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Long COVID Symptoms in a Prospective Cohort of Exposed and Infected Children and Adolescents and Their Parents One Year After SARS-CoV-2 Infection
22 Pages Posted: 3 Mar 2022
More...Abstract
Background: Long COVID in children and adolescents remains poorly understood due to a lack of well-controlled studies with long-term follow-up. In particular, the impact of the family context in persistent symptoms following SARS-CoV-2 infection remains unknown. We examined long COVID symptoms in a cohort of infected children, adolescents, and adults and their exposed but non-infected household members approximately 1 year after infection and investigated clustering of persistent symptoms within households.
Methods: 1267 members of 341 households (404 children aged <14 years, 140 adolescents aged 14-18 years and 723 adults) were categorized as having had either a SARS-CoV-2 infection or household exposure to SARS-CoV-2 without infection, based on three serological assays and history of laboratory-confirmed infection. Participants completed questionnaires assessing the presence of Long COVID symptoms 11-12 months after infection in the household using online questionnaires.
Findings: The prevalence of moderate or severe persistent symptoms was significantly higher elevated in infected than in exposed women (36.4% vs 14.2%), infected men (22.9% vs 10.3%) and infected adolescent girls (32.1% vs 8.9%). However, moderate or severe persistent symptoms were not more common in infected adolescent boys aged 14-18 or in children <14 years than in their exposed counterparts. The number of persistent symptoms reported by individuals was associated with the number of persistent symptoms reported by their household members.
Interpretation: In this well-controlled, multi-centre study, infected men, women and adolescent girls were at increased risk of negative outcomes 11-12 months after SARS-CoV-2 infection. Amongst non-infected adults, prevalence of negative outcomes was also high. Prolonged symptoms tended to cluster within families, suggesting family-level interventions for long COVID could prove useful.
Trial Registration Details: The study was registered at the German Clinical Trials Register (DRKS), study ID 00021521.
Funding Information: Ministry of Science, Research and the Arts, Baden-Württemberg, Germany.
Declaration of Interests: The authors declare that they have no relevant conflicts of interest.
Ethics Approval Statement: The study was conducted by the University Children’s Hospitals in Freiburg, Heidelberg, Tübingen and Ulm, Germany. Ethics approval was obtained from the Medical Faculties’ independent ethics committees (Freiburg: 256/20_201553; Heidelberg: S-294/2020; Tübingen: 293/2020BO2; Ulm: 152/20). Written informed consent was obtained from adults and from parents of children at both time points. Children gave written assent where age-appropriate and their preferences on whether to provide blood samples were respected. The study was conducted according to the Declaration of Helsinki, and designed, analysed and reported according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guidelines.
Keywords: COVID-19, Long COVID, Post-COVID syndrome, Children and young people, Paediatric, Adolescents, Families, SARS-CoV-2
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