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Long COVID or Post-COVID-19 Syndrome in Children: What Do We...
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Long COVID or Post-COVID-19 Syndrome in Children: What Do We Know So Far?

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Global Pediatric Health".

Deadline for manuscript submissions: closed (15 October 2023) | Viewed by 10971

Special Issue Editors

Prof. Dr. Reinhold Kerbl

E-Mail Website
Guest Editor
Department of Pediatrics and Adolescent Medicine, LKH Hochsteiermark, 8700 Leoben, Austria
Interests: pediatric hematology/oncology; sleep medicine; preventive pediatrics; sudden infant death syndrome (SIDS); global health
Prof. Dr. Angela S. Zacharasiewicz

E-Mail Website
Guest Editor
Department of Pediatrics and Adolescent Medicine, Klinik Ottakring, 1160 Vienna, Austria
Interests: pediatrics; pulmonology; allergology; post-COVID-19 syndrome

Special Issue Information

Dear Colleagues,

Post-COVID and Long COVID are entities that are not well defined in Pediatrics and Adolescent Medicine. Altogether, prevalence as well as presentation seem to differ from what is found in adults.

See https://pubmed.ncbi.nlm.nih.gov/35994282/ and https://pubmed.ncbi.nlm.nih.gov/36194229/

In recent months, numerous publications have dealt with this issue, however terminology still remains heterogenous and study results are controversial. Prospective large-scale studies and meta-analyses are still missing, thus leaving space for individual opinions and speculations.

A Special Issue of “Children” entitled

Post-COVID and Long COVID in children – what do we know so far?

should shed more light on this issue.

As guest editors, we invite you to submit your research work. Prospective controlled (large-scale) studies are preferred, but other contributions (e.g., case series) will be also considered according to their novelty.

Prof. Dr. Reinhold Kerbl
Prof. Dr. Angela S. Zacharasiewicz
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • post-COVID
  • long COVID
  • children and adolescents
  • terminology
  • incidence
  • risk factors
  • chronic fatigue
  • psychosomatics

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Published Papers (5 papers)

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Research

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19 pages, 1446 KiB  
Article
Neuropsychological Symptoms and Quality of Life during the COVID-19 Pandemic in Children: A Survey in a Pediatric Population in the Abruzzo Region, Italy
by Chiara Marcotullio, Marina Attanasi, Annamaria Porreca, Paola Di Filippo, Sara Matricardi, Annamaria Venanzi, Marco Schiavo, Antonio Paone, Nadia Rossi, Francesco Chiarelli and Giovanni Prezioso
Children 2024, 11(5), 532; https://doi.org/10.3390/children11050532 - 28 Apr 2024
Cited by 1 | Viewed by 1374
Abstract
Background: The SARS-CoV-2 pandemic has significantly affected the pediatric population. Long-term sequelae (Long COVID-19) may particularly involve the central nervous system, with possible effects on psychological well-being and quality of life (QoL), aspects that were already influenced by the restrictive measures and general [...] Read more.
Background: The SARS-CoV-2 pandemic has significantly affected the pediatric population. Long-term sequelae (Long COVID-19) may particularly involve the central nervous system, with possible effects on psychological well-being and quality of life (QoL), aspects that were already influenced by the restrictive measures and general social impact of the pandemic. Methods: We conducted a cross-sectional survey that aims at investigating the neuropsychological effects and the QoL impairment of SARS-CoV-2 on a cohort of children and adolescents in the Abruzzo region (Italy). A questionnaire was submitted to caregivers with the help of the PEDIATOTEM platform. A control group of healthy subjects was also included to distinguish between the effects of infection from the general influence of the pandemic. Results: A total of 569 subjects responded: 396 COVID-19 patients (99 of whom had Long COVID-19) and 111 controls. After the pandemic, when compared with the COVID-19 group, the controls reported significantly increased appetite, sleeping habits, and time spent remotely with friends and a reduction in physical activity and time spent in person with friends. A significant higher rate of controls asked for psychological/medical support for emotional problems. On the other hand, the Long COVID-19 group showed more fatigue and emotional instability with respect to non-Long-COVID-19 subjects. No differences in QoL results (EuroQOL) were found between the COVID-19 patients and controls, while the Long-COVID-19 subgroup showed significantly higher rates of pain/discomfort and mood instability, as confirmed by the analysis of variation of responses from the pre-COVID-19 to the post-COVID-19 period. Conclusions: Among COVID-19 patients, neuropsychological and QoL impairment was more evident in the Long COVID-19 subgroup, although emotional and relational issues were also reported by uninfected patients, with a growing request for specialist support as a possible consequence of social restriction. Full article
(This article belongs to the Special Issue Long COVID or Post-COVID-19 Syndrome in Children: What Do We Know So Far?)
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13 pages, 427 KiB  
Article
Potential Predictors of Long COVID in Italian Children: A Cross-Sectional Survey
by Marco Schiavo, Paola Di Filippo, Annamaria Porreca, Giovanni Prezioso, Greta Orlandi, Nadia Rossi, Francesco Chiarelli and Marina Attanasi
Children 2024, 11(2), 221; https://doi.org/10.3390/children11020221 - 9 Feb 2024
Cited by 1 | Viewed by 1590
Abstract
Background: Identifying predictive factors of long COVID syndrome (LCS) is essential to preventing and managing this condition. We investigated the prevalence, symptoms, and risk factors of LCS in a cohort of Italian children and adolescents. Methods: We carried out a cross-sectional survey on [...] Read more.
Background: Identifying predictive factors of long COVID syndrome (LCS) is essential to preventing and managing this condition. We investigated the prevalence, symptoms, and risk factors of LCS in a cohort of Italian children and adolescents. Methods: We carried out a cross-sectional survey on demographic characteristics and clinical data related to COVID-19 phase and LCS in a cohort of children and adolescents, sending a questionnaire by using the PEDIATOTEM platform. Results: The prevalence of LCS was 25% (99/396). The most frequent symptoms of LCS included nasal congestion, diarrhea, headache, and fatigue. We found no association between demographic data (gender, age, and ethnicity) and LCS. Additionally, we showed that patients with concurrent allergic rhinitis, atopic dermatitis, respiratory disease, gastrointestinal disease, and rheumatologic disease had a higher risk of LCS than patients without those comorbidities. Patients experiencing fatigue, muscle, and abdominal pain in COVID-19 showed a higher risk of LCS than patients complaining of other symptoms. We found no association between vaccination and LCS. Conclusions: Specific comorbidities or symptoms during acute illness were identified as being risk factors for LCS. Understanding which are the risk factors for LCS could yield a clearer picture of its pathogenesis. Full article
(This article belongs to the Special Issue Long COVID or Post-COVID-19 Syndrome in Children: What Do We Know So Far?)
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11 pages, 253 KiB  
Article
Social Stigma in Children with Long COVID
by Danilo Buonsenso, Anna Camporesi, Rosa Morello, Cristina De Rose, Matteo Fracasso, Daniela Pia Rosaria Chieffo and Piero Valentini
Children 2023, 10(9), 1518; https://doi.org/10.3390/children10091518 - 7 Sep 2023
Cited by 7 | Viewed by 3218
Abstract
There is growing evidence that adults with Long COVID suffer from different sets of stigmata related to their condition. In children with Long COVID, this aspect has never been investigated. This study aims to investigate if children with Long COVID also experience stigma. [...] Read more.
There is growing evidence that adults with Long COVID suffer from different sets of stigmata related to their condition. In children with Long COVID, this aspect has never been investigated. This study aims to investigate if children with Long COVID also experience stigma. Methods: Children with a previous SARS-CoV-2 infection evaluated at 3 month follow-ups in a pediatric post COVID unit were asked to fill in an online Long COVID Stigma Scale survey before they were assessed by a pediatrician. Doctors were unaware of children’s responses when they performed a diagnosis of Long COVID or full recovery from previous infection, according to the World Health Organization definition of pediatric Long COVID. Responses to the Stigma scale were then compared in the two cohorts of children. Results: 224 patients responded to the questionnaire; 40 patients were diagnosed with Long COVID. Children with Long COVID significantly more frequently felt embarrassed about having Long COVID (p 0.035), felt embarrassed about having physical limitations (p < 0.001), felt they were valued less due to Long COVID (p 0.003), felt they were different from other peers due to Long COVID (p 0.033), felt significantly more frequently that people behaved differently towards them because they might be lying since the diagnosis of Long COVID (p 0.006), that they were less respected by others due to Long COVID (p 0.017), that other people thought that Long COVID is not a real disease (p 0.007), that other people thought that developing Long COVID is a sign of weakness (p 0.008), and that other people might judge them negatively due to their diagnosis of Long COVID (p < 0.001). Conclusions: Children with Long COVID, similar to adults, are suffering from stigmata due to their condition,. These data may have implication and should be used by the public, policy makers, and healthcare professionals regarding pediatric Long COVID. Full article
(This article belongs to the Special Issue Long COVID or Post-COVID-19 Syndrome in Children: What Do We Know So Far?)
16 pages, 518 KiB  
Article
Risk Factors for Persistent Anosmia and Dysgeusia in Children with SARS-CoV-2 Infection: A Retrospective Study
by Francesco Mariani, Rosa Morello, Daniele Omar Traini, Anna La Rocca, Cristina De Rose, Piero Valentini and Danilo Buonsenso
Children 2023, 10(3), 597; https://doi.org/10.3390/children10030597 - 21 Mar 2023
Cited by 7 | Viewed by 2261
Abstract
Background: Olfactory and gustative dysfunctions are two of the most common post-acute sequelae of SARS-CoV-2 infection in children, which can have a negative impact on the routines of children and families. As several children have had COVID-19 since the Omicron variant, it is [...] Read more.
Background: Olfactory and gustative dysfunctions are two of the most common post-acute sequelae of SARS-CoV-2 infection in children, which can have a negative impact on the routines of children and families. As several children have had COVID-19 since the Omicron variant, it is important to investigate if this increase in infections is reflected in higher olfactory/taste disfunctions. The primary aim of this study was to characterize the presence of olfactory/gustative problems in a cohort of children, its evolution, and its association with risk factors such as COVID-19 variant, hospitalization, presence of olfactory/gustative dysfunction during the acute phase, and vaccination. Methods: This was a retrospective analysis of children with microbiologically confirmed SARS-CoV-2 infection evaluated in person at a referral pediatric post-COVID-19 clinic in Rome, Italy. We included children younger than 19 years old, evaluated from the beginning of the pandemic up to October 2022. At specific timepoints, we investigated the presence of olfactory/taste disfunctions and evaluated them according to the SARS-CoV-2 variants circulating at the time of infection. Results: A total of 1250 children (650 females; 52.0%) with a mean age of 6.77 (±4.12) years were included in the study. At 3, 6, 12, and 18 months, 12 (9.6%), 7 (5.6%), 2 (1.6%), and 1 (0.8%) of the children reported anosmia and dysgeusia post-COVID-19 infection, respectively. The presence of anosmia and dysgeusia during the acute phase of infection and being infected with a pre-Omicron variant were found to be significant risk factors for persistent olfactory and gustatory dysfunction during all follow-up periods. Conclusions: anosmia and dysgeusia symptoms tended to decrease gradually over time, but not all children recovered quickly. Full article
(This article belongs to the Special Issue Long COVID or Post-COVID-19 Syndrome in Children: What Do We Know So Far?)
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Review

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37 pages, 619 KiB  
Review
Long COVID in Children and Adolescents: A Critical Review
by Maria Rothensteiner, Franziska Leeb, Florian Götzinger, Marc Tebruegge and Angela Zacharasiewicz
Children 2024, 11(8), 972; https://doi.org/10.3390/children11080972 - 12 Aug 2024
Viewed by 1273
Abstract
(1) Background: Data on persisting symptoms after SARS-CoV-2 infection in children and adolescents are conflicting. Due to the absence of a clear pathophysiological correlate and a definitive diagnostic test, the diagnosis of Long COVID currently rests on consensus definitions only. This review aims [...] Read more.
(1) Background: Data on persisting symptoms after SARS-CoV-2 infection in children and adolescents are conflicting. Due to the absence of a clear pathophysiological correlate and a definitive diagnostic test, the diagnosis of Long COVID currently rests on consensus definitions only. This review aims to summarise the evidence regarding Long COVID in children and adolescents, incorporating the latest studies on this topic. (2) Methods: We designed a comprehensive search strategy to capture all relevant publications using Medline via the PubMed interface, with the initial literature search conducted in April 2023. To be included, publications had to present original data and include >50 participants with Long COVID symptoms aged between 0 and18 years. (3) Results: A total of 51 studies met the inclusion criteria, with most studies originating from Europe (n = 34; 66.7%), followed by the Americas (n = 8; 15.7%) and Asia (n = 7; 13.7%). Various study designs were employed, including retrospective, cross-sectional, prospective, or ambispective approaches. Study sizes varied significantly, with 18/51 studies having fewer than 500 participants. Many studies had methodological limitations: 23/51 (45.1%) studies did not include a control group without prior COVID-19 infection. Additionally, a considerable number of papers (33/51; 64.7%) did not include a clear definition of Long COVID. Other limitations included the lack of PCR- or serology-based confirmation of SARS-CoV-2 infection in the study group. Across different studies, there was high variability in the reported prevalence of Long COVID symptoms, ranging from 0.3% to 66.5%, with the majority of studies included in this review reporting prevalences of approximately 10–30%. Notably, the two studies with the highest prevalences also reported very high prevalences of Long COVID symptoms in the control group. There was a relatively consistent trend for Long COVID prevalence to decline substantially over time. The prevalence of Long COVID appeared to differ across different paediatric age groups, with teenagers being more commonly affected than younger children. Furthermore, data suggest that children and adolescents are less commonly affected by Long COVID compared to adults. In children and adolescents, Long COVID is associated with a very broad range of symptoms and signs affecting almost every organ system, with the respiratory, cardiovascular, and neuropsychiatric systems being most commonly affected. (4) Conclusions: The heterogeneity and limitations of published studies on Long COVID in children and adolescents complicate the interpretation of the existing data. Future studies should be rigorously designed to address unanswered questions regarding this complex disease. Full article
(This article belongs to the Special Issue Long COVID or Post-COVID-19 Syndrome in Children: What Do We Know So Far?)
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