Exploring the wellbeing and health of SARS-CoV-2 positive children and youth

In a recent study published in The Lancet Regional Healthresearchers explored the well-being and health of young people and children not hospitalized following testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Background

Compared to adults, SARS-CoV-2 infection in most children and youth (CYP) has been between asymptomatic and moderate. Nevertheless, as the cumulative infection rate in CYP increases, the prevalence of post-coronavirus disease 2019 (COVID-19) sequelae is becoming a growing concern. The long COVID or post-COVID-19 condition has shown an adverse effect on some CYPs; however, little is known about the frequency, distribution, or duration of poor well-being and health in CYP post-COVID-19.

About the study

In the current study, researchers reported intra-individual diversity in health and well-being six and 12 months after COVID-19 testing.

The CLoCk study is a cohort analysis of SARS-CoV-2 positive CYPs aged 11 to 17 years, matched by month of positive diagnosis, age, sex and geographic region to SARS-CoV-2 negative CYP using the national SARS-CoV-2 test dataset carried out by the UK Health Security Agency (UKHSA). This project aims to collect information for 24 months following a SARS-CoV-2 polymerase chain reaction (PCR) test performed from September 2020 to March 2021. Over 30,000 CYPs were recruited for the trial. Based on the month of testing, the team collected data at three, six, 12, and 24 months after testing for some people; six, 12 and 24 months after the test for the others; and 12 and 24 months post-test for the rest of the individuals.

The team presented data collected on the same CYP six and 12 months after the PCR test. The first contact was to complete an online health questionnaire by the CYPs during the PCR test. CYP answered follow-up questions at six and 12 months, which focused on their well-being and health. The questionnaires were completed by the CYP; however, a caretaker could help young CYPs and people with educational needs or disabilities.

The measures included demographic information and sections of the COVID-19 Pediatric Questionnaire from the International Consortium on Acute and Emerging Respiratory Infections (ISARIC). The team included 21 symptoms and substantiated tools for loneliness using the UCLA Adapted Three-Item Loneliness Scale and mental well-being using the Strengths and Difficulties Questionnaire. At the same time, quality of life and functioning were assessed using the EQ-5D-Y21 and the Chalder Fatigue Scale.

Results

After an average of 27.7 and 52.1 weeks, follow-up questionnaires for six months and 12 months were submitted, respectively. Almost 2,909 of 6,407 SARS-COV-2 positive CYPs and 2,177 of 6,542 SARS-COV-2 negative CYPs who responded at six months also responded at 12 months. Additionally, 10.9% of subjects testing positive felt exhausted, 4.4% experienced shortness of breath, 3.3% lost taste or smell, 1.7% reported dizziness or lightheadedness and 1.1% reported missed meals at all three times. Nearly 16 symptoms affected less than 1% of SARS-CoV-2 positive people at each of the three points, while 1.2% of those who tested negative reported fatigue. Less than 1% of SARS-CoV-2 negative people reported the remaining 20 symptoms. Thus, the range of symptom prevalence varied by SARS-CoV-2 PCR status.

Looking at intra-individual variation in symptom profiles, the prevalence of the 11 most prevalent symptoms at baseline decreased significantly over 12 months in the test-positive group. For CYP who first experienced any of these symptoms at six months, there is a reduction in frequency of 12 months. Nevertheless, for two symptoms, namely shortness of breath and fatigue, the overall incidence of positive tests increased by six months and continued to increase for 12 months.

The overall prevalence of difficulties with self-care, mobility, and feelings of sadness or isolation was minimal at all three time points for SARS-CoV-2 positive and negative individuals. Similar patterns were seen for performing routine activities and pain, as well as shortness of breath and exhaustion. However, there was a negligible difference between SARS-CoV-2 negative and positive people reporting these symptoms for the first time at 12 months with regard to the prevalence of discomfort or difficulty performing work tasks. routine.

Conclusion

Study results showed that among CYPs, the incidence of adverse symptoms reported after a positive SARS-CoV-2 diagnosis decreased over the course of a year. Some SARS-CoV-2 positive and negative people experienced adverse symptoms for the first time six and 12 months after diagnosis, such as tiredness, shortness of breath and tiredness, indicating that these symptoms are likely due to multiple reasons.