Prevalence and Symptom Profile of Long COVID among Schoolchildren in Vietnam, 2024, Vu et al.

[SNT Gatchaman]

Prevalence and Symptom Profile of Long COVID among Schoolchildren in Vietnam
Vu, Trang Thu; Nguyen, Khanh Cong; Nguyen, Hieu Thi; Hoang, Anh; Ngu, Nghia Duy; Tran, Duong Nhu; Phan, Hoa Bich; Nguyen, Ha Thi Thu; Pham, Thai Quang; Vogt, Florian

BACKGROUND
Long COVID is a recognized condition that can follow SARS-CoV-2 infection. It has been primarily observed and studied in adults. Evidence on long COVID among children is scarce. We aimed to estimate its prevalence and symptom profile among schoolchildren, and its effects on studying, daily activities, and quality of life.

METHODS
We conducted a cross-sectional online survey among caregivers of 2226 schoolchildren aged 12–17 in Thai Nguyen, Vietnam, from 11 April to 16 May 2023 using WHO definitions and a validated quality of life questionnaire.

RESULTS
Among 1507 children with confirmed SARS-CoV-2 infection ≥ 5 months prior, 85 (5.6%) had long COVID. Memory loss (85.9%), poor concentration capacity (58.8%), and fatigue (57.6%) were their most common symptoms. They reported more frequent interference with their studies, observed differences in school absence rates, reduced daily activities, worsened overall health status, and relatively higher utilization of health services compared with children who only suffered from acute COVID-19 symptoms after infection.

CONCLUSIONS
Given the near-ubiquitous exposure to SARS-CoV-2 among children at this stage of the pandemic, our findings contribute invaluable evidence of an emerging public health burden among the pediatric population in Vietnam and globally. Concerted public health measures are needed to reduce long-term impacts on health, education, and wellbeing.

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[SNT Gatchaman]

In this study, we used the WHO’s definition of long COVID as a continuation or development of new symptoms three months after infection, and the duration of symptoms lasting two months or longer. The prevalence of long COVID symptoms among those infected was 5.6%

 

[Hutan]

In Vietnam, each class usually uses an online group on a popular social platform called Zalo to connect teachers with parents/guardians, allowing teachers to communicate with all parents/guardians of children in their classes quickly and effectively. After obtaining permission from school headmasters and headroom teachers to invite parents/caregivers to complete a short anonymous online survey, we sent a RedCAP online survey to Zalo groups of parents/guardians in the two schools. Headroom teachers and school staff were not involved in the survey response process to avoid potential biases.

There were a total of 3087 eligible parents/guardians in these two schools (based on the total number of enrolled students). In this study, we used the WHO definition to classify symptoms that appeared three months after SARS-CoV-2 infection and lasted two or more months after a child’s COVID-19 infection as long COVID.

A total of 2398 parents/guardians opened our survey, and from those, 2339 parents/guardians consented and participated. We excluded 113 completed surveys: 19 due to logical errors of parents/guardians and 94 because students had turned 18 years of age by the time of the survey. In total, survey data from 2226 children were included in our study.

School-based sample. It's a good idea, a prospective sample. There's just the concern that the parents of a student who drops out of school due to Long Covid may not be receiving the online communication from the school.
The rate of response was pretty good.

Data on nineteen symptoms were collected by Yes/No questions, including: Cough, Fever, Loss of smell, Shortness of breath, Sore throat, Headache, Muscle pain, Abdominal pain, Diarrhea, Tiredness or fatigue that interferes with daily life, Sleep disorders (cannot sleep, sleep too much), Anxiety/depression, Poor concentration, Memory issues, Dizziness when the child stands up (light-headedness), Sore eyes, Raised welts on skin or swelling ear ache or ringing in the ears, and Red or purple sores or blisters on feet.

Rates of PEM weren't measured. Unfortunately the definition of Long Covid used is that WHO one, where the person just has to have one chronic symptom.

The most common long COVID symptoms recorded were memory issues, fatigue, cough, headache, fever, sore throat, light-headedness, and shortness of breath.

There were 85 schoolchildren who had at least one long COVID symptom. Among them, 85.9% had memory issues, 58.8% had poor concentration, 57.6% had tiredness or fatigue that interferes with daily life, 51.8% had a cough, 51.8% had a headache, 45.9% had a fever, 42.4% had a sore throat, 40% had dizziness or light-headedness when standing up, 35.3% had shortness of breath, 34.1% had sleep disorders, 29.4% had muscle pain, 25.9% had sore eyes, 18.8% had loss of smell, 18.8% had earache or ringing in ears, 16.5% had abdominal pain, 15.3% had anxiety or depression, 10.6% had diarrhea, 9.4% had swelling or raised welts on skin, and 4.7% had red or purple sores or blisters on their feet.

 

[Hutan]

Table 2: Of the 85 students with one or more Long covid symptoms:
62% of parents agreed that the child's studying had been affected

(54/85) 64% said that the child had been able to return to usual activities of daily life within a month of the illness
(12/85) 14% said the the child had been able to return to usual activities of daily life, but it took more than a month
(15/85) 18% said that the child had to increase rest hours
(0/85) 0% said that the child had to stop one or many activities
(4/85) 5% answered 'do not know' in reply to the question about whether the child had been able to continue their usual daily activities

However, only 43% of parents of the 85 children with one or more Long Covid symptoms said that their child had recovered from Covid-19.

The reported Long Covid prevalence of 5.6% includes a substantial number of children who were able to return to usual activities within a month of the illness. I think ME/CFS-type Long Covid is approximately the 15 children who had to increase rest hours, so 15/1507, about 1%, and even then there could be other causes.

Yeah, unfortunately, I think this paper just adds more confusion to the already highly confused issue of (pediatric) Long Covid prevalence.