publicly available data at the time of publication. Some information may be out of date. Visit our coronavirus hub for the most recent information on the COVID-19 pandemic.

People who recover from COVID-19 often report persistent symptoms or long COVID. According to the Centers for Disease Control and Prevention (CDC), people can develop post-COVID conditions following SARS-CoV-2 infection even if they did not have COVID-19 symptoms. Long-term effects may include fatigue, cognitive symptoms, and respiratory symptoms.

Many adults report long COVID symptoms. However, there is conflicting data about the long-term impact of SARS-CoV-2 infection in children. Most children and young people (CYP) are either asymptomatic or have milder COVID-19 symptoms than adults, but some studies report long COVID in children.

A group of U.K. researchers has completed a systematic analysis of the literature on long COVID in CYP. The study, which appears in the Journal of Infection, aimed to clarify whether persistent symptoms in young people are due to SARS-CoV-2 infection or the pressures of living in a pandemic.

Dr. Christopher Coleman, assistant professor of infection immunology at the University of Nottingham, U.K., told Medical News Today, “This is an important piece of research, as it attempts to pool all of the studies in this area — which should give a better conclusion than small studies.”

“Our findings suggest that persistent symptoms do occur in CYP after SARS-CoV-2 infection, but prevalence is much lower than originally suggested by many low-quality uncontrolled studies from early in the pandemic.”

– Dr. Olivia Swann, corresponding author and clinical lecturer in Paediatric Infectious Disease at the University of Edinburgh, U.K.

The researchers identified 3,357 studies, of which 22 met their criteria for analysis. Participants had to be 19 years or under, with confirmed or probable SARS-CoV-2 infection, and experience symptoms beyond the acute illness. The study analyzed data from 23,141 CYP in 12 countries, who were followed up for a median of 120 days.

The meta-analysis looked for evidence of many symptoms associated with long COVID. Across all studies, a total of 101 wide-ranging symptoms was reported, including cognitive difficulties, loss of smell, headache, sore throat, fatigue, insomnia, and diarrhea. The researchers assessed the prevalence, risk factors, type, and duration of long-term post-COVID symptoms.

“Most of these persistent symptoms were equally common in SARS-CoV-2 positive cases and SARS-CoV-2 negative controls.”

– Dr. Olivia Swann

The studies in the analysis had some limitations. All symptoms were self-reported by the participants, so could not be clinically verified. Of the 22 studies, only five had a SARS-CoV-2 negative control group. The authors regarded these as higher-quality studies, stressing the importance of a control group for avoiding bias.

Dr. Swann commented, “It’s important to note that the quality of published studies has been highly variable: Earlier studies without a control group paint a very different picture to more recent case-control studies, which are more reassuring.”

Speaking to MNT, Dr. Danelle Fisher, MD, FAAP (Fellow of the American Academy of Pediatrics), chair of pediatrics at Providence Saint John’s Health Center in Santa Monica, California, agreed, “There are limitations to this study but it is important to try to track the longevity of the symptoms and if possible compare it to control subjects, which has not yet been done.”

Those who had tested positive for SARS-CoV-2 were more likely to have a few symptoms, such as cognitive difficulties, headache, loss of smell, sore throat, and sore eyes, than those who had not been infected.

“The meta-analysis showed a slight increase in children and young people who had symptoms after COVID-19 infection including cognitive difficulties, headaches, fatigue, and loss of smell. These symptoms are also found after other related viral illnesses that are similar to COVID-19.”

– Dr. Danelle Fisher

The authors note that the higher-quality studies found a lower prevalence of all long-term symptoms.

One of the study authors, Dr. Shamez Ladhani, a pediatric infectious disease consultant at St. George’s Hospital, London, commented, “The vast majority of kids with COVID-19 will recover completely, but we do need better tools to identify (and resources to investigate and support) the small proportion of kids with persistent symptoms.”

Dr. Swann noted that the few symptoms found more frequently in CYP “can help us identify children who are persistently affected after SARS-CoV-2 and support their recovery.”

“Let’s stop the scaremongering and get the public messaging right.”

– Dr. Shamez Ladhani