Legacy of COVID-19 infection in children: long-COVID will have a lifelong health/economic impact, 2021, Munblit et al

Introduction
Studies have repeatedly shown that children less frequently and less severely manifest acute COVID-19 infection1 However, as with the whole of the world population, children have been subjected to the direct and indirect effects of lockdowns, restricted education and social interactions, with potential lifelong impacts on mental and physical health.2

Long-COVID
It has become apparent from follow-up of adults who had been hospitalised with the infection that lingering, and sometimes debilitating symptoms and signs, are relatively common.3 Even those with milder infections have reported persistent problems often known as long-COVID. Studies of this ill-defined syndrome in adults have begun to characterise constellations of symptoms and signs. While some are clearly directly due to organ damage during the acute phase of the illness (persistent lung function deficits; cardiovascular, renal and neurological problems), others are less easily attributed, including fatigue, poor concentration, shooting pains and impaired quality of life seen more frequently in women rather than men.4 A Lancet editorial, ‘Facing up to long COVID’, highlighted the increasing number of people suffering prolonged symptoms after recovery from the acute phase of COVID-19 infection. The editorial asks for research to elaborate on the risk factors, clinical features, diagnosis, management and outcomes.5 A similar editorial, ‘Meeting the challenge of long COVID’, has appeared in Nature Medicine.6 Sadly, neither editorial appeared to recognise that children and young people are also adversely affected. With increasing demand on health services, the UK National Institute for Clinical Excellence has published guidelines on management.7 The guidelines inappropriately categorise children with the elderly both in rudimentary suggestions for organisation of services and requirements for research.

Open access, https://adc.bmj.com/content/early/2021/05/27/archdischild-2021-321882