Post-Covid sequelae appear in adults and children, study shows

New research has shown that post-Covid sequelae occur equally in adults, children and adolescents up to three months after infection and can persist for at least eight months.

Led by researcher Martin Roessler, from the Technical University of Dresden, Germany, the study was the first to include a large number of participants of all ages to assess whether or not post-Covid effects could be a consequence of coronavirus infection.

The article was published this Thursday (10) in the specialized journal PLoS Medicine.

The survey was based on the six main German health insurance systems, which serve around 38 million people (or 52% of the population). From the records of coronavirus infection, the researchers selected 157,000 cases of Covid (11,500 in children and adolescents and 145,184 in adults) and compared them with about 1.2 million people in the control group, that is, who had never had the disease. illness. Only participants with a positive diagnosis for Covid until July 2020 were included.

Each patient was followed up for an average of 236 days (about eight months) in the case of children and adolescents, and 254 days (or about nine months) in the case of adults. Unlike other studies on post-Covid sequelae, which consider patients’ self-registration, the diagnosis of the various types of symptoms was made by health plan doctors.

All data were adjusted for pre-existing health conditions, including pre-existing diseases that could worsen Covid, as well as sex, age and the degree of severity of the disease, as these factors can influence the persistence of symptoms.

Ninety-six symptoms were recorded, divided into at least 13 groups of systems, such as cardiac, vascular, respiratory, among others. Overall, patients who had Covid had a 33% higher incidence for adults and 30% for children of post-Covid symptoms than the control group. The problems that appeared more frequently in both groups were cough, fever, headache, fatigue/exhaustion and chest or throat pain.

When separated by age group, the main post-Covid effects presented by children were fatigue and exhaustion (128% higher), cough (74% higher) and chest or throat pain (72% higher). In adults, the most frequent sequelae were loss of smell and taste (569%), fever (233%) and shortness of breath (188%).

In children, psychic effects and mental damage from long-term Covid were more common, while adults reported respiratory damage and body pain more often.

According to the authors, although post-Covid effects were recorded equally in both groups, the frequency was much higher in adults than in children. Although infections in this age group are less frequent than in adults, this did not influence the final result, he explained to Sheet Roessler.

“A higher incidence of Covid would not change the relationship between Covid and the long-term sequelae found, and the high transmission rates of the virus reinforce the need to assess post-Covid sequelae in children and adolescents,” he said.

It is already known that post-Covid sequelae can manifest in different ways, including in the brain, heart, lungs, vascular system and reproductive systems. Some research in the past has already sought to better understand which groups are most affected by long Covid, such as a higher incidence of effects in women.

The analysis by Roessler and colleagues did not find a significant relationship between hospitalization for Covid and the emergence of sequelae, although the small number of patients admitted to the study (5.8% in ward beds and 2.1% for ICU in the case of adults , and 1% in hospital beds and 0.4% in ICU, in the case of children) may have influenced. Nor was a relationship found between having a prior health condition and being more likely to have long-term Covid.

Other research points out that the effects of Covid can appear even in patients with mild to moderate disease, but this was not possible to observe in the German study.

Regarding the strains of the virus and its power to cause more serious infections, Roessler says that the study has a main limitation, which is that it was carried out before the emergence of the main variants of concern (VOCs) of Sars-CoV- two. “Since some of these variants, like the omicron, are much more transmissible, they can infect more people, and thus the effects of long-term Covid may be underestimated,” he says.

The authors highlight the importance of vaccination to stop or reduce the post-Covid effects. Vaccination in children up to 11 years old, even prevents the so-called SIM-P, a rare post-Covid syndrome that can bring cardiac sequels in the youngest. “The mitigation potential of vaccination was not included in the study period, and thus it is necessary to continue long-term observation to extrapolate our observations to the most recent waves of the pandemic,” they conclude.