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Long COVID symptoms in exposed and infected children, adolescents and their parents one year after SARS-CoV-2 infection: 2022, Haddad et al

Discussion in 'Long Covid research' started by Sly Saint, Sep 25, 2022.

  1. Sly Saint

    Sly Saint Senior Member (Voting Rights)

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    Long COVID symptoms in exposed and infected children, adolescents and their parents one year after SARS-CoV-2 infection: A prospective observational cohort study

    Summary
    Background
    Long COVID in children and adolescents remains poorly understood due to a lack of well-controlled studies with long-term follow-up. In particular, the impact of the family context on persistent symptoms following SARS-CoV-2 infection remains unknown. We examined long COVID symptoms in a cohort of infected children, adolescents, and adults and their exposed but non-infected household members approximately 1 year after infection and investigated clustering of persistent symptoms within households.
    Methods
    1267 members of 341 households (404 children aged <14 years, 140 adolescents aged 14-18 years and 723 adults) were categorized as having had either a SARS-CoV-2 infection or household exposure to SARS-CoV-2 without infection, based on three serological assays and history of laboratory-confirmed infection. Participants completed questionnaires assessing the presence of long COVID symptoms 11-12 months after infection in the household using online questionnaires.
    Findings
    The prevalence of moderate or severe persistent symptoms was statistically significantly higher in infected than in exposed women (36.4% [95% CI: 30.7–42.4%] vs 14.2% [95% CI: 8.7–21.5%]), infected men (22.9% [95% CI: 17.9–28.5%] vs 10.3% [95% CI: 5.8–16.9%]) and infected adolescent girls (32.1% 95% CI: 17.2–50.5%] vs 8.9% [95%CI: 3.1–19.8%]). However, moderate or severe persistent symptoms were not statistically more common in infected adolescent boys aged 14–18 (9.7% [95% CI: 2.8–23.6%] or in infected children <14 years (girls: 4.3% [95% CI: 1.2–11.0%]; boys: 3.7% [95% CI: 1.1–9.6%]) than in their exposed counterparts (adolescent boys: 0.0% [95% CI: 0.0–6.7%]; girls < 14 years: 2.3% [95% CI: 0·7–6·1%]; boys < 14 years: 0.0% [95% CI: 0.0–2.0%]). The number of persistent symptoms reported by individuals was associated with the number of persistent symptoms reported by their household members (IRR=1·11, p=·005, 95% CI [1.03–1.20]).
    Interpretation
    In this controlled, multi-centre study, infected men, women and adolescent girls were at increased risk of negative outcomes 11-12 months after SARS-CoV-2 infection. Amongst non-infected adults, prevalence of negative outcomes was also high. Prolonged symptoms tended to cluster within families, suggesting family-level interventions for long COVID could prove useful.

    https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(22)00427-3/fulltext


     
    RedFox, Hutan and Peter Trewhitt like this.
  2. Hutan

    Hutan Moderator Staff Member

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    There's the usual problem of defining who exactly had Covid-19, and who did not. Given all the participants had household exposure, the potential for an incorrect assignment to the Covid-negative group is considerable. It was possible for people to test positive on one serological assay and still be classed as Covid-negative.

     
  3. Hutan

    Hutan Moderator Staff Member

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    Further on that:
    There were significant numbers of people only identified by the serology (ie at least 2 out of the 3 antibody tests positive). And yet, 50 participants reported having a positive PCR test earlier in their illness, but were seronegative at the study baseline test. These 'non-seroconverters' were defined as infected.

    So, it's possible that the Covid positive group contained people who were in fact Covid negative.
    It's also possible that the Covid negative group contained people who had had Covid, but were non-seroconverters.

    There were also complications around people becoming infected after the baseline and before followup.
     
  4. Hutan

    Hutan Moderator Staff Member

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    Freiberg, Germany study, by the way.

    Screen Shot 2022-09-26 at 7.53.15 am.png

    That was interesting. Dysgeusia at baseline might be associated with dysgeusia at followup, but the presence of that symptom doesn't necessarily mean that the symptoms required for a post-Covid ME/CFS diagnosis were present. ie it depends how you define Long Covid.




    The authors note that there are various possible explanations for the household association including:
    1. a genetic tendency


    2.
    They quote the French study that found that self-reported Covid infection was more likely to be associated with persistent physical symptoms than confirmed Covid infection. The inference is that parents who perceive that they have symptoms are making the reporting their children's symptoms less accurate. However, it's possible that experiencing ongoing symptoms might make parents better at identifying similar symptoms in their children, actually making them more accurate reporters of their children's symptoms when they filled out the questionnaires for them.


    3.
    And that last paragraph is the point of the whole study - the identification of dysfunctional overly reactive families that are the cause of Long Covid. Whole families are therefore fodder for psychotherapy interventions. If a family reports that their child has Long Covid, then all the members of the family become liable to having their behaviour and perceptions 'fixed'.

    It's possible that stressed parents are producing stressed children in a stressful time. I don't think a study that identifies individual symptoms is going to properly separate these out from people with the constellation of symptoms that is post-Covid ME/CFS.
     
    Last edited: Sep 25, 2022
    Trish, Peter Trewhitt, RedFox and 3 others like this.

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