In a recent study published in Nature Communications, researchers compared seropositive and seronegative children between the ages of six months and 17 years to evaluate the chance aspects and prevalence of persistent symptoms of post-coronavirus disease (COVID) syndrome.

Study: A population-based serological study of post-COVID syndrome prevalence and risk aspects in children and adolescents. Image Credit: Alyona Shu/Shutterstock

Background

While long COVID symptoms and mechanisms have been extensively investigated in adult populations, the knowledge on the prevalence and diagnosis of long COVID or post-COVID syndrome in pediatric populations stays unclear. The dearth of knowledge on pediatric post-COVID syndrome can partly be explained by methodological challenges, equivalent to the absence of an official standardized definition for the occurrence of long COVID-like symptoms amongst children until now.

Some studies that reported the next prevalence of post-COVID symptoms in children didn’t include a control group, which is problematic since persistent symptoms from other viral infections could lead on to an overestimation of the prevalence of post-COVID symptoms.

Moreover, the usage of samples with confirmed reverse transcription polymerase chain response (RT-PCR) tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) excludes asymptomatic cases, leading to an underestimation of the infected population.

The prevalence of post-COVID symptoms within the pediatric population must be explored from a serological perspective using a non-infected control cohort to form a standardized diagnosis of the syndrome.

Concerning the study

In the current study, the researchers used data from an ongoing, prospective cohort study called SEROCoV-KIDS in Geneva, Switzerland, which longitudinally evaluates the health and development-related impacts of the coronavirus disease 2019 (COVID-19) pandemic in children and adolescents.

Baseline assessment included collecting blood samples to check for antibodies against SARS-CoV-2 nucleoprotein and a web-based questionnaire filled out by the parent or legal guardian, which evaluated the health and development of the parents and kids. The information also included information on sociodemographic aspects equivalent to sex, age, household financial status, and education level of the parents.

The baseline data comprised information on symptoms in children lasting a minimum of 4 weeks, regardless of the SARS-CoV-2 infection status. The information were then classified into different groups based on duration and kinds, including general, cardiovascular, respiratory, neurological, gastrointestinal, dermatological, or musculoskeletal. The severity of the symptoms was also assessed based on their impact on the kid’s each day life.

SARS-CoV-2 infections and seropositivity were measured using RT-PCR tests and serological assays. Anti-nucleoprotein antibodies were chosen to distinguish between the immune responses elicited by infections and people elicited by vaccination for the reason that approved vaccines throughout the study period comprised messenger ribonucleic acid (mRNA) vaccines that generated only anti-spike protein antibodies.

Results

The outcomes suggested that a big variety of pediatric patients suffered from persistent post-COVID syndrome symptoms, with the age-stratified evaluation indicating adolescents to be at substantial risk. Age, underlying chronic health conditions equivalent to asthma, and lower socioeconomic status were necessary post-COVID syndrome risk aspects.

Including asymptomatic or mildly symptomatic COVID-19 cases resulted in a lower estimation of post-COVID syndrome prevalence in comparison with other studies that only analyzed positive RT-PCR samples. The lower prevalence may be explained by recent SARS-CoV-2 infections which have not yet resulted within the manifestation of long-term symptoms.

Predominant post-COVID symptoms included abdominal pain, anosmia, difficulty concentrating, muscle pain, headaches, difficulty respiration, and constipation, with seropositive children experiencing higher severity of symptoms. Moreover, the increased likelihood of youngsters from a lower socioeconomic background experiencing post-COVID symptoms indicates higher susceptibility to SARS-CoV-2, higher incidence of comorbidities, and unequal vaccine uptake based on socioeconomic status.

While the outcomes already indicate the next prevalence of post-COVID symptoms in adolescents, the authors expect the worth to be higher in point of fact since adolescents are generally less forthcoming to their parents about their health concerns. The high prevalence of post-COVID symptoms amongst adolescents is concerning because it could exacerbate the already detrimental impacts of the COVID-19 pandemic on the mental and physical health and social lifetime of adolescents.

The usage of serological data within the assessment and the addition of mild and asymptomatic cases, in addition to a non-infected control group, were a number of the study’s strengths. Using serological tests circumvented the parental bias that would occur while reporting persistent symptoms. At the identical time, the parent-reported questionnaire was also a limitation for the reason that answers might have been influenced by their very own experiences.

Conclusions

Overall, the outcomes indicated that a big proportion of the pediatric seropositive population experienced persistent post-COVID symptoms. The adolescent population is at an increased risk of developing post-COVID syndrome, with socioeconomic status and chronic health conditions being other risk aspects.

While further research is required for a between understanding of post-COVID syndrome in children, the outcomes highlighted the necessity to develop strategies for detecting and managing these symptoms in children.