Infectious Disease

Rate of long COVID in hospitalized children nearly 10%, study finds

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Please see the study for all authors’ relevant financial disclosures.

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Nearly 6% of children who tested positive for SARS-CoV-2 after seeking care at an emergency department reported lasting effects from their infection, according to the results of a large study of pediatric long COVID published Friday.

The rate of long COVID in study participants who ended up being hospitalized was almost 10% — more than double the rate of children who were not hospitalized — although the authors of the study noted that “these rates were only slightly higher than the rates among SARS -CoV-2 negative controls.”

Children who tested positive for SARS-CoV-2 reported lasting effects. Source: Adobe Stock

“Early reports estimated that 25% to 58% of children experienced [long COVID] months after their acute illnesses and occurrence was not associated with disease severity,” the authors wrote in JAMA Network Open.

“However,” they wrote, “a subsequent study that included primarily nonhospitalized, SARS-CoV-2–positive children reported that only 4% were symptomatic 28 days after being tested and 2% were symptomatic 56 days after being tested. Although these risks were higher than reported among noninfected participants, other reports described no difference in the frequency of [long COVID] among pediatric COVID-19 patients and controls.”

The researchers examined data from 36 EDs in eight countries — including the United States, Canada and Italy — between March 7, 2020, and Jan. 20, 2021, and found 1,884 SARS-CoV-2-positive children with 90-day follow- up examinations. They matched 1,686 of the children with 1,701 SARS-CoV-2 negative controls.

According to the authors, 5.8% of patients — 9.8% of hospitalized children and 4.6% of discharged children — reported post-COVID-19 conditions after 90 days, including respiratory symptoms like cough, difficulty breathing or shortness of breath; and systemic issues like fatigue or weakness.

“Risk factors for reporting [long COVID] included the number of acute symptoms, length of hospitalization, and older age,” the authors wrote. “These findings can inform public health policy decisions regarding COVID-19 mitigation strategies for children and screening approaches for [long COVID] among those with severe infections.”

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Ziyad Al-Aly, MD)

Ziyad Al-Aly, MD

This is yet another piece of evidence that long COVID can also affect children, and it is evident among those who were nonhospitalized and is even higher among those who were hospitalized. The paper relied on a survey and did not look more deeply at cognitive function, educational attainment and other facets of a child’s development. It is going to be important to evaluate these factors to help us understand the full impact of a SARS-CoV-2 infection.

Overall, this is a sober reminder that long COVID spares no one; it can even affect kids. Parents should seriously consider vaccinating their kids for COVID-19; Also, measures to lower risk of exposure should be taken when feasible.

Ziyad Al-Aly, MD

Chief, research and development service

VA St Louis Health Care System

Disclosures: Al-Aly reports no relevant financial disclosures.

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