Corona Daily 012: Long Covid and Children

The coronavirus naturally keeps looking for new victims to attack.

Israel, one of the top vaccinated countries (85%+ adults fully vaccinated), saw the number of cases become negligible at the beginning of June. Later in the month, cases rose to more than 100 a day, most of them children under 16. Hurriedly, Israel’s Ministry of Health recommended all 12-15 year olds get vaccinated.

In the USA and UK, covid is becoming a disease of the unvaccinated. That often creates an image of those refusing to take vaccines. But the unvaccinated population also includes children for whom no vaccines are available.

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An Italian pediatrician, Danilo Buonsenso, first tried to quantify Long Covid in children. His team interviewed 129 children diagnosed with Covid-19 last year, and found that more than half of them still had lingering symptoms four months after the infection. Insomnia, fatigue, muscle pain and a persistent cold were the common symptoms.

Surprisingly some children, who were asymptomatic or had a mild covid infection, had developed Long Covid. This finding is common to studies from most countries. The original infection doesn’t need to be severe for a child to experience Long Covid.

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The data from the UK office of national statistics (ONS) updated in April 2021 showed that 9.8% of children aged 2-11 and 13% aged 12-16 reported at least one lingering symptom five weeks after infection. Another report released in April found that 25% of children discharged from hospitals in Russia had symptoms more than five months later.

Everywhere, the numbers are lower than those reported for adults. However, the numbers still worry parents, because the initial assumption was that Covid-19 didn’t pose risks to children. If 10-15% of the children, asymptomatic or with mild infection do have long-term symptoms; that is a puzzle scientists would like to study.

Jakob Armann, a German pediatrician, offers some positive news if his hypothesis is correct. Long Covid symptoms include fatigue, headache, difficulty concentrating and insomnia. Dr Armann says that other pandemic-related phenomena; school closures, isolation, no interaction with friends, in some cases family members falling ill or dying; could all produce the same symptoms. That would inflate the Long Covid stats artificially. To scientifically determine this, you need a control group, a group of non-infected children with similar symptoms.

Since May 2020, Dr Armann’s team has been taking blood samples from secondary-school children in Dresden to track rates of infection. In April and May 2021, over 1,500 German children were surveyed. Nearly 200 of them had antibodies suggesting prior infection. All children were asked questions to determine the proportion of Long Covid.

In May, Dr Armann reported the team found no difference in rates of symptoms between the two groups. (With and without prior covid-19 infection). This makes him believe Long Covid in children is probably much lower than suggested by many studies. It does exist, but the true figure is perhaps 1% rather than 10%, he says.

What is more important is to see how long the symptoms would last. If they were to last all their life, even 1% of children getting Long Covid is a serious issue, he adds.

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Most scientists are demanding a proper definition of Long Covid so that studies can decide how serious the problem is among children, and which children are at risk. Pediatricians know a great deal about chickenpox, because it has been around for seventy years, Covid only a little longer than a year.

Two weeks ago, a $40 million study was launched to examine Long Covid and MIS-C (multi-system inflammatory syndrome in children). In the USA, more than 3.6 million children have tested positive for covid-19 and more than 2800 cases of MIS-C, a serious condition possibly associated with the virus. MIS-C symptoms include fever, abdominal pain, bloodshot eyes, breathing trouble, rash, vomiting, diarrhea and neck pain. This can affect the heart function and blood pressure.

The study will enroll over 1,000 children (under 21) with confirmed history of covid infection. Another 1,000 children with no infection history will be enrolled as the control group.

Hopefully, the detailed study will produce results that are reassuring for parents the world over.

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Ravi