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Camporesi A, Morello R, La Rocca A, Zampino G, Vezzulli F, Munblit D, Raffaelli F, Valentini P, Buonsenso D. Characteristics and predictors of Long Covid in children: a 3-year prospective cohort study. EClinicalMedicine 2024; 76:102815. [PMID: 39296584 PMCID: PMC11408803 DOI: 10.1016/j.eclinm.2024.102815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 08/19/2024] [Accepted: 08/21/2024] [Indexed: 09/21/2024] Open
Abstract
Background Children can develop Long Covid, however long term outcomes and their predictors are poorly described in these patients. The primary aim is to describe characteristics and predictors of Long Covid in children assessed in-clinics up to 36 months post-SARS-CoV-2 infection, as well as investigate the role of vaccines in preventing Long Covid, risk of reinfections and development of autoimmune diseases. Methods Children aged 0-18 years old with confirmed SARS-CoV-2 infection were invited for a prospective follow-up assessment at a peadiatric post-covid clinic in Rome, Italy, at serial intervals (3-, 6-, 12-, 18-, 24- and 36-months post-infection onset, between 01/02/2020 and 28/02/2024). Long Covid was defined as persistence of otherwise unexplained symptoms for at least three months after initial infection. Findings 1319 patients were initially included, 1296 reached the 3 months follow-up or more. Of the patients who underwent multiple follow-ups, 23.2% (301), 169 (13.2%), 89 (7.9%), 67 (6.1%), 47 (7.1%) were diagnosed with Long Covid at 3-6-12-18-24 months, respectively For the primary outcome of Long Covid at three months, age >12 years (P < 0.001, OR 11.33, 95% CI 4.2; 15.15), comorbidities (P = 0.008, OR 1.83, 95% CI 1.06; 2.44), being infected with original variants (P < 0.001, OR 4.77, 95% CI 2.46; 14.47), female sex (P < 0.001, OR 1.62, 95% CI 1.02; 1.89) were statistically significant risk factors. Age >12 years (P = 0.002, OR 9.37, 95% CI 1.58; 8.64), and infection with original (P = 0.012, OR 3.52, 95% CI 1.32; 8.64) and alfa (P < 0.001, OR 4.09, 95% CI 2.01; 8.3) SARS-CoV-2 variants remained statistically significant risk factors for Long Covid duration for at least 18 months. Vaccination was associated with a lower risk of long covid at 3, 6 and 12 months for older children and a lower risk of reinfections. Being infected with the original SARS-CoV-2 variant was associated with a higher risk of new-onset autoimmune diseases ((P = 0.035, 95% CI 1.12; 2.4). One patient was diagnosed with Long Covid after a re-infection. Interpretation This is the longest follow-up study of children with SARS-CoV-2 infection, showing a significant and long-lasting burden of Long Covid in the pediatric population. Our findings highlight the urgent need of investing in pediatric Long Covid in order to find effective diagnostic and therapeutic approaches, as well can inform preventive strategies in case of future pandemics. Funding This study has been funde by Pfizer non-competitive grant, granted to DB (#65925795).
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Affiliation(s)
- Anna Camporesi
- Pediatric Anesthesia and Intensive Care, V. Buzzi Children's Hospital, Milano, Italy
| | - Rosa Morello
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Anna La Rocca
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Medicine ans Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giuseppe Zampino
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Federico Vezzulli
- Department of Pathophysiology and Transplantation, University of Milano, Milano, Italy
| | - Daniel Munblit
- Care for Long Term Conditions Division, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Francesca Raffaelli
- UOC Malattie Infettive - Dipartimento Scienze Mediche e Chirurgiche -. Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Centro di Salute Globale, Università Cattolica del Sacro Cuore, Rome, Italy
- Area Pediatrica, Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
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Martino L, Morello R, De Rose C, Buonsenso D. Persistent respiratory symptoms associated with post-Covid condition (Long Covid) in children: a systematic review and analysis of current gaps and future perspectives. Expert Rev Respir Med 2023; 17:837-852. [PMID: 37844017 DOI: 10.1080/17476348.2023.2271836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 10/13/2023] [Indexed: 10/18/2023]
Abstract
INTRODUCTION There is increasing evidence that also children can develop Long Covid. However, there are no specific reviews providing a clear description of reported respiratory symptoms and potential diagnostics. AREAS COVERED We performed on PubMed a systematic search of studies conducted on children aged less than 18 years with previous SARS-CoV-2 infection complaining about persistent respiratory symptoms; the aim of our review is to characterize the incidence, pattern and duration of respiratory symptoms after the acute infection in pediatric population. EXPERT OPINION Children can develop persisting respiratory symptoms, as documented by several follow-up studies both including or not control groups of non-infected children. However, the methodological variabilities of the analyzed studies does not allow to provide firm conclusions about the rate, type and best diagnostics for children with persistent respiratory symptoms. Future studies should investigate on larger pediatric cohorts the role of noninvasive diagnostics and new biomarkers as well as investigating therapeutic options both during acute infection or when Long Covid has been diagnosed.
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Affiliation(s)
- Laura Martino
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Rosa Morello
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Cristina De Rose
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Centro di Salute Globale, Università Cattolica del Sacro Cuore, Roma, Italia
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Seery V, Raiden S, Penedo JMG, Borda M, Herrera L, Uranga M, Marcó Del Pont M, Chirino C, Erramuspe C, Alvarez LS, Lenoir M, Morales LD, Davenport C, Huespe Auchter S, Monsalvo L, Sastoque L, Gavazzi M, Russo C, Sananez I, Pando MDLÁ, Laufer N, Muiños R, Ferrero F, Geffner J, Arruvito L. Persistent symptoms after COVID-19 in children and adolescents from Argentina. Int J Infect Dis 2023; 129:49-56. [PMID: 36736574 PMCID: PMC9892252 DOI: 10.1016/j.ijid.2023.01.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 01/10/2023] [Accepted: 01/24/2023] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES Although long COVID-19 is widely recognized in adults, less information is available about this condition in children, especially in developing countries. Here, we studied the long-term symptoms of SARS-CoV-2 infection beyond 3 months and the associated risk factors in a pediatric population. METHODS This observational study included 639 Argentinian children and adolescents with previously confirmed COVID-19 from June 2020-June 2021 and 577 children without previous COVID-19. Parents completed a survey about symptoms that their child had for >3 months after the diagnosis of SARS-CoV-2 infection. RESULTS At least one persistent symptom was observed more frequently in children with previous COVID-19 than in the non-COVID-19 group (34% vs 13%, P <0.0001). SARS-CoV-2 infection increased the risk of headache, dizziness, loss of taste, dyspnea, cough, fatigue, muscle pain, and loss of weight by three- to seven-fold. The loss of smell was only reported in infected children. After controlling for the other variables, older age, symptomatic COVID-19, and comorbidities were independent predictors of long-term symptoms. CONCLUSIONS One-third of children experienced persistent symptoms after COVID-19. Older age, symptomatic infection, and comorbidities were shown to be risk factors for long COVID-19. Pediatric long COVID-19 is a new condition that requires further investigation.
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Affiliation(s)
- Vanesa Seery
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Facultad de Medicina, UBA-CONICET, Paraguay 2155, C1121ABG CABA, Argentina
| | - Silvina Raiden
- Hospital General de Niños Pedro de Elizalde, Av. Montes de Oca 40, C1270 CABA, Argentina
| | - Juan Martín Gómez Penedo
- Laboratorio de Análisis Estadísticos, Secretaría de Investigaciones, Facultad de Psicología. UBA- CONICET. Av. Hipólito Yrigoyen 3242, C1207ABR CABA, Argentina
| | - Mauricio Borda
- Hospital Pediátrico Juan Pablo II, Av. Artigas 1435, W3400, Corrientes, Argentina
| | - Largión Herrera
- Hospital Dr. Salvador Mazza, Sta. Josefa Rosello 356, H3540, Chaco, Argentina
| | - Macarena Uranga
- Hospital Universitario Austral, Av. Juan Domingo Perón 1500, B1629, Buenos Aires, Argentina
| | - María Marcó Del Pont
- Hospital Universitario Austral, Av. Juan Domingo Perón 1500, B1629, Buenos Aires, Argentina
| | - Carina Chirino
- Policlínico Regional Juan Domingo Perón, Maipú 450, D5732, San Luis, Argentina
| | - Constanza Erramuspe
- Policlínico Regional Juan Domingo Perón, Maipú 450, D5732, San Luis, Argentina
| | - Laura Silvana Alvarez
- Hospital Universitario Austral, Av. Juan Domingo Perón 1500, B1629, Buenos Aires, Argentina
| | - Melisa Lenoir
- Hospital Universitario Austral, Av. Juan Domingo Perón 1500, B1629, Buenos Aires, Argentina
| | | | - Carolina Davenport
- Hospital General de Niños Pedro de Elizalde, Av. Montes de Oca 40, C1270 CABA, Argentina
| | | | - Liliana Monsalvo
- Hospital Dr. Salvador Mazza, Sta. Josefa Rosello 356, H3540, Chaco, Argentina
| | - Laura Sastoque
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Facultad de Medicina, UBA-CONICET, Paraguay 2155, C1121ABG CABA, Argentina
| | - Magalí Gavazzi
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Facultad de Medicina, UBA-CONICET, Paraguay 2155, C1121ABG CABA, Argentina
| | - Constanza Russo
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Facultad de Medicina, UBA-CONICET, Paraguay 2155, C1121ABG CABA, Argentina
| | - Inés Sananez
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Facultad de Medicina, UBA-CONICET, Paraguay 2155, C1121ABG CABA, Argentina
| | - María de Los Ángeles Pando
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Facultad de Medicina, UBA-CONICET, Paraguay 2155, C1121ABG CABA, Argentina
| | - Natalia Laufer
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Facultad de Medicina, UBA-CONICET, Paraguay 2155, C1121ABG CABA, Argentina
| | - Roberto Muiños
- Laboratorio de Análisis Estadísticos, Secretaría de Investigaciones, Facultad de Psicología. UBA- CONICET. Av. Hipólito Yrigoyen 3242, C1207ABR CABA, Argentina
| | - Fernando Ferrero
- Hospital General de Niños Pedro de Elizalde, Av. Montes de Oca 40, C1270 CABA, Argentina
| | - Jorge Geffner
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Facultad de Medicina, UBA-CONICET, Paraguay 2155, C1121ABG CABA, Argentina
| | - Lourdes Arruvito
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Facultad de Medicina, UBA-CONICET, Paraguay 2155, C1121ABG CABA, Argentina.
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