Preprint: Mental health of Adolescents in the Pandemic: Long-COVID19 or Long-Pandemic Syndrome?, 2021, Blankenburg et al.

Abstract

Background Post-COVID19 complications such as pediatric inflammatory multisystem syndrome (PIMS) and Long-COVID19 move increasingly into focus, potentially causing more harm in this age group than the acute infection. To better understand the symptoms of long-COVID19 in adolescents and to distinguish infection-associated symptoms from pandemic-associated symptoms, we conducted a Long-COVID19 survey, comparing responses from seropositive and seronegative adolescents. To our knowledge, data of Long-COVID19 surveys with seronegative control groups have not been published yet.

Methods Since May 2020 students grade 8-12 in fourteen secondary schools in Eastern Saxony were enrolled in the SchoolCovid19 study. Seroprevalence was assessed via serial SARS-CoV-2 antibody testing in all participants. Furthermore, during the March/April 2021 study visit all participants were asked to complete a 12 question Long-COVID19 survey regarding the occurrence and frequency of difficulties concentrating, memory loss, listlessness, headache, abdominal pain, myalgia/ arthralgia, fatigue, insomnia and mood (sadness, anger, happiness and tenseness).

Findings 1560 students with a median age of 15 years participated in this study. 1365 (88%) were seronegative, 188 (12%) were seropositive. Each symptom was present in at least 35% of the students within the last seven days before the survey. However, there was no statistical difference comparing the reported symptoms between seropositive students and seronegative students. Whether the infection was known or unknown to the participant did not influence the prevalence of symptoms.

Interpretation The lack of differences comparing the reported symptoms between seropositive and seronegative students suggests that Long-COVID19 might be less common than previously thought and emphasizing the impact of pandemic-associated symptoms regarding the well-being and mental health of young adolescents.

Funding This study was supported by a grant by the Federal State of Saxony. M.K.W. was supported by the Else Kröner-Fresenius Center for Digital Health (EKFZ), TU Dresden, Germany.

Competing Interest Statement
Reinhard Berner and Jakob P. Armann report grants from the Federal State of Saxony during the conduct of the study. The other authors have no conflicts of interest to disclose.

Full text at: https://www.medrxiv.org/content/10.1101/2021.05.11.21257037v1

 

The authors conducted antibody testing for the coronavirus in 1560 students with a median age of 15 years.

There was no statistical difference comparing the reported symptoms between, 188 (12%) seropositive students and 1365 (88%) seronegative students.

The study is mentioned in this article in the New York Times: The Truth About Long Covid Is Complicated. Better Treatment Isn’t. | Science for ME (s4me.info)

 

Symptoms were scored on a scale going from “not at all” “a little bit” “quite” “severe” “very severe”. The authors gave the first category a dummy code of 0 and all the other categories a code of 1 and then compared the two, which is a bit strange.



I've quickly looked at fisher exact tests if we compare the first three (nonsevere) versus the last two (severe). For memory loss and difficulty concentrating, I found p-values of 0.006 and 0.047 respectively. For fatigue, the result was nonsignificant but it is rather strange that none of the seropositive students reported severe fatigue.

 

The paper is light on details on the exact procedure carried out. Was collection of data dependent on school attendance?

PS: this would be important because ME/CFS in adolescents (a similar entity) is one of the largest causes of school absence. If patients are selected from those able to attend school, it introduces massive systematic bias that could hide much of the problem.

 

Agree, how come no data on response rate was given?

They say this was part of the SchoolCoviDD19 study. The trial registration seems to say:

"blood were collected from each individual during visits at each participating school between May 25th and June 30th, 2020."
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So if blood was drawn at school they might have missed patients who got covid and remained too ill to show up at school, as Strategist suggested.