45.3 Percent of Adolescents After 340 Days Still Have Persistent Long COVID-19 Symptoms That Are Different from Adults

Medical News: The lingering effects of COVID-19, known as Long COVID, continue to be a growing concern worldwide. While much research has focused on adults, a recent study sheds light on the unique experiences of adolescents. Researchers from the Istituto Superiore di Sanità (Rome, Italy), Fondazione Policlinico Universitario A. Gemelli IRCCS (Rome, Italy), and Meyer Children’s Hospital IRCCS (Florence, Italy), among other institutions, have uncovered intriguing findings. This Medical News report explores these findings and what they mean for adolescents, their families, and healthcare providers.


45.3 Percent of Adolescents After 340 Days Still Have Persistent Long COVID-19 Symptoms
That Are Different from Adults

Study Overview
The study analyzed 97 adolescents aged 12 to 17 years. These participants were evaluated for persistent symptoms associated with Long COVID, occurring well after their acute infection phase. Using a modified World Health Organization (WHO) form, researchers documented symptoms and evaluated their progression over time.
 
The study revealed that nearly half of the adolescents (45.3%) continued to experience symptoms after 340 days. Notably, their symptom profiles differed significantly from those of adults. The institutions involved in this research employed a rigorous methodology, which included two follow-up evaluations and clustering techniques to categorize symptoms and patterns.
 
Key Findings: A Unique Symptom Profile
The most prevalent symptoms reported by adolescents were fatigue (62.9%) and dyspnea (43.3%). Headaches, thoracic pain, and diarrhea were also common, affecting 28.9%, 22.7%, and 20.6% of participants, respectively. Interestingly, symptoms such as memory loss, sleep disturbances, and anxiety - frequently seen in adults with Long COVID - were less common in adolescents. This discrepancy underscores the need for age-specific approaches in diagnosis and treatment.
 
Persistent symptoms also varied depending on the severity of the initial COVID-19 infection and the phase of the pandemic. For instance, adolescents infected during the pre-Omicron phase experienced a higher overall number of symptoms (3.2 compared to 2.5 for those infected during the Omicron phase). Additionally, moderate to severe acute infections were linked to a greater number of long-term symptoms.
 
Symptom Persistence and Clusters
One year after their acute infection, 45.3% of the adolescents still experienced lingering symptoms. Fatigue and dyspnea remained the most persistent, though their prevalence decreased over time. For example, fatigue, initially present in 62.9% of participants, dropped to approximately 20% during the second follow-up evaluation.
 
Clustering analysis revealed two distinct groups of adolescents based on their symptoms. Cluster 1 included those with more severe symptoms and a higher prevalence of dyspnea, thoracic pain, and diarrhea. Cluster 2 consisted mainly of adoles cents with fewer and milder symptoms, largely infected during the Omicron phase.
 
Risk Factors and Implications
One of the study’s critical findings is the correlation between the number of initial symptoms and the likelihood of persistence. Adolescents who presented with multiple symptoms early on were more likely to experience long-term effects. This finding highlights the importance of early and comprehensive symptom management.
 
Comorbidities also played a role, albeit less prominently. Adolescents with pre-existing conditions like asthma or metabolic disorders showed specific symptom patterns, such as a higher prevalence of thoracic pain. However, the majority of participants did not have significant pre-existing conditions, suggesting that Long COVID’s impact extends broadly.
 
How Adolescents Differ from Adults
Compared to adults, adolescents exhibited a distinct Long COVID profile. Adults were more likely to report symptoms such as anxiety, memory loss, and sleep disturbances, whereas adolescents more frequently experienced physical symptoms like fatigue and dyspnea. This divergence may reflect differences in immune response, physical activity levels, or even psychological resilience.

Additionally, the study noted that the severity of acute infection seemed to play a larger role in adolescents. Those who required hospitalization during the acute phase - albeit a small percentage - were more likely to have persistent symptoms. This contrasts with adults, where even mild initial infections could lead to significant long-term effects.
 
Encouraging Recovery Trends
Despite the high prevalence of persistent symptoms, the study also brought good news. More than half of the adolescents who initially reported symptoms were symptom-free after a year. For those still experiencing symptoms, the intensity and number of symptoms significantly decreased over time. This gradual improvement aligns with other studies that suggest many Long COVID symptoms resolve with time and appropriate care.
 
Limitations and Future Directions
While comprehensive, the study had limitations. It focused on adolescents accessing specialized care, potentially skewing the data toward more severe cases. The researchers also acknowledged the need for larger, population-based studies to generalize findings. Furthermore, psychosocial impacts, such as school attendance and emotional well-being, were not extensively explored but remain critical areas for future research.
 
Vaccination status was another area warranting further investigation. Although 43% of participants were vaccinated before their infection, the study could not definitively assess the protective effect of vaccination against Long COVID in adolescents.
 
Conclusions
The findings from this study provide valuable insights into Long COVID in adolescents. Key takeaways include:
 
-Long COVID affects nearly half of adolescents one-year post-infection, with fatigue and dyspnea being the most common symptoms.
 
-The symptom profile in adolescents differs significantly from that of adults, necessitating tailored diagnostic and treatment approaches.
 
-The severity of initial infection and the number of early symptoms are strong predictors of long-term effects.
-While most adolescents show improvement over time, a substantial minority require ongoing care and monitoring.
 
These findings emphasize the need for age-specific healthcare strategies and continued research. Pediatricians, families, and policymakers must remain vigilant, ensuring that adolescents receive the support and care they need to recover fully.
 
The study findings were published in the peer-reviewed journal: Children.
https://www.mdpi.com/2227-9067/12/1/28
 
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