Thailand Medical Experts Find That 39.7 Percent Of Children Who Had COVID-19 Pneumonia Developed Long COVID!

Thailand Medical: The global impact of the COVID-19 pandemic, spanning from 2020 to 2022, has been extensive, leaving a lasting imprint on healthcare systems worldwide. While children have generally exhibited milder cases of COVID-19, an emerging concern is the prevalence of persistent symptoms, commonly referred to as long COVID. This groundbreaking study, conducted by the Department of Pediatrics, Division of Pulmonology at the Faculty of Medicine, Siriraj Hospital, Mahidol University in Bangkok and covered in this Thailand Medical News report, seeks to delve into the intricacies of long COVID in children, specifically those who had previously experienced COVID-19 pneumonia.


Thailand Medical Experts Find That 39.7 Percent Of Children Who
Had COVID-19 Pneumonia Developed Long COVID

Understanding Long COVID
Long COVID is a term used to describe the lingering symptoms that persist for more than 12 weeks after the initial COVID-19 infection. It encompasses a range of symptoms that may affect various bodily systems, posing challenges for both patients and healthcare providers. To date, the study of long COVID in children, including its impact on pulmonary function, has been limited. This study aims to address this gap by providing insights into the incidence, symptoms, and risk factors associated with long COVID in pediatric patients who have previously battled COVID-19 pneumonia.
 
Incidence and Symptomatology
The study enrolled 116 children who had been admitted with COVID-19 pneumonia between 2021 and 2022. The incidence of long COVID was strikingly high, reaching 39.7%, surpassing previous reports in the literature. Notably, all cases classified as severe pneumonia consistently reported persistent symptoms, providing a unique perspective on the correlation between the severity of the initial infection and the likelihood of developing long COVID.
 
The persistent symptoms were categorized into various organ systems, with respiratory symptoms emerging as the most common. Exercise intolerance, chronic cough, and fatigue were identified as the top three persistent symptoms, affecting 22.4%, 18.1%, and 15.5% of patients, respectively. The study's findings shed light on the need for healthcare providers to be vigilant for these symptoms in children recovering from COVID-19 pneumonia, as they may indicate the presence of long COVID.
 
Pulmonary Function and Abnormalities
The follow-up assessments, conducted approximately three months after the initial admission, unveiled intriguing details regarding pulmonary function and abnormalities in the study cohort. Abnormal chest radiographs were observed in 18.1% of cases, prompting further investigation into the potential impact of long COVID on respiratory health.
 
Of particular interest were the cases exhibiting restrictive ventilatory defects, a phenomenon observed in 6.9% of the patients. Among these cases, one demonstrated a concomitant diffusion defect, highlighting the diverse respiratory challenges that can emerge in the aftermath o f COVID-19 pneumonia.
 
Additionally, 6.0% of cases displayed exercise-induced hypoxemia after a 6-minute walk test, suggesting that physical exertion may trigger respiratory issues in some children recovering from COVID-19 pneumonia.
 
Comparisons of spirometry variables between children with and without long COVID revealed a significant difference in FEF25-75 (z score), emphasizing the importance of assessing specific lung function parameters in identifying respiratory abnormalities associated with long COVID in pediatric patients.
 
Risk Factors and Associations
An essential aspect of the study involved identifying risk factors associated with the development of long COVID in children. Older age emerged as a significant factor, with an adjusted odds ratio of 1.13 (95% CI: 1.05–1.22, p value 0.002). This finding underscores the need for tailored monitoring and care for older pediatric patients recovering from COVID-19 pneumonia.
 
Furthermore, the study highlighted that children with allergic diseases, including allergic rhinitis, atopic dermatitis, and asthma, faced a higher risk of long COVID. The adjusted odds ratio for allergic diseases was 4.05 (95% CI: 1.36–12.06, p value 0.012). This association brings attention to the potential role of the immune response in long COVID and emphasizes the importance of considering underlying allergic conditions when managing pediatric patients recovering from COVID-19 pneumonia.
 
Another noteworthy association was found with children residing in polluted areas. Living in environments with elevated pollution levels was associated with an increased risk of long COVID, with an adjusted odds ratio of 2.73 (95% CI: 1.18–6.33, p value 0.019). This finding raises concerns about the potential impact of environmental factors on the recovery trajectory of pediatric patients post-COVID-19 pneumonia.
 
Quality of Life and Psychosocial Impact
Beyond the physiological aspects, the study delved into the psychosocial impact of long COVID on pediatric patients. Quality-of-life scores were assessed, revealing a significant decline during COVID-19 pneumonia, a decline that persisted at the follow-up assessment. This insight highlights the multifaceted nature of long COVID, encompassing not only physical but also psychological dimensions that warrant comprehensive care and support.
 
Implications for Clinical Practice
The findings of this study have far-reaching implications for clinical practice, emphasizing the need for a holistic approach to the management of pediatric patients recovering from COVID-19 pneumonia. Healthcare providers should be attuned to the diverse symptoms associated with long COVID, with particular attention to exercise intolerance, chronic cough, and fatigue. Comprehensive follow-up assessments, including pulmonary function tests and chest radiographs, are crucial to identifying and addressing potential respiratory abnormalities.

Tailored rehabilitation programs may be essential for children experiencing persistent symptoms, aiming to enhance their recovery and overall well-being. The study also underscores the importance of monitoring and support for children residing in polluted areas and those with underlying allergic conditions.
 
Conclusion
In conclusion, this comprehensive study from Thailand provides a pioneering exploration into the complexities of long COVID in pediatric patients recovering from COVID-19 pneumonia. The high incidence, diverse symptomatology, and associations with age, allergic diseases, and environmental factors highlight the need for continued research and tailored interventions in this vulnerable population.

As our understanding of long COVID evolves, healthcare providers must remain vigilant and adaptable in their approach to pediatric care post-COVID-19 pneumonia. The findings of this study serve as a crucial foundation for future investigations, guiding the development of evidence-based strategies to mitigate the impact of long COVID on the health and well-being of children worldwide.
 
The study findings were published in the peer reviewed journal: pediatric Pulmonology (Wiley).
https://onlinelibrary.wiley.com/doi/10.1002/ppul.26910
 
For the latest on Long COVID, keep on logging to Thailand Medical News.