A battle is raging over long-term covid in children

A battle is raging over long-term covid in children

Children develop many other difficult-to-define syndromes after covid. Fatigue is common. Some children may have a cough or sore throat for months. Others take months to recover their sense of taste and smell. Some are too weak to attend school or have signs of heart damage, others have seizures and blackouts. Symptoms may temporarily disappear before they relapse. Some children have a single lasting symptom, while many others experience a constellation.

Symptoms also vary in severity — and these differences may be overlooked in studies comparing children who did or did not receive SARS-CoV-2. A questionnaire asking children if they had a headache may not distinguish a mild headache from a severe experience that prevents a child from opening their eyes or getting out of bed.

In reality, long-term covid will likely involve several conditions. “It’s not a diagnosis, it’s not a disease … we don’t know what it is,” Forrest says. “It’s squishy.” Stephenson and Mcfarland have met with WHO representatives to discuss a possible definition for long-term covid in children, but none has been established so far. The WHO says more studies and research are needed.

While progress in finding a clinical definition has stalled, there is at least some agreement on a way to define long-term covid in children for research purposes.

In February, Stephenson and colleagues released a definition of long-term covid in children to use in research stating that symptoms should follow a confirmed case of Covid-19, impact the child’s life and affect the physical, mental or social well-being, and must last for a minimum of 12 weeks. Stephenson hopes the WHO will tailor its definition to this, but in the meantime, this definition should at least ensure that researchers study the same thing, he says.

Vaccination value

The only way to prevent long-term covid is to avoid contracting SARS-CoV-2. That’s why many doctors and scientists encourage people to get vaccinated. It’s not clear how much protection vaccines can provide against long-term covid, but some recent studies suggest that vaccination can reduce a child’s risk of serious disease from the omicron variant by two-thirds.

Long-term covid is thought to be more likely to follow more serious infections, but it can also follow mild or even asymptomatic cases. “This seems to be more the case in children, which I think is unique and disturbing,” said Yvonne Maldonado, an infectious disease pediatrician at Stanford University and chair of the American Academy of Pediatrics’ Committee on Infectious Diseases.

Measuring temperature in a sick child

GETTY

Because vaccinations can reduce the severity of cases and should reduce transmission, they are recommended for all children over the age of 5 in the US. By March 30, 58% of 12- to 17-year-olds had received both doses of a Covid-19 vaccine, according to CDC data published by the American Academy of Pediatrics. Only 27% of 5 to 11 year olds had it.

In the UK, Covid-19 vaccinations for young children are at the center of another debate. The UK’s Joint Vaccination and Immunization Committee (JCVI), which advises the government, announced a plan last month to provide all children aged 5 to 11 with a Covid-19 vaccine, but only on “non-urgent” reasons. base.

“I think the JCVI has always been right,” Absoud says. “The way they’ve left it now is it’s a choice for families.”

“A lot of children” are affected

Binita Kane at Manchester University NHS Foundation Trust

Of course, there are other ways to reduce transmission in children. The experts we contacted emphasized the importance of keeping schools open and said measures such as improving ventilation and air quality and masking, at least among adult caregivers, during transmission peaks could help reduce the number keep cases low and both long-term covid and “long pandemic syndrome.” They are also among the only options we have to protect children under the age of 5.

All children significantly affected by SARS-CoV-2, directly or indirectly, need support to recover, so arguments about the prevalence of long-term covid in children may be irrelevant. “Whether it’s a long-term covid or a long-term pandemic syndrome, everything needs to be treated,” Villapol says.

Even if only 1% of children develop covid long-term after infection, the total number of children affected will reach the millions, given the number of children who have already contracted the virus. The JCVI’s guidelines on immunizing children suggest that 85% of children in the UK aged 5 to 11 had been infected with the virus by the end of January 2022 before being eligible for vaccination. “It’s a lot of kids,” Kane says.

Today, Kane’s daughter Jasmin is doing better. A new treatment regimen seems to have helped, and while it hasn’t fully restored her energy levels, she’s “improved remarkably,” Kane says.

The problem is, as researchers debate prevalence, the focus is diverted from biological causes and potential treatments, meaning many other children are still suffering, she says.

“We can’t wait for years,” Kane says. “We have to move on.”

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