A new challenge: post-COVID syndrome in adolescents

ABSTRACT

Post-COVID syndrome (or long COVID) is a set of multiple symptoms oc-curring after a documented SARS-CoV-2 infection and persisting for more than 2 months. The pediatric population is also affected, especially pre-adolescents and adolescents, even if data about this age group are still scarce. Persistent symptoms can have a strong impact on quality of life and schooling, school absenteeism and social withdrawal being of major concern. For this reason, the Division of General Pediatrics at the Univer-sity Hospital of Geneva has set up in May 2021 a specific consultation for adolescents with post-COVID syndrome, offering global and multidiscipli-nary care. To date 50 patients have been addressed to our consultation by their gen-eral practitioner. The mean age is 14 years, two thirds are girls. The symp-toms are multiple and non-specific, and are similar to those described in adults. The most frequent ones are fatigue, dizziness, headaches, dysp-nea, loss of smell, brain fog, sleep disorders, mood disorders. The Peds-QL questionnaire (assessing 4 aspects of teenagers' daily life), shows an impact of these symptoms on the quality of life, schooling and daily activities being the most affected. Reassuringly, peer relationships seem preserved. Impact on schooling is important, with two thirds of pa-tients reporting an impact on school performance, and one fourth having extended school absenteeism. The Adolescent Depression Rating Scale shows that 44% of our patients are at risk for depression. One third needs a psychological support. If necessary, patients can be referred to specialized consultations in our multidisciplinary group (ENT, pulmonology, neurology, cardiology, etc.) or to complementary examinations (Tilt-Test, stress test). Patients having symptoms due to physical activity (fatigability, shortness of breath, dysau-tonomia with standing position intolerance) can benefit from a progres-sive and individualized reconditioning program with an adapted sport coach. We offer a global follow-up to patients and families. School attendance is supported by making individual arrangements if required, through close collaboration with the education system. Repetition of the questionnaires 3-6 months after the beginning of the follow-up shows a trend towards clear improvement, however a longer follow-up period would be necessary to confirm these observations. (To allow fully up-to-date informations, numbers are susceptible to change until June).