In a recent study published within the journal JAMA Network Open, a team of researchers investigated the prevalence of post-coronavirus disease 2019 (COVID-19) condition (PCC), also often known as long-COVID, in adolescents and young adults who experienced acute severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) but weren’t hospitalized.

Study: Prevalence and Characteristics Associated With Post–COVID-19 Condition Amongst Nonhospitalized Adolescents and Young Adults. Image Credit: fizkes/Shutterstock.com

Background

Post-COVID-19 condition comprises a wide selection of persistent symptoms comparable to shortness of breath, fatigue, headaches, post-exertional malaise, and ‘brain fog’ or cognitive impairments lasting greater than three months after recovering from the SARS-CoV-2 infection.

The prevalence of PCC in adolescents and youngsters stays unclear, with meta-analysis reports indicating a 32–62% occurrence of fatigue.

Various prospective cohort studies have also reported the occurrence of post-infective fatigue syndrome after infections with giardiasis, mononucleosis, and fever, where patients experience persistent symptoms comparable to fatigue causing severe disability despite clinical examination findings being scarce.

While studies have examined aspects comparable to endotheliopathy, immune function dysregulation, inflammatory responses, and viral reservoirs as possible mechanisms of PCC, indirect stressors comparable to fear of the virus attributable to the social changes enforced through the COVID-19 pandemic are also suggested as possible contributors to PCC.

Nonetheless, there are few studies examining the prevalence of PCC in non-hospitalized adolescents and young adults with COVID-19.

Concerning the study

The current study examined two cohorts of non-hospitalized young adults and adolescents who tested positive or negative for SARS-CoV-2  through a reverse-transcriptase polymerase chain response (RT-PCR) test.

The participants were followed-up at six and 12 months. Throughout the study period, the Alpha variant of SARS-CoV-2 was dominant within the geographical area where the study was conducted.

Sex and age-matched individuals with negative RT-PCR test results for SARS-CoV-2 were included within the control cohort. The participants underwent a physical examination, cognitive function tests, a recording of the vital signs, and provided blood samples.

Standard spirometry was used to measure the forced expiratory volume in a single second forced vital capability, while an electrocardiogram was used to calculate the variability indices of the center rate. Recognition, recall, verbal learning, and dealing memory were tested through the cognitive function tests.

A spread of immune markers, including C-reactive protein, monocyte chemotactic protein, immunoglobulins M, G, and A, tumor necrosis factor α (TNF-α), interleukins, macrophage inflammatory proteins, interferon-γ, and lots of more were assayed using the plasma from the blood samples.

Antibodies against the SARS-CoV-2 nucleocapsid protein and spike protein receptor binding domain and Epstein-Barr virus were also assayed to detect previous infections.

Astrocytic activation and axonal damage within the brain were tested using assays to detect glial fibrillary acidic protein and neurofilament light chain.

Moreover, questionnaires were used to acquire information on current medications, family disease history, substance abuse, smoking behavior, levels of physical activity, etc.

The data on parents’ occupations was used to find out their socioeconomic status. Traits comparable to body vigilance, emotional awareness, neuroticism, tendencies to fret, loneliness, and quality of life were also charted.

Results

The findings indicated that although the prevalence of PCC at six months amongst adolescents and young adults who had suffered from COVID-19 but had not been hospitalized was 48.5%, the prevalence of PCC was also found to be high (47.1%) within the control group consisting of people who tested negative for SARS-CoV-2.

The outcomes suggested that the occurrence of acute COVID-19 didn’t determine the danger of PCC, and protracted symptoms at six months or more were depending on the severity of symptoms at baseline, no matter COVID-19 status.

The authors imagine that mild acute SARS-CoV-2 infections don’t drive persistent symptoms of fatigue, dyspnea, and memory-related problems and are common in the final adolescent and young adult populations.

A major rise within the occurrence of mental distress, especially amongst young people, through the COVID-19 pandemic has been reported by several studies, which might be related to persistent physical symptoms.

Subsequently, nonspecific, indirect stressors through the pandemic might be contributing to the rise in persistent symptoms of fatigue and disability, and these findings must be considered while implementing disease mitigation measures.

Conclusions

Overall, the outcomes indicated that acute SARS-CoV-2 infections in young adults and adolescents should not driving the persistent symptoms of fatigue, dyspnea, and brain fog.

Nonetheless, psychosocial aspects, unique or exacerbated through the COVID-19 pandemic, might be related to these persistent symptoms and disability.

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