Long Covid effects could be worse in children warns leading Scots pediatrician

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The message that coronavirus does very little harm to children ‘might now be weaker’, a leading paediatrician has said, as new research suggests higher numbers than expected may be experiencing long term effects.

Office of National Statistics (ONS) data found 13% of children aged between two and 11 across the UK were still experiencing symptoms including headaches, a cough or fatigue at five weeks and this rose to 15% in 12 to 16-year-olds.

While attention has mainly focused on their ability to transmit the virus to adults, Debby Bogaert, a Professor of Paediactric Infectious Diseases at Edinburgh University, said the data showed there was a need to look more closely at the impact on children themselves.

She said it is possible that the longer term effects may be worse that in adults because they are still growing and developing and said, for this reason, it was wise to limit the spread of any viral infection.

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Prof Bogaert said she fully supported pupils returning to school as soon as it was safely possible but said children, also, ‘had the right to be protected’. 

The ONS research looked at the prevalence of the most commonly reported Covid symptoms amongst 9, 063 people aged between two and 70 and over who tested positive for Covid-19 between April 22 and December 14.

Children between the ages of 2 and 16 were most likely to experience headache, while a persistent cough or fatigue was more common in those aged 12 -16 and the likelihood increased the older participants were.

Another paediatrician at Glasgow’s Royal Hospital for Children said he had seen a handful of referrals which were likely to be Long Covid but said it was probably that other cases might not have been formally diagnosed.  

Studies are underway in Glasgow and Edinburgh to try to get a more accurate picture of the incidence across Scotland.

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Professor Bogaert said:  “We have been communicating that we should be careful in allowing the spread of virus amongst children because they might infect their parents, or grandparents or teachers. That discussion is very valid. 

“But the argument that it likely does very little harm to children might be now a bit weaker. 

“I think there are now arguments which say, we need to be cautious. 

“Children don’t seem to have very acute infections but might have longer lasting effects that need to be studied. The long term effects might be more because they are still growing and developing.

“I’ve always said I think it’s wise to limit viral infections and also in children despite the fact that they very rarely get very serious disease because we don’t know what the long term consequences are.

“We do know they play a role in community spread but we now have a bit more evidence to try to prevent infections in children at all.

“Children need their social contact, they need school and I fully support that but they have also the right to be protected and that’s becoming more clear.

“We need to make sure there are proper measures in place such as ventilation and space, hygiene and masks. Everything that counts for the general population should  count for children as well.

She added: “I think that should already have been the message but it’s now underlining that it’s also important for children.”

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Adults aged 35-49 were most likely to report any Long Covid symptoms (27%) closely followed by those aged 50-69.  The loss of taste or sense of smell and muscle pain was lowest in the youngest age group. 

“They have only checked a limited number of symptoms, studies involving adults have looked at groups of symptoms,” added Prof Bogaert.

A spokeswoman for the ONS said it was important to note that the figures were estimates and said that the data requires further analysis. No breakdown was given for the number of participants in each age group.

A campaign group which has been surveying the parents of children with Covid said almost 50% had reported that symptoms lasted more than nine months. Long Covid Kids said 207 families had responded so far. 

Dr Ross Langley, a Paediatric Consultant in Respiratory and Sleep Medicine at the Royal Hospital for Children in Glasgow said the ONS figures were higher than he would have expected and underlined the need for further investigation. 

He said: “The problem with Long Covid in children is that it’s an unknown quantity in some respects.

“I think the interest in it has been minimal compared with the effects on adults and I suspect that’s due to the fact that in children we haven’t seen anywhere near the levels of severe disease as we have seen in the adult population. 

“There are kids getting unwell but nowhere near the same numbers. Children often present with varying symptoms so they might be referred to different specialties so the problem is even at the GP coalface people might not be necessarily joining the dots and diagnosing it as Long Covid but might get referred with a chronic cough.

“So what we are trying to do in Glasgow and with our Edinburgh colleagues is to establish what the incidence is and then try to establish some sort of bespoke pathway to help us get some data on these children. How many there are, what the symptoms are, do they have any physical abnormalities and how best can we support them.

“It’s like everything in medicine, if you don’t look you don’t find. We’ve probably had a handful of referrals that are likely to be Long Covid.”

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Research published in December suggests Covid-19 could be causing lung abnormalities still detectable more than three months after patients are infected.

A study of 10 adult patients at Oxford University found evidence of damage using an MRI technique that had not been picked up by conventional scans.

A spokesman for the Scottish Government said: “The Chief Scientist Office has funded 9 extensive research projects on Long Covid through £2.5 million of funding, and this will increase clinical knowledge on the long-term effects.

“We will continue to engage with people who have Long Covid, NHS Boards and the wider clinical community to deepen our understanding of the symptoms and impact to help us continue to deliver the support people need.”

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