Acute and long-term outcomes of SARS-CoV-2 infection in school-aged children in England: Study protocol for the joint analysis of the COVID-19 schools infection survey (SIS) and the COVID-19 mapping and mitigation in schools (CoMMinS) study

PLoS One. 2024 May 22;19(5):e0303892. doi: 10.1371/journal.pone.0303892. eCollection 2024.

Abstract

Background: The symptom profiles of acute SARS-CoV-2 infection and long-COVID in children and young people (CYP), risk factors, and associated healthcare needs, are poorly defined. The Schools Infection Survey 1 (SIS-1) was a nationwide study of SARS-CoV-2 infection in primary and secondary schools in England during the 2020/21 school year. The Covid-19 Mapping and Mitigation in Schools (CoMMinS) study was conducted in schools in the Bristol area over a similar period. Both studies conducted testing to identify current and previous SARS-CoV-2 infection, and recorded symptoms and school attendance. These research data have been linked to routine electronic health record (EHR) data.

Aims: To better understand the short- and long-term consequences of SARS-CoV-2 infection, and their risk factors, in CYP.

Methods: Retrospective cohort and nested case-control analyses will be conducted for SIS-1 and CoMMinS data linked to EHR data for the association between (1) acute symptomatic SARS-CoV-2 infection and risk factors; (2) SARS-CoV-2 infection and long-term effects on health: (a) persistent symptoms; (b) any new diagnosis; (c) a new prescription in primary care; (d) health service attendance; (e) a high rate of school absence.

Results: Our study will improve understanding of long-COVID in CYP by characterising the trajectory of long-COVID in CYP in terms of things like symptoms and diagnoses of conditions. The research will inform which groups of CYP are more likely to get acute- and long-term outcomes of SARS-CoV-2 infection, and patterns of related healthcare-seeking behaviour, relevant for healthcare service planning. Digested information will be produced for affected families, doctors, schools, and the public, as appropriate.

Conclusion: Linked SIS-1 and CoMMinS data represent a unique and rich resource for understanding the impact of SARS-CoV-2 infection on children's health, benefiting from enhanced SARS-CoV-2 testing and ability to assess a wide range of outcomes.

MeSH terms

  • Adolescent
  • COVID-19* / diagnosis
  • COVID-19* / epidemiology
  • Case-Control Studies
  • Child
  • England / epidemiology
  • Female
  • Humans
  • Male
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2* / isolation & purification
  • Schools*

Grants and funding

This work is part of the Data and Connectivity National Core Study, led by Health Data Research UK in partnership with the Office for National Statistics and funded by UK Research and Innovation (PI RD; grant ref MC_PC_20029; https://www.hdruk.ac.uk/). Funding to support the analyses has been secured from the National Institute of Health Research (NIHR) School of Primary Care Research (Co-PIs KJL and RD; reference 637; https://www.spcr.nihr.ac.uk/). The funders did not and will not have a role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The umbrella study for the work is the ELUCIDate study (“ELUcidate long-term consequences of Childhood Infections using administrative and research Data”; https://elucidatestudy.blogs.bristol.ac.uk/).