International study identifies risks for long COVID in children

Nearly six per cent of children who presented to the Emergency Department (ED) with COVID-19 reported symptoms of long COVID 90 days later, according to a study conducted in eight countries and published in JAMA Network Open. Initial hospitalization of 48 or more hours, four or more symptoms at the initial ED visit, and age 14 years or older were associated with long COVID.

“We found that in some children, illness with COVID-19 is associated with reporting persistent symptoms after three months,” says principal investigator Dr. Stephen Freedman, MD, paediatric emergency medicine physician with Alberta Health Services, and associate professor of medicine at the Cumming School of Medicine (CSM).

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

The study included 1,884 children with COVID-19 who had 90-day followup. Long COVID was found in nearly 10 per cent of hospitalized children and five per cent in children discharged from the ED. Dr. Anna Funk, PhD, an epidemiologist and UCalgary postdoctoral fellow, was lead author of the study.

“Reported rates of long COVID in adults are substantially higher than what we found in children,” says co-principal investigator Dr. Nathan Kuppermann, MD, MPH, from University of California, Davis School of Medicine, Sacramento.

“Our findings can inform public health policy decision regarding COVID-19 mitigation strategies for children and screening approaches for long COVID among those with severe outcomes.”

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

“Our finding that children who had multiple COVID-19 symptoms initially were at higher risk for long COVID is consistent with studies in adults,” says co-principal investigator Dr. Todd Florin, MD, MSCE, from Ann & Robert H. Lurie Children’s Hospital of Chicago and Northwestern University Feinberg School of Medicine.

“Unfortunately, there are no known therapies for long COVID in children and more research is needed in this area. However, if symptoms are significant, treatment targeting the symptoms is most important. Multidisciplinary care is warranted if symptoms are impacting quality of life.”