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Long Covid-19 in Children: are 84,430 kids being forgotten? by Helena Jones

Hi there all you STEM enthusiasts! How are you all? We have all enjoyed watching the Covid-19 restriction loosen slightly and life beginning to resume in the UK. Although there is optimism for the future, today's article investigates a crucial topic which desperately needs further research to ensure children with long-Covid do not go ignored. Thank you to Helena for this insightful article.


As the coronavirus pandemic continues to impact our lives in a multitude of different ways, it is estimated that 15.3%, or 1 in 7 of England’s population have had Covid-19 (Wise, 2021) by mid-January of 2021. The Office for National Statistics estimated that around 1 in 5 people who test positive for Covid-19 experience symptoms for over 5 weeks, and 1 in 10 have symptoms for 12 weeks or longer (Office for National Statistics, 2020). These symptoms vary from fatigue, shortness of breath, chest pain, “brain fog” to insomnia and change to sense of taste or smell (NHS, 2021).


However, amongst children, the most common symptom is fatigue, followed by stomach pain and gastrointestinal issues from an informal survey completed by the children’s parents from the LongCovidSOS. Data about Long Covid in children is lacking, as it is thought that the majority of paediatric infections are mild or even asymptomatic. The ONS and Long Covid Kids estimate that there are between 79,000 to 84,430 children suffering from Long Covid-19 as of March 13th 2021.


In a preprint article, that has not yet been peer-reviewed, researchers from Italy, Russia and the UK assessed 129 children after they were diagnosed with Covid-19. This is thought to be the first study showing evidence for Long Covid in children. Shockingly, 42.6% are still impaired from their symptoms during daily activities and only 41.8% of children had fully recovered (Buonsenso et al., 2021). Recognised complications from acute Covid-19, Multisystem Inflammatory Syndrome (MIS-C) and myocarditis was reported by 3 and 2 children respectively. These findings are supported by a very small Swedish study in which patients experienced Long Covid symptoms for at least six months, which affected their schooling to the extent that on average they would only attend around half of the time months after testing positive (Ludvigsson, 2020).


Although MIS-C has been reported repeatedly in adults, the British Medical Journal set out to express the link with children. The BMJ analysed data on 651 children and young people who were admitted to hospital in the first six months of last year. Of those, 11% developed MIS-C and were on average aged 10.7, confirming the link between MIS-C and Covid-19 in children. This is a poignant finding as “children with MIS-C were five times more likely to be admitted to critical care” (Swann et al., 2020).


In October, the Head of NHS England announced £10 million for 69 Long Covid clinics for adults across the country. Sir Simon Stevens said that the “NHS is taking practical action to help patients suffering ongoing health issues as a result of coronavirus” (NHS England, 2020a) and this rehabilitation can be accessed by referral from a General Practitioner or other healthcare professional. The support will include physical, cognitive and psychological assessments which will then allow patients to be referred onto other specialist clinics such as cardiac, rehabilitation or mental health services. This will all be overseen by medical specialists, researchers and even patients as part of a new NHS England Long Covid taskforce (NHS England, 2020). Undeniably, this is fantastic progress for the thousands of adults suffering from these symptoms, however, it has been criticised that these clinics are exclusively for adults (Which? News, 2021). Unfortunately, this leaves the estimated 84,430 children and young people currently suffering from Long Covid’s debilitating symptoms with little help.


The Founder of Long Covid Kids, Sammie McFarland called for “researchers and doctors to be much more curious about the effects of Long Covid on children so that we can then make wise decisions going forward” (Sky News, 2021). The British Medical Journal share this opinion; “there is a need for clinicians, at primary and secondary care levels, to be alert and aware of the multisystem symptoms in children” (British Medical Journal, 2020).

As of March 2021, Covid-19 cases in the UK are decreasing, but the effect of children starting back at school on the 8th, may cause a rise in the number of cases in those age groups. For any child experiencing Long Covid, there remains less focused support than adults and children’s daily lives are being disrupted. Further research is needed, otherwise these children cannot help but question whether they have been forgotten.


References:


British Medical Journal (2020). Counting long covid in children. [online] The BMJ. Available at: https://blogs.bmj.com/bmj/2020/10/16/counting-long-covid-in-children/


Buonsenso, D., Munblit, D., De Rose, C., Sinatti, D., Ricchiuto, A., Carfi, A. and Valentini, P. (2021). Preliminary Evidence on Long COVID in children. MedRXiv.


Long Covid SOS (2020). Long Covid in Children. [online] LongCovidSOS. Available at: https://www.longcovidsos.org/post/long-covid-in-children [Accessed 29 Mar. 2021].


Ludvigsson, J.F. (2020). Case report and systematic review suggest that children may experience similar long‐term effects to adults after clinical COVID‐19. Acta Paediatrica.

NHS (2021). Long-term Effects of Coronavirus (long COVID). [online] nhs.uk. Available at: https://www.nhs.uk/conditions/coronavirus-covid-19/long-term-effects-of-coronavirus-long-covid/.

NHS England (2020a). NHS England» Long COVID patients to get help at more than 60 clinics. [online] . Available at: https://www.england.nhs.uk/2020/12/long-covid-patients-to-get-help-at-more-than-60-clinics/ [Accessed 30 Mar. 2021].

NHS England (2020b). NHS England» NHS to offer “long covid” sufferers help at specialist centres. [online] www.england.nhs.uk. Available at: https://www.england.nhs.uk/2020/10/nhs-to-offer-long-covid-help/.


Office for National Statistics (2020). The prevalence of long COVID symptoms and COVID-19 complications - Office for National Statistics. [online] www.ons.gov.uk. Available at: https://www.ons.gov.uk/news/statementsandletters/theprevalenceoflongcovidsymptomsandcovid19complications [Accessed 29 Mar. 2021].


Sky News (2021). Coronavirus: Children are suffering with long COVID, new research shows. [online] www.youtube.com. Available at: https://www.youtube.com/watch?v=qK8JvHCVcC0.

Swann, O.V., Holden, K.A., Turtle, L., Pollock, L., Fairfield, C.J., Drake, T.M., Seth, S., Egan, C., Hardwick, H.E., Halpin, S., Girvan, M., Donohue, C., Pritchard, M., Patel, L.B., Ladhani, S., Sigfrid, L., Sinha, I.P., Olliaro, P.L., Nguyen-Van-Tam, J.S. and Horby, P.W. (2020). Clinical characteristics of children and young people admitted to hospital with covid-19 in United Kingdom: prospective multicentre observational cohort study. BMJ, [online] 370. Available at: https://www.bmj.com/content/370/bmj.m3249 .


Which? News. (2021). Long Covid: what is it and what help is available? [online] Available at: https://www.which.co.uk/news/2021/02/long-covid-what-is-it-and-what-help-is-available/ [Accessed 30 Mar. 2021].


Wise, J. (2021). Covid-19: One in seven people in England have antibodies from infection or vaccination, finds study. British Medical Journal, [online] (2021;372:n561), p. Available at: https://www.bmj.com/content/372/bmj.n561 [Accessed 29 Mar. 2021].


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