Yildirim Arslan Sema, Avcu Gulhadiye, Sahbudak Bal Zumrut, Arslan Asli, Ozkinay Feristah Ferda, Kurugol Zafer
Division of Infectious Disease, Department of Pediatrics, Medical School of Ege University, Izmir, Turkey.
Eur J Pediatr. 2023 Oct;182(10):4565-4571. doi: 10.1007/s00431-023-05134-6. Epub 2023 Aug 1.
The post-COVID-19 syndrome is a new syndrome defined in patients with a history of probable or confirmed SARS-CoV-2 infection, usually within three months of the onset of COVID-19, with symptoms and effects lasting at least 2 months. This study is aimed at comprehensively comparing symptoms of the post-COVID-19 syndrome in children with Delta and Omicron variants. This prospective study included children with COVID-19 followed in hospitalized or outpatient clinics in a tertiary hospital. We used a special questionnaire to ask about the presence of persistent symptoms more than 12 weeks after the initial diagnosis. Patients with positive SARS-CoV-2 PCR were selected randomly and grouped according to the dominant variants in our country at that time as follows: Omicron group (after December 16, 2021); Delta (B.1.617.2) group (August 15, 2021, and December 15, 2021). This study included 200 children, 71 of whom were in the Delta group and 129 of whom were in the Omicron group. Weakness (8.5% vs. 1.6%; p = 0.017), the impact of physical efforts (5.6% vs. 3.9%; p = 0.020), fatigue (22.5% vs. 8.5%; p = 0.009), anxiety disorder (12.7% vs. 0.8%; p = 0.001), and gastrointestinal changes (12.7% vs. 4.7%, p = 0.050) were statistically significantly higher in patients with the Delta variant compared to patients with the Omicron variant. There were no differences between the groups regarding anorexia, anosmia/ageusia, arthralgia, influenza-like symptoms, sleeping disorders, decreased physical activity daily, headache, need for analgesia, concentration and memory disorder, and weight loss (p > 0.05). Conclusion: This study showed that weakness, the impact of physical efforts, fatigue, anxiety disorder, and gastrointestinal changes were more frequent in the Delta group compared to the Omicron group. The incidence of post-COVID-19 syndrome is high in children as well as adults and affects several systems; therefore, it should be kept in mind that children should be followed for post-COVID-19 syndrome. What is Known: • Despite the milder severity of acute COVID-19 in children, post-COVID-19 symptoms may occur. The post-COVID-19 condition is complex and novel, especially in the pediatric population. What is New: • Post-COVID-19 symptoms in children differ depending on the viral variant. Post-COVID-19 syndrome has a great impact on the social life of children which may have serious and long-term effects.
新冠后综合征是一种新定义的综合征，发生于有疑似或确诊的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染史的患者，通常在新冠发病后的三个月内出现，症状和影响持续至少2个月。本研究旨在全面比较感染德尔塔毒株和奥密克戎毒株的儿童的新冠后综合征症状。这项前瞻性研究纳入了在一家三级医院住院部或门诊部接受随访的新冠儿童患者。我们使用一份特殊问卷询问初始诊断12周后持续症状的情况。随机选取SARS-CoV-2聚合酶链反应（PCR）检测呈阳性的患者，并根据当时我国占主导地位的毒株进行分组，如下：奥密克戎组（2021年12月16日之后）；德尔塔（B.1.617.2）组（2021年8月15日至2021年12月15日）。本研究纳入了200名儿童，其中71名在德尔塔组，129名在奥密克戎组。与奥密克戎毒株感染患者相比，德尔塔毒株感染患者的虚弱（8.5%对1.6%；p = 0.017）、体力活动影响（5.6%对3.9%；p = 0.020）、疲劳（22.5%对8.5%；p = 0.009）、焦虑症（12.7%对0.8%；p = 0.001）和胃肠道变化（12.7%对4.7%，p = 0.050）在统计学上显著更高。两组在食欲减退、嗅觉丧失/味觉丧失、关节痛、流感样症状、睡眠障碍、每日体力活动减少、头痛、镇痛需求、注意力和记忆障碍以及体重减轻方面无差异（p>0.05）。结论：本研究表明，与奥密克戎组相比，德尔塔组的虚弱、体力活动影响、疲劳、焦虑症和胃肠道变化更为常见。新冠后综合征在儿童和成人中的发病率都很高，且会影响多个系统；因此，应牢记对儿童进行新冠后综合征的随访。已知信息：•尽管儿童急性新冠的严重程度较轻，但仍可能出现新冠后症状。新冠后状况复杂且新颖，尤其是在儿科人群中。新发现：•儿童的新冠后症状因病毒毒株而异。新冠后综合征对儿童的社交生活有很大影响，可能产生严重的长期后果。
