Preprint Long-Term Effects of COVID-19 in Children and Young People: A 24-Month National Cohort Study, 2023, Pereira

Discussion in 'Long Covid research' started by Dolphin, Dec 28, 2023.

  1. Dolphin

    Dolphin Senior Member (Voting Rights)

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    https://www.researchsquare.com/article/rs-3750111/v1

    Long-Term Effects of COVID-19 in Children and Young People: A 24-Month National Cohort Study

    Snehal Pinto Pereira1

    Terence Stephenson

    Manjula Nugawela

    Emma Dalrymple

    Anthony Harnden

    Elizabeth Whittaker

    Isobel Heyman

    Tamsin Ford2

    Terry Segal

    Trudie Chalder

    Shamez Ladhani

    Kelsey McOwat

    Ruth Simmons

    Laila Xu

    Lana Fox-Smith

    ORCID

    CLoCk Consortium

    Roz Shafran

    1 University College London,

    2 University Cambridge

    https://doi.org/10.21203/rs.3.rs-3750111/v1

    This work is licensed under a CC BY 4.0 License

    Background

    Most children and young people (CYP) in the United Kingdom have been infected with SARS-COV-2 and some continue to experience impairing symptoms after infection. Using data from a national cohort study, we report on symptoms and their impact 24 months post-infection for the first time.

    Methods

    The CloCk study is a national cohort in England, of CYP aged 11-to-17-years when they had a SARS-CoV-2 PCR test between September 2020 and March 2021. Of 31,012 CYP invited to complete a questionnaire 24-months post-PCR test, 12,632 CYP participated and were included in our analytic sample (response rate=40·7%). CYP were divided into four groups depending on their infection status: ‘initial test-negatives with no subsequent positive test’ (NN); ‘initial test-negatives with a subsequent positive test’ (NP); ‘initial test-positives with no report of subsequent re-infection’ (PN); and ‘initial test-positives with report of subsequent re-infection’ (PP). We examined whether symptom profiles 24-months post index-test differed by infection status using chi-squared or Mann-Whitney tests.

    Findings

    7.2% of CYP consistently fulfilled the definition of PCC at 3-, 6-, 12- and 24-months. These young people had a median of 5 or 6 symptoms at each time point. Between 20-25% of all four infection status groups reported 3 or more symptoms 24 months after testing and 10-25% of CYP experienced 5+ symptoms, with the reinfected (PP) group having more symptoms than the other two positive groups (NP and PN); the NN group had the lowest symptom burden (p<0.001). Symptoms or their impact did not vary by vaccination status.

    PCC was more common in older (vs. younger) CYP and in the most (vs. least) deprived quintile. PCC was almost twice as common in females (vs. males) in both infection status groups.

    Interpretation

    The discrepancy in the proportion of CYP who fulfilled the Delphi consensus PCC definition at 24 months and those who consistently fulfilled the definition across time with multiple symptoms, highlights the importance of longitudinal studies and the need to consider clinical impairment and range of symptoms. Relatedly, further studies are needed to understand the pathophysiology, develop diagnostic tests and identify effective interventions for young people who continue to be significantly impaired by PCC.

     
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  2. Trish

    Trish Moderator Staff Member

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    Counting the number of symptoms seems to me a daft way of assessing disease existence and severity. What about severity of each symptom and impairment of function?
     
    Lou B Lou, Michelle, sebaaa and 10 others like this.
  3. Amw66

    Amw66 Senior Member (Voting Rights)

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    Is there a questionnaire for that ? ( Sarcasm)
     
    Kiwipom, Michelle, alktipping and 4 others like this.
  4. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    The abstract does even remember to tell us what PCC is.
    It doesn't appear to tell us anything useful.
     
    Kiwipom, Michelle, alktipping and 3 others like this.
  5. Amw66

    Amw66 Senior Member (Voting Rights)

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    £££s for something an undergraduate could have come up with ?

    Interesting to see how long COVID kids respond .
    They have been vocal previously on aspects of this study
     
    Last edited: Dec 28, 2023
    Lou B Lou, Kiwipom, Michelle and 5 others like this.
  6. rvallee

    rvallee Senior Member (Voting Rights)

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    The first paper from this group basically concluded "Long Covid? Doesn't appear to exist". It was a terrible paper. This is also a terrible paper, it's lazy and uninterested. It features prominent deniers of Long Covid and chronic illness in general, and they sure did a poor job of even defining it properly.

    But it's part of the millions wasted by the MRC on bad Long Covid research, and to them that's a job well done because results don't matter.
     
    Lou B Lou, Kiwipom, RedFox and 2 others like this.
  7. Amw66

    Amw66 Senior Member (Voting Rights)

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    Cue a strategically placed billboard ?
     
  8. dave30th

    dave30th Senior Member (Voting Rights)

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    I haven't read the paper. Can someone translate the first part of this sentence for me? I don't understand what they're saying.
     
  9. SNT Gatchaman

    SNT Gatchaman Senior Member (Voting Rights)

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    I think it's commenting on the evidence that LC (frequently?) doesn't simply continue uninterrupted from acute Covid. Instead patients recover to full health, possibly having been acutely asymptomatic and then progress to LC after weeks or months. Also that the symptoms that form LC (eg. fatigue/PEM/neuro-cognitive/gut/cardiovascular) are not those that feature in the acute infection.
     
  10. SNT Gatchaman

    SNT Gatchaman Senior Member (Voting Rights)

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    Ie some declared at 6 months (or later).

     
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