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Thors V, Bjornsdottir KL, Love TJ, Haraldsson A. Long COVID in Icelandic Children: A Matched Cohort Study of Nonspecific Symptoms Following SARS-CoV-2 Infection. Pediatr Infect Dis J 2024; 43:226-233. [PMID: 37991394 DOI: 10.1097/inf.0000000000004187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
PURPOSE Pediatric severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infections are usually mild and the mortality rates are low, but concerns have been raised about long-term symptoms that may resemble other postinfectious syndromes. Studies with robust control groups and high response rates have been few. METHODS We obtained identifiers for all 837 Icelandic children diagnosed with SARS-CoV-2 by PCR between March 2020 and June 2021 and contacted them by telephone. We asked about 10 physical and mental symptoms being present at least twice weekly for at least 2 months. Participants who reported symptoms were contacted again a year later. For each subject who completed the questionnaire, an age- and sex-matched comparator without SARS-CoV-2 infection was asked to complete the same questionnaire, and the risk difference was calculated. RESULTS Responses from 643 cases and 602 comparators were analyzed. Children who had been infected with SARS-CoV-2 were more likely to report one or more symptoms, except for anxiety/depression and sleep disturbances. Fatigue and loss of concentration were evidently more common in cases among teenagers (risk difference: 15%; 95% CI: 7-22% and 15%; 95% CI: 7-23%, respectively). At the second follow-up, close to a third of Long COVID cases had resolved but some participants had developed new persistent symptoms. CONCLUSION Symptoms of Long COVID in children are common and impact their quality of life. The importance of further unraveling the pathophysiology of acute and long-term symptoms following SARS-CoV-2 infection in children is vital as well as potential preventive measures.
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Affiliation(s)
- Valtyr Thors
- From the Children's Hospital Iceland, Landspitali, University Hospital Reykjavik, Iceland
- University of Iceland, Faculty of Medicine, Reykjavik, Iceland
| | | | - Thorvardur Jon Love
- University of Iceland, Faculty of Medicine, Reykjavik, Iceland
- Landspitali, University Hospital, Reykjavik, Iceland
| | - Asgeir Haraldsson
- From the Children's Hospital Iceland, Landspitali, University Hospital Reykjavik, Iceland
- University of Iceland, Faculty of Medicine, Reykjavik, Iceland
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Munro A, Buonsenso D, González-Dambrauskas S, Hughes RC, Bhopal SS, Vásquez-Hoyos P, Cevik M, Rubio MLM, Roland D. In-person schooling is essential even during periods of high transmission of COVID-19. BMJ Evid Based Med 2023; 28:175-179. [PMID: 37068921 DOI: 10.1136/bmjebm-2023-112277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/02/2023] [Indexed: 04/19/2023]
Affiliation(s)
- Alasdair Munro
- NIHR Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Center for Global Health Research Studies, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Sebastián González-Dambrauskas
- Red Colaborativa Pediátrica de Latinoamérica (LARed Network), Montevideo, Uruguay
- Departamento de Pediatría y Unidad de Cuidados Intensivos de Niños del Centro Hospitalario Pereira Rossell, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - Robert C Hughes
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Sunil S Bhopal
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Pablo Vásquez-Hoyos
- Departamento de Pediatria, Sociedad de Cirugía de Bogotá Hospital de San José, Bogota, Colombia
- Departamento de Pediatría, Facultad de Medicina, Universidad Nacional de Colombia, Bogota, Colombia
- Red Colaborativa Pediátrica de Latinoamérica (LARed Network), Bogota, Colombia
| | - Muge Cevik
- Division of Infection and Global Health Research, School of Medicine, University of St Andrews, Edinburgh, UK
| | - Maria Lucia Mesa Rubio
- Facultad de Medicina, Universidad de Los Andes, Bogotá, Colombia
- Pediatra Social Hospital Universitario Fundación Santa fe de Bogotá, Bogota, Colombia
| | - Damian Roland
- Paediatric Emergency Medicine Leicester Academic (PEMLA) group, Children's Emergency Department, Leicester Royal Infirmary, Leicester, UK
- SAPPHIRE Group, Health Sciences, University of Leicester, Leicester, UK
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Ahmed A, DeWitt ME, Dantuluri KL, Castri P, Buahin A, LaGarde WH, Weintraub WS, Rossman W, Santos RP, Gibbs M, Uschner D. Characterisation of infection-induced SARS-CoV-2 seroprevalence amongst children and adolescents in North Carolina. Epidemiol Infect 2023; 151:e63. [PMID: 37009915 PMCID: PMC10154644 DOI: 10.1017/s0950268823000481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 03/15/2023] [Accepted: 03/22/2023] [Indexed: 04/04/2023] Open
Abstract
Few prospective studies have documented the seropositivity among those children infected with severe acute respiratory syndrome coronavirus 2. From 2 April 2021 to 24 June 2021, we prospectively enrolled children between the ages of 2 and 17 years at three North Carolina healthcare systems. Participants received at least four at-home serological tests detecting the presence of antibodies against, but not differentiating between, the nucleocapsid or spike antigen. A total of 1,058 participants were enrolled in the study, completing 2,709 tests between 1 May 2021 and 31 October 2021. Using multilevel regression with poststratification techniques and considering our assay sensitivity and sensitivity, we estimated that the seroprevalence of infection-induced antibodies among unvaccinated children and adolescents aged 2-17 years in North Carolina increased from 15.2% (95% credible interval, CrI 9.0-22.0) in May 2021 to 54.1% (95% CrI 46.7-61.1) by October 2021, indicating an average infection-to-reported-case ratio of 5. A rapid rise in seropositivity was most pronounced in those unvaccinated children aged 12-17 years, based on our estimates. This study underlines the utility of serial, serological testing to inform a broader understanding of the regional immune landscape and spread of infection.
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Affiliation(s)
- Amina Ahmed
- Levine Children’s Hospital, Atrium Health, Charlotte, NC, USA
- Department of Internal Medicine, Section on Infectious Diseases, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Michael E. DeWitt
- Department of Internal Medicine, Section on Infectious Diseases, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | | | - Paola Castri
- Department of Internal Medicine, Section on Infectious Diseases, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Asare Buahin
- Milken School of Public Health, George Washington University, Washington, DC, USA
| | - William H. LaGarde
- Department of Pediatrics, WakeMed Health and Hospitals, Raleigh, NC, USA
| | - William S. Weintraub
- MedStar Healthcare Delivery Research Network, MedStar Health Research Institute, Washington, DC, USA
- MedStar Healthcare Delivery Research Network, Georgetown University, Washington, DC, USA
| | - Whitney Rossman
- Center for Outcomes Research and Evaluation, Atrium Health, Charlotte, NC, USA
| | | | - Michael Gibbs
- Department of Emergency Medicine, Atrium Health, Charlotte, NC, USA
| | - Diane Uschner
- Milken School of Public Health, George Washington University, Washington, DC, USA
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Perez CA, Ormazabal I, Pérez-Valenzuela J, Araya A, Medina RA, Perret C. Clinical and epidemiological characteristics of SARS-CoV-2 virus in ambulatory children under 2 years old. Front Pediatr 2022; 10:957273. [PMID: 36523397 PMCID: PMC9745022 DOI: 10.3389/fped.2022.957273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 11/11/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND SARS-CoV-2 is an emerging virus that has mainly affected adults; hence, most clinical information has been derived from that population. Most pediatric cases are mild and with nonspecific symptoms requiring outpatient management. Children are a major source of spread for most traditional respiratory viruses. Their role in SARS-CoV-2 transmission was thought to be relevant. Children under the age of two comprise a group that is more susceptible to infection since vaccines have not been approved for them until recently. The knowledge of clinical manifestation of COVID-19 in young children is scarce. OBJECTIVES To describe the clinical, epidemiological, and demographic characteristics of children under 2 years old with confirmed COVID-19, who did not require hospitalization. METHODS This descriptive study was performed from May, 2020 to June, 2021. Children ages 0-2 years with COVID-19, confirmed by transcriptase-polymerase chain reaction assay that were performed in laboratories of the Red de Salud UC CHRISTUS Health Network, were selected to be contacted. If the parents accepted participating and their children were not hospitalized, a survey was sent to the patients' caregivers. RESULTS Of the 242 cases, 159 caregivers answered the survey (65.7%). The median age of the subjects was 14 months, and 53.5% were males. Fifty percent had comorbidities, of which one third corresponded to atopy. Ninety eight percent were secondary cases. Most of them were infected within their households (81%). The most frequent sources were their parents, followed by their grandparents. The most common symptom was fever (78%) followed by irritability (67.3%), rhinorrhea (66%), and fatigue (64.8%). Infants less than 6 months old more often presented with conjunctival congestion and less loss of appetite compared to older children (p < 0.05). CONCLUSIONS This study provides valuable insights regarding COVID-19 in ambulatory young children. Most cases of SARS-CoV-2 infection in children under 2 years old do not require hospitalization. There was a slight male predominance, and the majority had been infected within their households. SARS-CoV-2 infection should be suspected in children under 2 years old presenting with fever, irritability, fatigue, and rhinorrhea. Children with positive household contacts and fever should also be tested for COVID-19.
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Affiliation(s)
- Carolina A Perez
- Department of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Ivana Ormazabal
- School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Andrea Araya
- Department of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rafael A Medina
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.,Advanced Interdisciplinary Rehabilitation Register (AIRR) - COVID-19 Working Group, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.,Deparment of Microbiology, Icahn School of Medicine at Mount Sinai, New York, United States
| | - Cecilia Perret
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
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