UCL Great Ormond Street Institute of Child Health, London, United Kingdom.
Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London, United Kingdom.
PLoS One. 2023 Mar 6;18(3):e0277704. doi: 10.1371/journal.pone.0277704. eCollection 2023.
Little is known about the prevalence and natural trajectory of post-COVID symptoms in young people, despite very high numbers of young people having acute COVID. To date, there has been no prospective follow-up to establish the pattern of symptoms over a 6-month time period.
A non-hospitalised, national sample of 3,395 (1,737 SARS-COV-2 Negative;1,658 SARS-COV-2 Positive at baseline) children and young people (CYP) aged 11-17 completed questionnaires 3 and 6 months after PCR-confirmed SARS-CoV-2 infection between January and March 2021 and were compared with age, sex and geographically-matched test-negative CYP.
Three months after a positive SARS-CoV-2 PCR test, 11 of the 21 most common symptoms reported by >10% of CYP had reduced. There was a further decline at 6 months. By 3 and 6 months the prevalence of chills, fever, myalgia, cough and sore throat of CYP who tested positive for SARS-CoV-2 reduced from 10-25% at testing to <3%. The prevalence of loss of smell declined from 21% to 5% at 3 months and 4% at 6 months. Prevalence of shortness of breath and tiredness also declined, but at a lower rate. Among test-negatives, the same common symptoms and trends were observed at lower prevalence's. Importantly, in some instances (shortness of breath, tiredness) the overall prevalence of specific individual symptoms at 3 and 6 months was higher than at PCR-testing because these symptoms were reported in new cohorts of CYP who had not reported the specific individual symptom previously.
In CYP, the prevalence of specific symptoms reported at time of PCR-testing declined with time. Similar patterns were observed among test-positives and test-negatives and new symptoms were reported six months post-test for both groups suggesting that symptoms are unlikely to exclusively be a specific consequence of SARS-COV-2 infection. Many CYP experienced unwanted symptoms that warrant investigation and potential intervention.
尽管有大量年轻人患有急性 COVID，但对于年轻人感染 COVID 后的症状发生率和自然病程知之甚少。迄今为止，尚无前瞻性随访研究来确定 6 个月内症状模式。
在 2021 年 1 月至 3 月期间，对 3395 名（1737 名 SARS-COV-2 阴性；1658 名 SARS-COV-2 阳性）年龄在 11-17 岁的非住院青少年进行了全国性抽样调查，这些儿童和青少年在 PCR 确诊 SARS-CoV-2 感染后 3 个月和 6 个月完成了问卷调查，并与年龄、性别和地理位置匹配的阴性对照 CYP 进行了比较。
在 SARS-CoV-2 PCR 检测呈阳性后 3 个月，报告的 21 种最常见症状中，有 11 种症状的 CYP 报告比例降至 10%以上。6 个月后进一步下降。到 3 个月和 6 个月时，CYP 感染 SARS-CoV-2 检测呈阳性者的寒战、发热、肌痛、咳嗽和咽痛的发生率从检测时的 10-25%降至<3%。嗅觉丧失的发生率从 21%降至 3 个月时的 5%和 6 个月时的 4%。呼吸急促和疲倦的发生率也有所下降，但下降幅度较小。在阴性对照组中，观察到相同的常见症状和趋势，但发生率较低。重要的是，在某些情况下（呼吸急促、疲倦），3 个月和 6 个月时特定个体症状的总体发生率高于 PCR 检测，因为这些症状是在之前未报告特定个体症状的新 CYP 队列中报告的。
在 CYP 中，PCR 检测时报告的特定症状的发生率随时间推移而下降。在阳性和阴性检测者中观察到类似的模式，两组在 PCR 检测后 6 个月都报告了新症状，这表明症状不太可能仅仅是 SARS-COV-2 感染的特定后果。许多 CYP 经历了不需要的症状，需要进行调查和潜在的干预。
