Long COVID symptoms in SARS-CoV-2-positive children aged 0–14 years and matched controls in Denmark (LongCOVIDKidsDK):..., 2022, Kikkenborg Berg et al

Full title: Long COVID symptoms in SARS-CoV-2-positive children aged 0–14 years and matched controls in Denmark (LongCOVIDKidsDK): a national, cross-sectional study

Summary

Background
After the acute phase of SARS-CoV-2 infection, children can develop long COVID symptoms. We aimed to investigate the prevalence of long-lasting symptoms, the duration and intensity of symptoms, quality of life, number of sick days and absences from daycare or school, and psychological and social outcomes in children aged 0–14 years who had been infected with SARS-CoV-2 relative to controls with no history of SARS-CoV-2 infection.

Methods
A nationwide cross-sectional study was conducted including children with a confirmed SARS-CoV-2-positive PCR test (cases) and matched controls from Danish national registers. A survey was sent to mothers (proxy reporting) of children aged 0–14 years who had had a positive SARS-CoV-2 test between Jan 1, 2020, and July 12, 2021, and a control group matched (1:4) by age and sex. The survey included the Pediatric Quality of Life Inventory (PedsQL) and the Children's Somatic Symptoms Inventory-24 (CSSI-24) to capture current overall health and wellbeing, and ancillary questions about the 23 most common long COVID symptoms. Descriptive statistics and logistic regression analysis were used. Clinically relevant differences were defined as those with a Hedges' g score greater than 0·2. This study is registered at ClinicalTrials.gov (NCT04786353).

Findings
Responses to the survey were received from 10 997 (28·8%) of 38 152 cases and 33 016 (22·4%) of 147 212 controls between July 20, 2021, and Sept 15, 2021. Median age was 10·2 years (IQR 6·6–12·8) in cases and 10·6 years (6·9–12·9) in controls. 5267 (48·2%) cases and 15 777 (48·3%) controls were female, and 5658 (51·8%) cases and 16 870 (51·7%) controls were male. Cases had higher odds of reporting at least one symptom lasting more than 2 months than did controls in the 0–3 years age group (478 [40·0%] of 1194 vs 1049 [27·2%] of 3855; OR 1·78 [95% CI 1·55–2·04], p<0·0001), 4–11 years age group (1912 [38·1%] of 5023 vs 6189 [33·7%] of 18 372; 1·23 [1·15–1·31], p<0·0001), and 12–14 years age group (1313 [46·0%] of 2857 vs 4454 [41·3%] of 10 789; 1·21 [1·11–1·32], p<0·0001). Differences in CSSI-24 symptom scores between cases and controls were statistically significant but not clinically relevant. Small clinically relevant differences in PedsQL quality-of-life scores related to emotional functioning were found in favour of cases in the children aged 4–11 years (median score 80·0 [IQR 65·0–95·0]) in cases vs 75·0 [60·0–85·0] in controls; p<0·0001) and 12–14 years (90·0 [70·0–100·0] vs (85·0 [65·0–95·0], p<0·0001). PedsQL social functioning scores were also higher in cases (100·0 [90·0–100·0] than controls (95·0 [80·0–100·0]) in the 12–14 years age group (p<0·0001; Hedges g>0·2).

Interpretation
Compared with controls, children aged 0–14 years who had a SARS-CoV-2 infection had more prevalent long-lasting symptoms. There was a tendency towards better quality-of-life scores related to emotional and social functioning in cases than in controls in older children. The burden of symptoms among children in the control group requires attention. Long COVID must be recognised and multi-disciplinary long COVID clinics for children might be beneficial.

Open access, https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(22)00154-7/fulltext

 

Somehow, the reliability of the data is not questioned. All it means is that those scores aren't reliable for much, amount to very fuzzy data, which is normal considering they can't control for anything, are simply too vague for this purpose. But where people want to see patterns, they will point them out no matter how absurd it sounds.

https://twitter.com/user/status/1540248560444223488

 

This one is weird. They report statistically significantly better physical functioning means in almost all age groups for those infected over controls, plus better emotional, social and school functioning in older age groups for those infected. They want to brush this off as kids who haven't been infected yet being scared and some other mumbo jumbo, but it seems much more likely that they have a confounder in there. I suspect it might be that kids who were more likely to get a tested might have higher socioeconomic status.

Also, why would you report medians when you're looking for Long Covid, which is definitely present in significantly less than half of kids? Medians don't tell you much about the bottom of the distribution of scores, which is what you should be looking at.

 

What's fun here is they've flipped the script on the typical anxiety explanation (Long Covid in kids is just anxiety) and are now claiming that not having had Covid means kids have more anxiety about getting Covid and thus report worse functioning. So no matter what the data shows, they'll blame it on anxiety!

 

Why rely on 50:50 odds when you can simply use a coin with two same sides?