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Post COVID-19 condition after delta infection and omicron reinfection in children and adolescents, Ertesvåg et al, 2023

Discussion in 'Long Covid research' started by Kalliope, May 7, 2023.

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  1. Kalliope

    Kalliope Senior Member (Voting Rights)

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    eBioMedicine
    Part of THE LANCET Discovery Science
    Post COVID-19 condition after delta infection and omicron reinfection in children and adolescents

    Summary

    Background
    The burden of COVID-19 in children and adolescents has increased during the delta and omicron waves, necessitating studies of long-term symptoms such as fatigue, dyspnoea and cognitive problems. Furthermore, immune responses in relation to persisting symptoms in younger people have not been well characterised. In this cohort study, we investigated the role of antibodies, vaccination and omicron reinfection upon persisting and long-term symptoms up to 8 months post-delta infection.

    Methods
    SARS-CoV-2 RT-PCR positive participants (n = 276, aged 10–20 years) were prospectively recruited in August 2021. We recorded the major symptoms of post COVID-19 condition and collected serum samples 3- and 8-months post delta infection. Binding antibodies were measured by spike IgG ELISA, and surrogate neutralising antibodies against Wuhan and delta variants by the hemagglutination test (HAT).

    Findings
    After delta infection, persisting symptoms at 3 months were significantly associated with higher delta antibody titres (OR 2.97, 95% CI 1.57–6.04, p = 0.001). Asymptomatic acute infection compared to symptomatic infection lowered the risk of persisting (OR 0.13, 95% CI 0.02–0.55, p = 0.013) and long-term (OR 0.28 95% CI 0.11–0.66, p = 0.005) symptoms at 3 and 8 months, respectively. Adolescents (16–20 years) were more likely to have long-term symptoms compared to children (10–15 years) (OR 2.44, 95% CI 1.37–4.41, p = 0.003).

    Interpretation
    This clinical and serological study compares long-term symptoms after delta infection between children and adolescents. The association between high antibody titres and persisting symptoms suggest the involvement of an immune mechanism. Similarly to adults, the dominant long-term symptoms in children are fatigue, dyspnoea and cognitive problems.
     
    Kalliope, May 7, 2023
    #1
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  2. Kalliope

    Kalliope Senior Member (Voting Rights)

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    Shared by virologist Stephen Griffin on Twitter who comments:

    "Our findings emphasise the importance of reducing the COVID-19 burden in young people" Omicron breakthrough in CYP with previous delta infection more likely to cause #LongCovidKids
    Yes, a 3.5 yr PHEIC is arbitrarily ended, but a pandemic remains

     
    Kalliope, May 7, 2023
    #2
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  3. Midnattsol

    Midnattsol Moderator Staff Member

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    upload_2023-5-7_12-17-49.png
    The table on absenteeismen is sobering if that shows that about 1/4 of participants is absent from school/work/extracuricular activities eight months post delta infection. And from the text itself nine of those absent had asymptomatic infection.
     
    Midnattsol, May 7, 2023
    #3
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  4. Kalliope

    Kalliope Senior Member (Voting Rights)

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    There were some articles in the Norwegian media not long ago about an increase of children refusing to go to school. This was explained as due to psychosocial factors concerning the pandemic, but I remember thinking it could just as well be post viral disease. poor kids. what are we doing to them?

    haven't seen any articles recently though concerning school absence so don't know if the trend is still high or has improved.
     
    Kalliope, May 7, 2023
    #4
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  5. Midnattsol

    Midnattsol Moderator Staff Member

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    Agree. It makes me so frustrated and sad. There has been more students who have taken zero ECTSs/credits as well, but there were also record high numbers that applied to go to universities at the start of the pandemic so I'm not sure if it is due to illness or not. Sick leave in students is not easy to count.

    A friend of mine is worried since there were previously little to no problems at her kids' school and now she thinks it is due to rampant covid infections among the children. In the table above cognitive dysfunction does not seem to contribute much to absenteeism, but it is definitely something that can cause irritation and worsen interaction with others. But I don't think we'll get to know the answer to what is going on. For example, if the child is not able to articulate why they do not want to go to school (fatigue kicks in after a few hours? Sound and light sensitivity that gets worse throughout the day? Only manages a few days a week but then the body just screams "NO!" as was the case with me with my migraines growing up?)

    I didn't quite get the reinfection part in this study, based on the Figure reinfection in the youngest children increased their symptom burden, while this did not happen as much to the older children/young adults. The older group had higher symptom burden overall, but with reinfection the younger children came up to their level. I also think there will be underreporting of symptoms in the youngest, I mean just by thinking back to everything I thought was normal when I was 10 because I was constantly told there was nothing wrong with me.
     
    Midnattsol, May 7, 2023
    #5
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