Natural course of health and well-being in non-hospitalised children and young people after testing for SARS-CoV-2: a prospective follow-up study over 12 months

Snehal M Pinto Pereira; Roz Shafran; Manjula D Nugawela; Laura Panagi; Dougal Hargreaves; Shamez N Ladhani; Sophie D Bennett; Trudie Chalder; Emma Dalrymple; Tamsin Ford; Isobel Heyman; Kelsey McOwat; Natalia K Rojas; Kishan Sharma; Ruth Simmons; Simon R White; Terence Stephenson

doi:10.1016/j.lanepe.2022.100554

Natural course of health and well-being in non-hospitalised children and young people after testing for SARS-CoV-2: a prospective follow-up study over 12 months

Lancet Reg Health Eur. 2023 Feb:25:100554. doi: 10.1016/j.lanepe.2022.100554. Epub 2022 Dec 5.

Authors

Snehal M Pinto Pereira¹, Roz Shafran², Manjula D Nugawela², Laura Panagi³, Dougal Hargreaves⁴, Shamez N Ladhani^{5

6}, Sophie D Bennett², Trudie Chalder⁷, Emma Dalrymple², Tamsin Ford³, Isobel Heyman², Kelsey McOwat⁵, Natalia K Rojas², Kishan Sharma⁸, Ruth Simmons⁵, Simon R White^{3

9}, Terence Stephenson²

Affiliations

¹ Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London, WC1E 6BT, UK.
² UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK.
³ Department of Psychiatry, University of Cambridge, Hershel Smith Building Cambridge Biomedical Campus, CB2 0SZ, UK.
⁴ Mohn Centre for Children's Health & Wellbeing, School of Public Health, Imperial College London, UK.
⁵ Immunisation Department, Public Health England, 61 Colindale Avenue, London, NW9 5EQ, UK.
⁶ Paediatric Infectious Diseases Research Group, St. George's University of London, Cranmer Terrace, London, SW17 0RE, UK.
⁷ Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De'Crespigny Park, London, SE5 8AF, UK.
⁸ Division of Neuroscience & Experimental Psychology, University of Manchester, UK.
⁹ Medical Research Council Biostatistics Unit, University of Cambridge, East Forvie Building, Cambridge Biomedical Campus, CB2 0SR, UK.

Abstract

Background: Despite high numbers of children and young people (CYP) having acute COVID, there has been no prospective follow-up of CYP to establish the pattern of health and well-being over a year following infection.

Methods: A non-hospitalised, national sample of 5086 (2909 SARS-COV-2 Positive; 2177 SARS-COV-2 Negative at baseline) CYP aged 11-17 completed questionnaires 6- and 12-months after PCR-tests between October 2020 and March 2021 confirming SARS-CoV-2 infection (excluding CYP with subsequent (re)infections). SARS-COV-2 Positive CYP was compared to age, sex and geographically-matched test-negative CYP.

Findings: Ten of 21 symptoms had a prevalence less than 10% at baseline, 6- and 12-months post-test in both test-positives and test-negatives. Of the other 11 symptoms, in test-positives who had these at baseline, the prevalence of all symptoms declined greatly by 12-months. For CYP first describing one of these at 6-months, there was a decline in prevalence by 12-months. The overall prevalence of 9 of 11 symptoms declined by 12-months. As many CYP first described shortness of breath and tiredness at either 6- or 12-months, the overall prevalence of these two symptoms in test-positives appeared to increase by 6-months and increase further by 12-months. However, within-individual examination demonstrated that the prevalence of shortness of breath and tiredness actually declined in those first describing these two symptoms at either baseline or 6-months. This pattern was also evident for these two symptoms in test-negatives. Similar patterns were observed for validated measures of poor quality of life, emotional and behavioural difficulties, poor well-being and fatigue. Moreover, broadly similar patterns and results were noted for the sub-sample (N = 1808) that had data at baseline, 3-, 6- and 12-months post-test.

Interpretation: In CYP, the prevalence of adverse symptoms reported at the time of a positive PCR-test declined over 12-months. Some test-positives and test-negatives reported adverse symptoms for the first time at six- and 12-months post-test, particularly tiredness, shortness of breath, poor quality of life, poor well-being and fatigue suggesting they are likely to be caused by multiple factors.

Funding: NIHR/UKRI (ref: COVLT0022).

Keywords: CYP, Children and young people; Children and young people; IQR, Interquartile range; Long COVID; Longitudinal; Symptoms; UKHSA, United Kingdom Health Security Agency; Well-being.

Abstract

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