Case report and systematic review suggest that children may experience similar long-term effects to adults after clinical COVID-19.

Jonas F Ludvigsson

Journal: Acta paediatrica (Oslo, Norway : 1992) 2021;110(3):914-921

PMID: 33205450

Free Full Text on PubMed Central View on PubMed

Plain Language Summary

The long-term effects of COVID-19 is becoming increasingly documented in adults. Symptoms such as fatigue, headache and depression have all been reported, however data on the possible long-term effects of COVID-19 in children is scarce. The aim of this systematic review and case report was to describe the long-term effects of COVID-19 in five children and support this with other reports in the literature. The results showed that of the five case reports of long COVID, four were girls aged 9-15 years. All subjects reported symptoms lasting between 6-8 months. Most common symptoms were fatigue, difficulty breathing and heart issues. The systematic literature review did not find any publications which documented long COVID in children. It was concluded that children may experience long COVID symptoms and girls may be more susceptible. This study could be used by healthcare professionals to understand that children may also be affected by long COVID and that patients should be monitored for symptoms for at least 6-8 months.

Abstract

AIM

Persistent symptoms in adults after COVID-19 are emerging and the term long COVID is increasingly appearing in the literature. However, paediatric data are scarce.

METHODS

This paper contains a case report of five Swedish children and the long-term symptoms reported by their parents. It also includes a systematic literature review of the MEDLINE, EMBASE and Web of Science databases and the medRxiv/bioRxiv pre-print servers up to 2 November 2020.

RESULTS

The five children with potential long COVID had a median age of 12 years (range 9-15) and four were girls. They had symptoms for 6-8 months after their clinical diagnoses of COVID-19. None were hospitalised at diagnosis, but one was later admitted for peri-myocarditis. All five children had fatigue, dyspnoea, heart palpitations or chest pain, and four had headaches, difficulties concentrating, muscle weakness, dizziness and sore throats. Some had improved after 6-8 months, but they all suffered from fatigue and none had fully returned to school. The systematic review identified 179 publications and 19 of these were deemed relevant and read in detail. None contained any information on long COVID in children.

CONCLUSION

Children may experience similar long COVID symptoms to adults and females may be more affected.

Address: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.; Department of Paediatrics, Orebro University Hospital, Orebro, Sweden.; Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK.; Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York, USA.

DOI: 10.1111/apa.15673