UCL Great Ormond Street Institute of Child Health.
Paediatric Infectious Diseases Research Group, St. George's University of London, London, UK.
Curr Opin Infect Dis. 2022 Oct 1;35(5):461-467. doi: 10.1097/QCO.0000000000000854. Epub 2022 Aug 3.
Although acute COVID-19 has been milder in children and young people compared with adults, there is a concern that they may suffer persistent symptoms. There is a need to define the clinical phenotype, determine those most at risk, the natural course of the condition and evaluate preventive and therapeutic strategies for both mental health and physical symptoms.
More recent studies with control groups reported a lower prevalence of persistent symptoms in children and young people exposed to SARS-CoV-2. A systematic review and meta-analysis found that the frequency of the majority of reported persistent symptoms is similar in SARS-CoV-2 positive cases and controls. Children and young people infected with SARS-COV-2 had small but significant increases in persisting cognitive difficulties, headache and loss of smell. Factors associated with persisting, impairing symptoms include increased number of symptoms at the time of testing, female sex, older age, worse self-rated physical and mental health, and feelings of loneliness preinfection.
This review highlights the importance of a control group in studies following SARS-CoV-2 infection, the need for case definitions and research to understand the outcomes of long COVID in children and young people.
目的综述：尽管与成年人相比，儿童和青少年的急性 COVID-19 症状较轻，但人们担心他们可能会出现持续症状。因此，有必要确定临床表型，确定哪些人面临最大风险，了解病情的自然病程，并评估针对心理健康和身体症状的预防和治疗策略。
最近发现：最近的一些研究发现，在接触 SARS-CoV-2 的儿童和青少年中，持续症状的发生率较低。一项系统综述和荟萃分析发现，在 SARS-CoV-2 阳性病例和对照组中，大多数报告的持续症状的频率相似。感染 SARS-CoV-2 的儿童和青少年的认知困难、头痛和嗅觉丧失等持续存在的问题略有增加。与持续存在、损害症状相关的因素包括检测时症状数量增加、女性、年龄较大、自我评估的身心健康状况较差，以及感染前的孤独感。
总结：本综述强调了在 SARS-CoV-2 感染后进行研究时使用对照组的重要性，以及需要制定病例定义和开展研究以了解儿童和青少年长新冠的结局。
