A new paper from the Corona-Kinderstudie has recently been published in the journal EBioMedicine. The study investigated Long COVID symptoms in exposed and infected children, adolescents and their parents one year after SARS-CoV-2 infection.

The Corona-Kinderstudie is a cooperation between four University Hospitals in Baden-Württemberg (Freiburg, Heidelberg, Tübingen and Ulm) initiated and financed by the state of Baden-Württemberg. Freiburg’s involvement in the study is led by Professor Philipp Henneke and Dr. Roland Elling. For more information, please visit the study website (www.corona-kinderstudie.de, in German) or email the study team (corona.kinderstudie@uniklinik-freiburg.de).

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

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.

Haddad, A., Janda, A., Renk, H., Stich, M., Frieh, P., Kaier, K., Lohrmann, F., Nieters, A., Willems, A., Huzly, D., Dulovic, A., Schneiderhan-Marra, N., Jacobsen, E. M., Fabricius, D., Zernickel, M., Stamminger, T., Bode, S., Himpel, T., Remppis, J., Engel, C., … Elling, R. (2022). Long COVID symptoms in exposed and infected children, adolescents and their parents one year after SARS-CoV-2 infection: A prospective observational cohort study. EBioMedicine, 84, 104245. Advance online publication. https://doi.org/10.1016/j.ebiom.2022.104245