Long COVID in pediatrics-epidemiology, diagnosis, and management

Research output: Contribution to journalReview articleContributedpeer-review

Contributors

  • Nicole Toepfner - , Department of Paediatrics (Author)
  • Folke Brinkmann - , University Hospital Schleswig-Holstein - Campus Lübeck (Author)
  • Silvia Augustin - , Munich Municipal Hospital Schwabing, Klinikum Rechts der Isar (MRI TUM) (Author)
  • Silvia Stojanov - , Munich Municipal Hospital Schwabing, Klinikum Rechts der Isar (MRI TUM) (Author)
  • Uta Behrends - , Munich Municipal Hospital Schwabing, Klinikum Rechts der Isar (MRI TUM) (Author)

Abstract

This review summarizes current knowledge on post-acute sequelae of COVID-19 (PASC) and post-COVID-19 condition (PCC) in children and adolescents. A literature review was performed to synthesize information from clinical studies, expert opinions, and guidelines. PASC also termed Long COVID - at any age comprise a plethora of unspecific symptoms present later than 4 weeks after confirmed or probable infection with severe respiratory syndrome corona virus type 2 (SARS-CoV-2), without another medical explanation. PCC in children and adolescents was defined by the WHO as PASC occurring within 3 months of acute coronavirus disease 2019 (COVID-19), lasting at least 2 months, and limiting daily activities. Pediatric PASC mostly manifest after mild courses of COVID-19 and in the majority of cases remit after few months. However, symptoms can last for more than 1 year and may result in significant disability. Frequent symptoms include fatigue, exertion intolerance, and anxiety. Some patients present with postural tachycardia syndrome (PoTS), and a small number of cases fulfill the clinical criteria of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). To date, no diagnostic marker has been established, and differential diagnostics remains challenging. Therapeutic approaches include appropriate self-management as well as the palliation of symptoms by non-pharmaceutical and pharmaceutical strategies. Conclusion: PASC in pediatrics present with heterogenous severity and duration. A stepped, interdisciplinary, and individualized approach is essential for appropriate clinical management. Current health care structures have to be adapted, and research was extended to meet the medical and psychosocial needs of young people with PASC or similar conditions. What is Known: • Post-acute sequelae of coronavirus 2019 (COVID-19) (PASC) - also termed Long COVID - in children and adolescents can lead to activity limitation and reduced quality of life. • PASC belongs to a large group of similar post-acute infection syndromes (PAIS). Specific biomarkers and causal treatment options are not yet available. What is New: • In February 2023, a case definition for post COVID-19 condition (PCC) in children and adolescents was provided by the World Health Organization (WHO), indicating PASC with duration of at least 2 months and limitation of daily activities. PCC can present as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). • Interdisciplinary collaborations are necessary and have been established worldwide to offer harmonized, multimodal approaches to diagnosis and management of PASC/PCC in children and adolescents.

Details

Original languageEnglish
Pages (from-to)1543-1553
Number of pages11
JournalEuropean journal of pediatrics
Volume183
Issue number4
Publication statusPublished - Apr 2024
Peer-reviewedYes

External IDs

PubMedCentral PMC11001657
Scopus 85183130823

Keywords

Keywords

  • Adolescent, COVID-19 Testing, COVID-19/diagnosis, Child, Disease Progression, Fatigue Syndrome, Chronic, Humans, Infant, Newborn, Post-Acute COVID-19 Syndrome, Quality of Life, SARS-CoV-2