ABSTRACT
Background The COVID-19 pandemic profoundly affected the life of children and ado-lescents, with potential negative repercussions on their well-being. How-ever, this impact may have differed depending on context, household or individual level characteristics. We aimed to 1) identify risk factors for having been heavily impacted by the COVID-19 pandemic 2) evaluate the association between experiencing a heavy pandemic impact and the health-related quality of life (HRQoL) and mental health status of children and adolescents. Methods We invited children of adult participants in a Geneva population-based cohort (Specchio-COVID19), and from a random sample drawn from state registries to participate in the SEROCoV-KIDS cohort study. Children and adolescents aged 2-17 years old were included between December 2021 and February 2022. Parents were asked about the impact of the pandemic on their child(ren) with the Coronavirus impact scale, which covers health, financial and social aspects at the child and household level;a score higher than one standard deviation above the mean was deemed as a heavy im-pact. They also reported about their child(ren)'s HRQoL with the Ped-sQLTM, mental health with the Strengths and Difficulties Questionnaire, and on socio-demographic characteristics. Risk factors for having been heavily impacted by the COVID-19 were estimated with generalized esti-mating equations, as was the association between having experienced a heavy pandemic impact and having a poor HRQoL or mental health. Results Out of 1051 participants, 133 (12.7%) had experienced a heavy COVID-19 impact, 164 (15.6%) had a poor HRQoL, and 112 (12.7%) a poor mental health. Older age (aOR = 1.06;95%CI = 1.01-1.11), average to poor parent-child relationship (aOR = 5.34;95%CI = 2.39-11.94), average to poor par-ent's mood (aOR = 2.77;95%CI = 1.63-4.71) and average to poor house-hold financial situation (aOR = 2.68;95%CI = 1.51-4.76) were associated with having been heavily impacted by the pandemic, after adjustment for age and sex. Participants who had experienced a heavy COVID-19 impact were more likely to present a poor HRQoL (aOR = 2.60;95%CI = 1.64-4.13) and a poor mental health (aOR = 3.75;95%CI = 2.15-6.55) compared to those with an average impact. Discussion Older children and adolescents, living in unfavourable family and financial conditions seemed at higher risk for being heavily impacted by the pan-demic, which in turn was strongly associated with a decreased HRQoL and mental health.
ABSTRACT
Background and Objectives Evidence to date indicates that children, like adults, can present post-COVID syndrome. However, data on paediatric post-COVID syndrome re-mains unclear. In this study we present preliminary results regarding the duration and characteristics of paediatric persistent symptoms, stratifying by serological status, confirmed infection and age groups. Methods Children aged 6 months to 17 years of adults participating in a Geneva population-based cohort (Specchio-COVID19) and from a random sample drawn from state registries were invited to participate in the SEROCoV-KIDS longitudinal study, from December 1st 2021 to February 18th 2022. Children were tested for anti-SARS-CoV-2 antibodies targeting the nucle-ocapsid (N) protein which is only detected after SARS-CoV-2 infection. Parents filled-in a questionnaire on persistent symptoms (lasting over 12 weeks), compatible with post-COVID syndrome. We estimated sex-and age-adjusted prevalence using marginal prediction after logistic regres-sion. Findings Of 1015 children from 602 households, 555 (54.6%) were seropositive and 247 (24%) had a confirmed SARS-CoV-2 infection. Overall, 78 (7.7%) chil-dren had experienced persistent symptoms lasting over 12 weeks. The most frequent persistent symptoms declared among seropositives were fatigue, lower mood, insomnia and loss of smell. The adjusted prevalence of persistent symptoms among seropositive chil-dren was 9.0% (95%CI: 6.7-11.6) and of 5.0% (95%CI: 3.1-7.2) among ser-onegatives with an adjusted prevalence difference (ΔaPrev) of 4.0% (95%CI: 1.0-7.3). Stratifying by age group, we observed that the preva-lence of post-COVID was higher among adolescents (ΔaPrev = 8.3%;95%CI: 3.6-13.5) than among younger children (ΔaPrev = 2.1% (95%CI: -4.0-3.6) among 6-11 years old and ΔaPrev = 5.1% (95%CI:-2.4-12.8) among 0-5 years old). Interpretation A significant proportion of children, especially adolescents, experience symptoms lasting over 12 weeks after a SARS-CoV-2 infection. However, many parents declared persistent symptoms compatible with post-COVID in seronegative children, which highlights the complexity of identifying post-COVID, clinically and methodologically. We need further investiga-tion on timing of seroconversion and persistent symptoms, and potential other diagnoses. Nevertheless, the growing evidence of paediatric post-COVID indicates that more awareness in early detection and care man-agement are needed.