Basaca Diana-Georgiana, Jugănaru Iulius, Belei Oana, Nicoară Delia-Maria, Asproniu Raluca, Stoicescu Emil Robert, Mărginean Otilia
Disturbances of Growth and Development on Children Research Center, "Victor Babeș" University of Medicine and Pharmacy, 300041 Timișoara, Romania.
Ph.D. School Department, 'Victor Babeş' University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania.
J Clin Med. 2025 Jan 9;14(2):378. doi: 10.3390/jcm14020378.
Long COVID, also known as post-acute sequelae of SARS-CoV-2 infection (PASC), is increasingly recognized as a condition affecting not only adults but also children and adolescents. While children often experience milder acute COVID-19 symptoms compared to adults, some develop persistent physical, psychological, and neurological symptoms lasting for weeks or months after initial infection. The most commonly reported symptoms include debilitating fatigue, respiratory issues, headaches, muscle pain, gastrointestinal disturbances, and cognitive difficulties, which significantly impact daily activities, schooling, and social interactions. Additionally, many children with long COVID experience psychological symptoms, such as anxiety, depression, mood swings, and irritability, likely exacerbated by prolonged illness and lifestyle disruptions. Risk factors for long COVID in children include pre-existing health conditions such as asthma, obesity, and neurological disorders, with adolescents and females seemingly more affected. Hypothesized mechanisms underlying long COVID include chronic immune dysregulation, persistent viral particles stimulating inflammation, autonomic nervous system dysfunction, and mitochondrial impairment, which may collectively contribute to the variety of observed symptoms. Long-term outcomes remain uncertain; however, long COVID can lead to school absenteeism, social withdrawal, and psychological distress, potentially affecting cognitive development. Severe cases may develop chronic conditions such as postural orthostatic tachycardia syndrome (POTS) and reduced exercise tolerance. This review synthesizes the existing literature on long COVID in children, examining its prevalence, symptomatology, risk factors, and potential mechanisms, with an emphasis on the need for further clinical studies. While existing research largely relies on surveys and self-reported data, clinical assessments are essential to accurately characterize long COVID in pediatric populations and to guide effective management strategies.
长期新冠，也称为新冠病毒2感染的急性后遗症（PASC），越来越被认为是一种不仅影响成人，也影响儿童和青少年的病症。与成人相比，儿童感染新冠病毒后急性症状通常较轻，但有些儿童在初次感染后会出现持续数周或数月的身体、心理和神经症状。最常报告的症状包括使人虚弱的疲劳、呼吸问题、头痛、肌肉疼痛、胃肠道紊乱和认知困难，这些症状对日常活动、上学和社交互动有显著影响。此外，许多患长期新冠的儿童会出现心理症状，如焦虑、抑郁、情绪波动和易怒，长期患病和生活方式中断可能会加剧这些症状。儿童患长期新冠的风险因素包括哮喘、肥胖和神经紊乱等先前存在的健康状况，青少年和女性似乎受影响更大。长期新冠潜在的发病机制包括慢性免疫失调、持续的病毒颗粒刺激炎症、自主神经系统功能障碍和线粒体损伤，这些因素可能共同导致各种观察到的症状。长期后果仍不确定；然而，长期新冠会导致缺课、社交退缩和心理困扰，可能影响认知发展。严重病例可能会发展为慢性疾病，如体位性直立性心动过速综合征（POTS）和运动耐量降低。这篇综述综合了关于儿童长期新冠的现有文献，研究了其患病率、症状、风险因素和潜在机制，强调了进一步开展临床研究的必要性。虽然现有研究很大程度上依赖于调查和自我报告的数据，但临床评估对于准确描述儿科人群的长期新冠情况以及指导有效的管理策略至关重要。
