Department of Pediatric and Adolescent Medicine, NIDO Denmark, Hospitalsenheden Vest, Gl. Landevej 61, 7400, Herning, Denmark.
Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark.
Eur J Pediatr. 2022 Apr;181(4):1597-1607. doi: 10.1007/s00431-021-04345-z. Epub 2022 Jan 9.
UNLABELLED: Most children have a mild course of acute COVID-19. Only few mainly non-controlled studies with small sample size have evaluated long-term recovery from SARS-CoV-2 infection in children. The aim of this study was to evaluate symptoms and duration of 'long COVID' in children. A nationwide cohort study of 37,522 children aged 0-17 years with RT-PCR verified SARS-CoV-2 infection (response rate 44.9%) and a control group of 78,037 children (response rate 21.3%). An electronic questionnaire was sent to all children from March 24th until May 9th, 2021. Symptoms lasting > 4 weeks were common among both SARS-CoV-2 children and controls. However, SARS-CoV-2 children aged 6-17 years reported symptoms more frequently than the control group (percent difference 0.8%). The most reported symptoms among pre-school children were fatigue Risk Difference (RD) 0.05 (CI 0.04-0.06), loss of smell RD 0.01 (CI 0.01-0.01), loss of taste RD 0.01 (CI 0.01-0.02) and muscle weakness RD 0.01 (CI 0.00-0.01). Among school children the most significant symptoms were loss of smell RD 0.12 (CI 0.12-0.13), loss of taste RD 0.10 (CI 0.09-0.10), fatigue RD 0.05 (CI 0.05-0.06), respiratory problems RD 0.03 (CI 0.03-0.04), dizziness RD 0.02 (CI 0.02-0.03), muscle weakness RD 0.02 (CI 0.01-0.02) and chest pain RD 0.01 (CI 0.01-0.01). Children in the control group experienced significantly more concentration difficulties, headache, muscle and joint pain, cough, nausea, diarrhea and fever than SARS-CoV-2 infected. In most children 'long COVID' symptoms resolved within 1-5 months. CONCLUSIONS: Long COVID in children is rare and mainly of short duration. WHAT IS KNOWN: • There are increasing reports on 'long COVID' in adults. • Only few studies have evaluated the long-term recovery from COVID-19 in children, and common for all studies is a small sample size (median number of children included 330), and most lack a control group. WHAT IS NEW: • 0.8% of SARS-CoV-2 positive children reported symptoms lasting >4 weeks ('long COVID'), when compared to a control group. • The most common 'long COVID' symptoms were fatigue, loss of smell and loss of taste, dizziness, muscle weakness, chest pain and respiratory problems. • These 'long COVID' symptoms cannot be assigned to psychological sequelae of social restrictions. • Symptoms such as concentration difficulties, headache, muscle- and joint pain as well as nausea are not 'long COVID' symptoms. • In most cases 'long COVID' symptoms resolve within 1-5 months.
背景:大多数儿童的急性 COVID-19 呈轻症。仅有少数样本量较小的非对照研究评估了儿童 SARS-CoV-2 感染后的长期康复情况。本研究旨在评估儿童的“长新冠”症状和持续时间。
方法:这是一项全国性的队列研究,纳入了 37522 名年龄 0-17 岁、经 RT-PCR 证实的 SARS-CoV-2 感染儿童(应答率 44.9%)和 78037 名对照儿童(应答率 21.3%)。我们于 2021 年 3 月 24 日至 5 月 9 日向所有儿童发送了电子问卷。SARS-CoV-2 儿童和对照组中,持续超过 4 周的症状均较常见。然而,6-17 岁 SARS-CoV-2 儿童报告的症状比对照组更频繁(差异百分比 0.8%)。学龄前儿童中最常见的症状是疲劳(风险差异 0.05,95%CI 0.04-0.06)、嗅觉丧失(0.01,0.01-0.01)、味觉丧失(0.01,0.01-0.02)和肌肉无力(0.01,0.00-0.01)。学龄儿童中最显著的症状是嗅觉丧失(0.12,0.12-0.13)、味觉丧失(0.10,0.09-0.10)、疲劳(0.05,0.05-0.06)、呼吸问题(0.03,0.03-0.04)、头晕(0.02,0.02-0.03)、肌肉无力(0.02,0.01-0.02)和胸痛(0.01,0.01-0.01)。对照组儿童经历的注意力困难、头痛、肌肉和关节疼痛、咳嗽、恶心、腹泻和发热症状显著多于 SARS-CoV-2 感染者。大多数儿童的“长新冠”症状在 1-5 个月内缓解。
结论:儿童“长新冠”少见且多为短期病程。
已知情况:成人“长新冠”的报告日益增多。只有少数研究评估了儿童 COVID-19 的长期康复情况,所有研究的共同特点是样本量小(纳入的儿童中位数为 330 例),且多数缺乏对照组。
新发现:SARS-CoV-2 阳性儿童中,有 0.8%报告持续超过 4 周的症状(“长新冠”),而对照组为 0.8%。最常见的“长新冠”症状是疲劳、嗅觉和味觉丧失、头晕、肌肉无力、胸痛和呼吸问题。这些“长新冠”症状不能归因于社交限制带来的心理后遗症。注意力困难、头痛、肌肉和关节疼痛以及恶心等症状不属于“长新冠”症状。大多数情况下,“长新冠”症状在 1-5 个月内缓解。
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