Stephenson Terence, Pinto Pereira Snehal M, Nugawela Manjula D, Dalrymple Emma, Harnden Anthony, Whittaker Elizabeth, Heyman Isobel, Ford Tamsin, Segal Terry, Chalder Trudie, Ladhani Shamez N, McOwat Kelsey, Simmons Ruth, Xu Laila, Fox-Smith Lana, Shafran Roz
UCL Great Ormond Street Institute of Child Health, London, UK.
Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London, London, UK.
Commun Med (Lond). 2024 Dec 4;4(1):255. doi: 10.1038/s43856-024-00657-x.
Some children and young people (CYP) infected with SARS-COV-2 experience impairing symptoms post-infection, known as post-COVID-19 condition (PCC). Using data from the National Long COVID in Children and Young People (CloCk) study, we report symptoms and their impact up to 24-months post-infection.
CloCk is a cohort of CYP in England aged 11-to-17-years when they had a SARS-CoV-2 PCR-test (between September 2020 and March 2021). Of 31,012 eligible CYP 24-months post-PCR test, 12,632 participated (response = 40.7%). CYP were grouped by infection status: 'initial test-negatives; no subsequent positive-test' (NN); 'initial test-negatives; subsequent positive-test' (NP); 'initial test-positives; no reported re-infection' (PN); and 'initial test-positives; reported re-infection' (PP). The Delphi research definition of PCC in CYP was operationalised; symptom severity/impact and validated scales (e.g., Chalder Fatigue Scale) were recorded. We examine symptom profiles 24-month post-index-test by infection status.
7.2% of CYP consistently fulfil the PCC definition at 3-, 6-, 12- and 24-months. These CYPs have a median of 5-to-6 symptoms at each time-point. Between 20% and 25% of all infection status groups report 3+ symptoms 24-months post-testing; 10-25% experience 5+ symptoms. The reinfected group has more symptoms than the other positive groups; the NN group has the lowest symptom burden (p < 0.001). PCC is more common in older CYPs and in the most deprived. Symptom severity/impact is higher in those fulfilling the PCC definition.
The discrepancy in the proportion of CYP fulfilling the Delphi PCC definition at 24-months and those consistently fulfilling the definition across time, highlights the importance of longitudinal studies and the need to consider clinical impairment and range of symptoms.
一些感染了新冠病毒的儿童和年轻人（CYP）在感染后会出现影响健康的症状，即新冠后状况（PCC）。利用来自全国儿童和年轻人长期新冠（CloCk）研究的数据，我们报告了感染后长达24个月的症状及其影响。
CloCk研究队列中的CYP在英格兰年龄为11至17岁，他们接受了新冠病毒PCR检测（2020年9月至2021年3月之间）。在PCR检测24个月后的31012名符合条件的CYP中，12632人参与了研究（应答率=40.7%）。CYP按感染状态分组：“初次检测阴性；无后续阳性检测”（NN）；“初次检测阴性；后续阳性检测”（NP）；“初次检测阳性；无报告再次感染”（PN）；以及“初次检测阳性；报告再次感染”（PP）。采用了CYP中PCC的德尔菲研究定义；记录了症状严重程度/影响以及经过验证的量表（如查尔德疲劳量表）。我们按感染状态检查初次检测后24个月的症状概况。
7.2%的CYP在3个月、6个月、12个月和24个月时始终符合PCC定义。这些CYP在每个时间点的症状中位数为5至6种。在所有感染状态组中，20%至25%的人在检测后24个月报告有3种以上症状；10%至25%的人有5种以上症状。再次感染组的症状比其他阳性组更多；NN组的症状负担最低（p<0.001）。PCC在年龄较大的CYP和最贫困人群中更为常见。符合PCC定义的人群中症状严重程度/影响更高。
在24个月时符合德尔菲PCC定义的CYP比例与始终符合该定义的比例之间的差异，凸显了纵向研究的重要性以及考虑临床损伤和症状范围的必要性。
