Paediatric Post Covid-19 Condition: Experience of a Northern Paediatric Post Covid-19 Assessment Centre

ABSTRACT

Aims Post COVID-19 condition is defined by the WHO as a 'condition (which) occurs in individuals with a history of probable or confirmed SARS-CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms that last for at least 2 months and cannot be explained by an alternative diagnosis and generally have an impact on everyday functioning [1].' South Tees' Paediatric Post COVID-19 Assessment Clinic is one of fifteen tertiary paediatric clinics commissioned in England for the multidisciplinary assessment of children and young people (CYP) with suspected post COVID-19 condition. To assess patient data from clinic to identify any patterns of susceptibility and contextualise data in terms of the national picture. Methods Data was obtained from the referral form, clinic notes and service evaluation tool. Results In the period from July 2021 to February 2022, twelve CYP completed assessment. (See figure 1 for referral and assessment pathway). Of the assessed patients, eleven were of white and one of mixed ethnicity, seven were female and five male, three were between 6-11 years, six between 12-15 years and three between 16-18 years. Four were classified as being from a deprived location defined by living in a postcode that was classed as quintile 1 or 2 in the indices of multiple deprivation. Chronic fatigue and 'brain fog' were the two most common symptoms. However, symptoms like tinnitus (one child) and chronic chesty cough with wheeze (one child) were also noted. Four patients have still not managed full-time return to school. Two of these have attendance below 25%. Conclusion Though our experience was in line with national figures in terms of symptom profile, increased prevalence in females and teenagers [2], total number of referrals for assessment is significantly lower than expected. From the local area CYP population estimates [3] and most recent Office for National Statistics 'self-reported long COVID survey' results [2], we would have expected to see significantly higher numbers of patients with post COVID-19 condition (~150-250 patients under 16 years of age at the lowest estimate) but this is not the case. It is possible that symptoms reported in the survey are not severe enough to have significant impact on daily living warranting referral. The reduced referral numbers could also be due to reduced awareness (clinicians and community) or symptoms being attributed to other causes resulting in non-referral to appropriate services. Despite small numbers, one third of CYP seen in clinic continue to have multiple symptoms and have not been able to return to full-time education. This would have significant impact on long-term health and wellbeing of these CYP. There is an urgent need for research to find rehabilitation and therapeutic strategies for these CYP. 1. 'A clinical case definition of post COVID-19 condition by a Delphi consensus'. (2021) World Health Organization. 2. 'Prevalence of ongoing symptoms following coronavirus (COVID-19) infection in the UK'. (2022) Office for National Statistics. 3. 'Local population diversity'. (2018) Middlesbrough Council.