Long-term COVID-19 a problem for children

CALGARY - Their symptoms may be less severe, but a study shows that nearly six per cent of children with COVID-19 still reported symptoms three months later.

The eight-country study included 1,884 kids aged 17 and younger who went to an emergency department with COVID-19 and had 90-day followups.

Long-term COVID-19 was found in nearly 10 per cent of children who were admitted to hospital and five per cent of children who were seen in an emergency department and discharged.

The study involved the University of Calgary's Cumming School of Medicine, the University of California, Davis School of Medicine in Sacramento, Calif., Ann and Robert H. Lurie Children's Hospital of Chicago and Chicago's Northwestern University Feinberg School of Medicine.

It was peer-reviewed and published in JAMA Network Open on Friday.

The study says long COVID was more likely in children aged 14 and older who had spent time in hospital with more severe symptoms.

"We found that in some children, illness with COVID-19 is associated with reporting persistent symptoms after three months," said principal investigator Dr. Stephen Freedman, a pediatric emergency medicine physician and a clinician-scientist in the Cumming School of Medicine.

"Our results suggest that appropriate guidance and followup are needed, especially for children at high risk for long COVID."

The most reported persistent symptoms in children were fatigue or weakness, cough, difficulty breathing or shortness of breath.

The study focused on emergency room admissions as opposed to community or school locations because researchers were able to piggy back on another study about pediatric pneumonia that was already underway more than two years ago.

"In the context of this emerging disease, everyone was in a really urgent state to get studies up and running. So we actually had a really nice infrastructure to quickly build on," said Dr. Anna Funk, an infectious disease immunologist and co-principal investigator on the study from the Cumming School of Medicine.

"They weren't necessarily admitted into the hospital and they didn't all come in a state of emergency. But they came in to be tested, which might have been the testing centre or the easiest place to get a test at four in the morning," she added.

Funk said if the study had involved children with milder cases outside an emergency room, the long-term rate would likely have been somewhat lower.

Of the patients who were followed, she said, a majority were quite young. The average age was three.

"We did also find it was more likely that children who were older, older than 14, were more likely to report these post-COVID conditions as well."

The study was able to do followups with 80 per cent of the patients up to 90 days but Funk thinks more research should be done to find out if the health problems are chronic.

The study found reported rates of long COVID in adults are substantially higher than what was found in children.

"Unfortunately, there are no known therapies for long COVID in children and more research is needed in this area," said Dr. Todd Florin from Ann and Robert H. Lurie Children's Hospital of Chicago.

"However, if symptoms are significant, treatment targeting the symptoms is most important. Multidisciplinary care is warranted if symptoms are impacting quality of life."

Funk said one thing parents could take from the results is that vaccinations are something to seriously consider.

"Six per cent is still one in 20 children and that may concern some people when they're thinking about vaccinating their children," she said.

"We know vaccines are known to reduce severe illness, so this would seem to be a nice intervention in order to possibly reduce post-COVID conditions in children."