Children with Covid-19 who present with four or more symptoms at the first visit are more likely to develop symptoms of long COVID after 3 months, according to a new study in JAMA Network Open.¹

Researchers from Europe, US and Australia examined 1884 children for post–COVID-19 conditions 90 days after they tested positive for Covid-19. These children were selected from 36 emergency departments (EDs) within the Pediatric Emergency Research Network in 8 countries between March 7, 2020, and January 20, 2021 and their median age was 3 years. More than half were boys. Fever was the most common symptom (~66%) with which these children presented to the ED. The other common symptoms were cough (48.7%) and rhinorrhea or congestion (47.4%).

The prospective study found that nearly 6% of Covid-positive children who presented to the Emergency department or hospital developed post-Covid symptoms within 90 days after discharge. Hospitalized children were more at risk. Almost 10% of children who required hospitalization developed symptoms of long Covid versus 4.6% of those who were not hospitalized. The most common symptom among these children was fatigue or weakness.

Children who were hospitalized for 48 hours or more likely to develop at least one long Covid symptom with adjusted odds ratio (aOR) of 2.67.The probability of developing long Covid increased in proportion to the number of symptoms during the acute infection; the aOR for ≥4 symptoms was 2.35, while for 7 or more symptoms, the aOR was 4.59.

Age of the child was also found to influence the risk of long Covid. Long Covid was more common in older children (≥14 years) than in those younger than one year of age. Covid-positive children, both hospitalized and non-hospitalized, had greater probability of developing post-Covid symptoms compared to children who were negative for SARS-CoV-2 with a difference of 5.2%.

This study has shown that children who tested positive for Covid-19 are at risk of post-Covid. The number of presenting symptoms during the index visit, duration of hospitalization and older age of the child were found to increase the risk of long Covid. Hence, children with these risk factors should be particularly screened for symptoms of post-Covid during follow-up.

Reference

1. Anna L Funk, et al. Post-COVID-19 Conditions Among Children 90 Days After SARS-CoV-2 Infection. JAMA Netw Open. 2022 Jul 1;5(7):e2223253. doi: 10.1001/jamanetworkopen.2022.23253.