Long COVID in Children – The Lancet Child & Adolescent Health


Recent data analysis of the Zoe app (jointly launched by Zoe Limited and King’s College London) by Erika Molteni and colleagues
1
  • Molteni E
  • Sudre CH
  • Canas LS
  • et al.
Duration of illness and symptom profile in symptomatic UK school-aged children tested for SARS-CoV-2.

assessed the profile and duration of symptoms in children with a confirmed positive SARS-CoV-2 test. The study provides important information on symptomatology, but likely underestimates the true prevalence of long-term COVID in children. According to the Methods section, the study appears to only assess children with a defined duration of illness (onset and recovery). Recovery was defined as a return to an asymptomatic state or the cessation of symptom recording. As such, this would exclude all children with an ongoing illness and classify children who stop recording as cured, even though they may still have symptoms. The authors tested their hypothesis that stopping the recording indicated recovery by removing these patients from their calculus and found no significant difference in the long prevalence of COVID or the average duration of symptoms. However, if the patients who stopped recording continued to experience symptoms, these longer lasting symptoms would not be identified by the study and their effect would not be taken into account in the existing hypothesis test.

In addition, the study excludes all children who had a deviation in registration or reported being asymptomatic for more than a week before symptoms returned. Patients with long-term COVID exhibit a wide range of changing symptoms, including asymptomatic periods. Many long COVID symptoms were added to the Zoe app in November 2020, but were not included in the existing scan. With only 77 (4.4%) of 1,734 patients with a disease duration greater than 28 days, even small changes in the number of patients could lead to substantial changes in prevalence. Due to the methods used, the study likely underestimates the true prevalence of the disease in children. Understanding the true prevalence of long-term COVID in children is of critical importance as many governments use this data to shape policies, from school safety measures to funding research.

We do not declare any competing interests.

Reference

  1. 1.
    • Molteni E
    • Sudre CH
    • Canas LS
    • et al.

    Duration of illness and symptom profile in symptomatic UK school-aged children tested for SARS-CoV-2.

    Lancet Child Adolesc Health. 2021; 5: 708-718

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