General

Illness duration and symptom profile in symptomatic UK school-aged children tested for SARS-CoV-2 

Molteni E, Sudre CH, Canas LS, Bhopal SS, Hughes RC, Antonelli M, Murray B, Kläser K, Kerfoot E, Chen L, Deng J, Hu C, Selvachandran S, Read K, Capdevila Pujol J, Hammers A, Spector TD, Ourselin S, Steves CJ, Modat M, Absoud M, Duncan EL. Lancet Child Adolesc Health. 2021 Oct;5(10):708-718. doi: 10.1016/S2352-4642(21)00198-X. Epub 2021 Aug 3. Erratum in: Lancet Child Adolesc Health. 2021 Aug 31;: PMID: 34358472; PMCID: PMC8443448.

Data from UK school-aged children (age 5-17 years) were reported by an adult proxy using the mobile app launched jointly by Zoe Limited and King's College London. Overall, 1734 children had a positive SARS-CoV-2 test result and calculable illness duration within the study timeframe (illness onset between Sept 1, 2020, and Jan 24, 2021). The most common symptoms were headache (62.2%), and fatigue (55·0%). Median illness duration was 6 days (IQR 3-11) versus 3 days (2-7) in children testing negative, and was positively associated with age. After day 28 the symptom burden was low (median 2 symptoms, IQR 1-4) compared with the first week of illness (median 6 symptoms, 4-8). Only 1·8% of 1 379 children experienced symptoms for at least 56 days. 

Link to study: Illness duration and symptom profile in symptomatic UK school-aged children tested for SARS-CoV-2

Long-term Symptoms After SARS-CoV-2 Infection in Children and Adolescents 

Radtke T., Ulyte A., Puhan MA., Kriemler S. JAMA. 2021 Jul 15;326(9):869–71. doi: 10.1001/jama.2021.11880. Epub ahead of print. PMID: 34264266; PMCID: PMC8283661.

Using Ciao Corona a longitudinal cohort study investigating SARS-CoV-2 seroprevalence in 55 randomly selected schools in Zurich, Switzerland, the persistence of symptoms in 109 seropositive and 1246 seronegative children was evaluated. Overall, 4% of seropositive children reported at least 1 symptom lasting beyond 12 weeks versus 2% of seronegative children, and similar proportions of seropositive and seronegative children reported excellent or good health. 

Link to study : Long-term Symptoms After SARS-CoV-2 Infection in Children and Adolescents

Post-acute COVID-19 outcomes in children with mild and asymptomatic disease 

Say D, Crawford N, McNab S, Wurzel D, Steer A, Tosif S. Lancet Child Adolesc Health. 2021 Jun;5(6):e22-e23. doi: 10.1016/S2352-4642(21)00124-3. Epub 2021 Apr 21. PMID: 33891880; PMCID: PMC8057863.

Out of 171 children with COVID-19 (median age 3 years, IQR 1-8 years, and 53% boys) at the Royal Children's Hospital (RCH) in Melbourne, Australia, 151 had a follow-up at 3–6 months, of whom 36% had an asymptomatic infection and 64% had symptoms during the acute phase of their infection. Of the 151 participants, 8% had post-acute COVID-19 symptoms including mild post-viral cough (4%) and fatigue (2%). The duration of post-viral cough ranged from 3 weeks to 8 weeks and of post-viral fatigue ranged from 6 weeks to 8 weeks from the time of symptom onset. At the most recent review in March, 2021, all 151 children had returned to their baseline health status and post-acute COVID-19 symptoms had resolved. 

Link to study: Post-acute COVID-19 outcomes in children with mild and asymptomatic disease

Persistent symptoms following SARS-CoV-2 infection amongst children and young people: A meta-analysis of controlled and uncontrolled studies 

Behnood SA, Shafran R, Bennett SD, Zhang AXD, O'Mahoney LL, Stephenson TJ, Ladhani SN, De Stavola BL, Viner RM, Swann OV. J Infect. 2021 Nov 20:S0163-4453(21)00555-7. doi: 10.1016/j.jinf.2021.11.011. Epub ahead of print. PMID: 34813820; PMCID: PMC8604800.

A systematic review of published and unpublished literature using 13 online databases between December 2019 and July 2021. Twenty two of 3357 unique studies were eligible, including 23,141 children and young people. Median duration of follow-up was 125 days (IQR 99–231). Pooled risk difference in post-COVID cases compared to controls (5 studies) were significantly higher for cognitive difficulties (3% (95% CI 1, 4)), headache (5% (1, 8)), loss of smell (8%, (2, 15)), sore throat (2% (1, 2)) and sore eyes (2% (1, 3)) but not abdominal pain, cough, fatigue, myalgia, insomnia, diarrhea, fever, dizziness or dyspnea. Pooled prevalence of symptoms in post-COVID participants in 17 studies ranged from 15% (diarrhea) to 47% (fatigue). Age was associated with higher prevalence of all symptoms except cough. Higher study quality was associated with lower prevalence of all symptoms, except loss of smell and cognitive symptoms. 

Link to study : Persistent symptoms following SARS-CoV-2 infection amongst children and young people: A meta-analysis of controlled and uncontrolled studies