AN EVOLVING PICTURE:
‘Long COVID’ describes both ongoing symptomatic COVID-19 (5–12 weeks after onset) and post-COVID-19 syndrome (≥12 weeks after onset).1 Long COVID is also a patient-preferred term2 so will be used throughout this editorial to describe symptoms lasting ≥4 weeks after an acute episode of COVID-19.
As the phenomenon of long COVID emerged and came to be recognised, including with the publication of the guideline by the National Institute for Health and Care Excellence, Scottish Intercollegiate Guideline Network, and the Royal College of General Practitioners,1 there was still limited evidence about whether children and young people could suffer with prolonged symptoms following an acute COVID-19 infection. The general opinion was still that SARS-CoV-2 was a mild infection in the young.3
Narratives emerged, however, from parents describing prolonged problems in their children, following an acute COVID- 19 infection,4 and this was borne out in the scientific literature.5
Jasmin (young person with long COVID) describes her situation: ‘I’m Jasmin. I am 11 years old and I have suffered from long COVID for over a year. I was perfectly fit and happy, and enjoyed doing sports. Having long COVID has really changed my life in many different ways. I can’t go to school much anymore, I don’t see my friends, I can’t exercise, I can’t even walk far without a wheelchair. I think that a lot of people don’t understand what the illness is and how difficult it is for me.’
The prevalence of long COVID in children is disputed. Evidence from the CLoCK study,6 which recruited a cohort of 11–17- year- olds from the general UK population between January and March 2021, gives a broad estimate. The study reported 66.5% of children had symptoms 3 months after a positive polymerase chain reaction (PCR) test, compared with 53.3% who had a negative test; 30.3% versus 16.2% had ≥3 symptoms at 3 months. The big limitation of this study was the response rate of only 13.4%. The researchers say that if this 13.4% is representative of all 11–17 year olds who have tested positive for COVID-19, over 32 000 (one in seven) young people throughout England would still have ≥3 physical symptoms 3 months later. However, if only teenagers who responded to the survey had any persisting problems and those who chose not to respond had completely recovered, this would mean a best-case scenario of 4000 cases of long COVID in children and young people.
The Office for National Statistics prevalence estimates indicate that 149 000 children and young people (aged 5–16 years) had symptoms lasting for ≥4 weeks after infection, 31 000 of whom have had symptoms for over a year.7 The impact of the Delta and Omicron waves on these figures is yet to be determined.
Read the rest of this article HERE.
Source: Carolyn A Chew-Graham, Tracy A Briggs and Binita Kane. Long COVID in children and young people: uncertainty and contradictions. British Journal of General Practice 2022; 72 (719): 253-254. DOI: https://doi.org/10.3399/bjgp22X719501 https://bjgp.org/content/72/719/253 (Full text)