A study funded by the National Institutes of Health (NIH) has found that while there are similar patterns of how long COVID affects virtually every organ system in both younger children and adolescents, younger children were more likely to experience headache, while those older were most likely to suffer from low energy and tiredness.
The findings, published this week in JAMA, comes from data collected via the NIH’s Researching COVID to Enhance Recovery (RECOVER) Initiative, a broad project focused on learning more about long COVID, and how to treat and prevent its occurrence. The new data are an important step in better understanding how long COVID affects different populations.
“Most research characterizing long COVID symptoms is focused on adults, which can lead to the misperception that long COVID in children is rare or that their symptoms are like those of adults,” said David Goff, MD, PhD, division director for the division of cardiovascular sciences at the NIH’s National Heart, Lung, and Blood Institute. “Because the symptoms can vary from child to child or present in different patterns, without a proper characterization of symptoms across the life span, it’s difficult to know how to optimize care for affected children and adolescents.”
For this observational study, more than 3,800 children and adolescents who had been infected with the SARS-CoV-2 virus were enrolled at more than 60 sites across the U.S. between March 2022 and December 2023. A comparison group of roughly 1,500 children and adolescents with no prior COVID history were also enrolled to enable researchers to tease out of the data whether observed prolonged symptoms were directly related to long COVID or simply related to the effects of the pandemic itself.
To gather their data, the researchers collected surveys from care givers that asked about 75 different prolonged symptoms in all major body symptoms that occurred at least 90 after the initial infection and lasted more than a month. Respondents were also asked to provide information on the caregivers’ perceptions of the enrolled person’s health and quality of life. Using these data the team was able to generated a long COVID research index of common symptoms that indicate the likelihood a child or adolescent is suffering from these lingering effects.
Among school-age children the investigators found 18 symptoms common to long COVID with headache topping the list as a symptom in 57% of participants. Other common symptoms included trouble with memory or focus (44%), sleep disturbances (44%) and stomach pain (43%). Adolescents, roughly four out of five long COVID sufferers (8o%) reported daytime tiredness or sleepiness, followed by body muscle or joint pain (60%), headache (55%), and trouble with memory and focus (47%).
Lead author of the study Rachel Gross, MD, an associate professor of pediatrics and population health at NYU Grossman School of Medicine noted that these most common symptoms were not the only ones observed in the two cohorts and were also not the most severe symptoms experienced by many, but that they were the most predictive symptoms of whether a person had long COVID.
While there was significant overlap in the symptoms experienced by both younger children and adolescents, the study developed separate research indexes for each group. Of those enrolled in the study, 20% of the school age children met the long COVID research index threshold and 14% of adolescent met the threshold.
These early data can now serve as a backdrop for continuing research about the effects of long COVID on these two populations but does not provide any clinical care guidelines.
“Our next step is to study children ages 5 years and younger so we can better understand long COVID in the very young,” Gross added.
