Postacute sequelae of SARS-CoV-2 in children
Rao, S; Gross, RS; Mohandas, S; et al., Pediatrics
Published
March 2024
Journal
Pediatrics
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has caused significant medical, social, and economic impacts globally, both in the short and long term. Although most individuals recover within a few days or weeks from an acute infection, some experience longer lasting effects. Data regarding the postacute sequelae of severe acute respiratory syndrome coronavirus 2 infection (PASC) in children, or long COVID, are only just emerging in the literature. These symptoms and conditions may reflect persistent symptoms from acute infection (eg, cough, headaches, fatigue, and loss of taste and smell), new symptoms like dizziness, or exacerbation of underlying conditions. Children may develop conditions de novo, including postural orthostatic tachycardia syndrome, myalgic encephalomyelitis/chronic fatigue syndrome, autoimmune conditions and multisystem inflammatory syndrome in children. This state-of-the-art narrative review provides a summary of our current knowledge about PASC in children, including prevalence, epidemiology, risk factors, clinical characteristics, underlying mechanisms, and functional outcomes, as well as a conceptual framework for PASC based on the current National Institutes of Health definition. We highlight the pediatric components of the National Institutes of Health-funded Researching COVID to Enhance Recovery Initiative, which seeks to characterize the natural history, mechanisms, and long-term health effects of PASC in children and young adults to inform future treatment and prevention efforts. These initiatives include electronic health record cohorts, which offer rapid assessments at scale with geographical and demographic diversity, as well as longitudinal prospective observational cohorts, to estimate disease burden, illness trajectory, pathobiology, and clinical manifestations and outcomes.
Authors
Suchitra Rao, Rachel S Gross, Sindhu Mohandas, Cheryl R Stein, Abigail Case, Benard Dreyer, Nathan M Pajor, H Timothy Bunnell, David Warburton, Elizabeth Berg, Jonathan B Overdevest, Mark Gorelik, Joshua Milner, Sejal Saxena, Ravi Jhaveri, John C Wood, Kyung E Rhee, Rebecca Letts, Christine Maughan, Nick Guthe, Leah Castro-Baucom, Melissa S Stockwell
Keywords
Child; Humans; Autoimmune Diseases; COVID-19/complications/epidemiology; Disease Progression; Observational Studies as Topic; Post-Acute COVID-19 Syndrome; SARS-CoV-2; Systemic Inflammatory Response Syndrome; United States
Short Summary
This paper talks about Long COVID in children. Long COVID is when a person still feels sick for at least 3 months after having COVID-19. This paper looks at how common it is, who gets it, what causes it, and what happens to children who have it. Researchers from the RECOVER study and other groups across the US looked at earlier studies about children and Long COVID. They put together what those studies found and think that up to 5.8 million children in the US might have Long COVID. The researchers talked about their plan for better understanding Long COVID by using RECOVER’s definition of Long COVID and what RECOVER has learned so far. Authors of this paper share that future research on Long COVID in children should do the following: 1) describe Long COVID symptoms and how they show up together in groups, 2) understand why some children get Long COVID and others don’t, 3) learn how symptoms come back when children get stressed or get COVID again, 4) find ways to stop hidden health problems from turning into long-term issues in adulthood, and 5) see if COVID vaccines can stop Long COVID from showing up. The authors of this paper also believe that more research should be done to find good treatments, test different medicines, and compare different ways to help children with Long COVID.