Long-COVID symptoms in teens may evolve over time

Teen boy asleep on bed with laptop

Long-COVID symptoms in adolescents may change over time, finds a study of nearly 5,100 non-hospitalized 11- to 17-year-olds in the United Kingdom published yesterday in The Lancet Regional Health-Europe.

A team led by University College London researchers administered symptom questionnaires to 5,086 nonhospitalized preteens and teens 6 and 12 months after they underwent COVID-19 polymerase chain reaction (PCR) testing from October 2020 to March 2021, before the Delta and Omicron variant waves. Of that number, 2,909 tested positive, and 2,177 tested negative.

Overall prevalence fell by 1 year

Participants were asked to recall any of 21 symptoms at the time of the PCR test. Symptoms were more common among participants who tested positive than those with a negative result at baseline and 6 and 12 months. For example, 10.9% of those who tested positive reported fatigue at all three time points, compared with 1.2% among those with a negative result.

Ten of the 21 symptoms had a prevalence of less than 10% at all time points, regardless of test result. The other 11 symptoms declined greatly by 12 months in both those who tested positive and had them at baseline and in those who first described them at 6 months.

The prevalence of shortness of breath and fatigue in those who reported them at 6 or 12 months appeared to increase at both 6 and 12 months in those who tested positive. But examination of individual questionnaires showed that the prevalence of these two symptoms actually declined at baseline or 6 months. The same pattern was also seen in participants who tested negative.

"The prevalence of adverse symptoms reported at the time of a positive PCR-test declined over 12-months," the study authors wrote.

Some symptoms appeared at 6 or 12 months

The authors also noted, "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."

In a University College London news release, corresponding author Snehal Pinto Pereira, PhD, said that the findings suggest that researchers need to track individual disease courses using repeated measurement of the same participants over time. "Simply reporting repeated cross-sectional prevalences—or snapshots—of symptoms over time may obscure important information about long Covid in young people that has clinical relevance," she said.

Simply reporting repeated cross-sectional prevalences—or snapshots—of symptoms over time may obscure important information.

The researchers will continue to analyze questionnaire results from participants for as long as 2 years after the initial PCR test, according to the release.

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