Long Covid in children: what does the data show?

As Omicron sweeps across the globe, some experts are warning that health services need to prepare for a wave of long Covid cases in children as well as adults.

Bloomberg said it is too soon to know whether the new variant will cause the “mysterious constellation of symptoms, usually diagnosed many weeks after the initial illness” that has come to be known as long Covid. But “scientists are racing to pinpoint the cause of the bedeviling condition and find treatments before a potential explosion” in cases.

In England, the percentage of people testing positive for Covid-19 is now decreasing for most age groups – but for schoolchildren infection rates are on the rise.

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The final week of January saw the highest number of absences in schools for the whole 2021/22 academic year so far, reported the BBC. The Office for National Statistics (ONS) found that children aged two to school Year 6, and school Year 7 to school Year 11, were the only ones with increasing Covid rates in the week ending 22 January 2022.

So how many children have long Covid? There is a lack of data on this, partly due to the “absence of a clear definition for the phenomenon”, the “variance in research methodologies”, and “the fact that we are still less than two years into the pandemic”, noted David Meyer at Fortune.

An editorial in the BMJ by three experts in paediatric infectious diseases agreed that the “broad range of symptoms” make it hard to pinpoint the number of people affected. They include “objective complications” such as lung disease, but also mental health conditions and “more subjective, non-specific symptoms resembling those seen in post-viral chronic fatigue syndrome”, wrote Petra Zimmermann, Laure F Pittet and Nigel Curtis last month. On top of this, “most studies to date have substantial limitations”, they said.

The latest figures from the ONS, published on 6 January, showed that an estimated 117,000 children aged two to 16 had long Covid, up from 77,000 the previous month, with a total number of 1.3m long Covid sufferers across all ages.

These figures were based on 351,850 survey responses, with self-reported long Covid defined as “symptoms persisting for more than four weeks after the first suspected coronavirus infection that were not explained by something else”.

Separate analysis, published in a pre-print last summer from the UK-based CLoCK (Children and young people with Long Covid) study, suggested that 70% of children and young people experience fewer long Covid symptoms after three months.

The remaining 30%, however, were “more likely to have poorer physical and mental health, experience pain/discomfort, and issues with mobility, self-care and usual activities”, reported Cristiana Vagnoni in an article for Parliament.uk. The study found that children in this less common subgroup “were likely to be female, older, with poorer baseline physical and mental health”, she said.

Professor Christina Pagel, director of University College London’s clinical operational research unit, has called for children aged five and above to be offered vaccination against Covid-19 and told The Guardian that long Covid was a serious concern.

However, Professor Adam Finn, head of the Bristol Children’s Vaccine Centre and a member of the Joint Committee on Vaccination and Immunisation, told the paper that long Covid appears to be more rare, mild and shorter-term for children than adults.

The impact of vaccinations on long Covid is also still under investigation, although Priya Venkatesan at The Lancet pointed to “encouraging emerging data that individuals who are vaccinated against Covid-19 are less likely to report long Covid symptoms”.