Respiratory function and symptoms after acute COVID-19 infection in children and adolescents

ABSTRACT

Introduction: Significant long-term effects on both symptomatology and respiratory function have been recognised in adult populations after COVID-19 infection, termed 'Long COVID'. These have caused loss of productivity and increased need for healthcare services. This study aimed to measure symptoms and lung function in children and adolescents after acute COVID-19 infection. Method(s) Clinical follow up, body plethysmography, and double diffusion testing were performed on 18 children and adolescents (age 7-17 years) within 3-6 months of their infection. The Liverpool respiratory questionnaire and PROMIS paediatric sleep questionnaires were also administered. 5 patients were infected with the alpha variant, while 13 had the delta variant. Of those with the delta variant, 7 had COVID pneumonitis requiring hospitalisation during their acute illness. None had been vaccinated against COVID-19. Result(s) Most children recovered well with minimal residual symptoms, and maintained lung function within normal limits. However, 3 of the 18 children had ongoing symptoms that impacted their day-to-day activities. These included fatigue, exercise limitation, sleep impairment and persistent post-viral cough. Of these, 2 children had abnormalities on double diffusion testing, despite normal spirometry. There were no significant differences between the alpha and delta cohorts or between children treated at home vs those requiring hospitalisation. Conclusion(s) 'Long COVID' also affects paediatric populations, particularly in terms of ongoing fatigue and exercise limitation. Double diffusion testing may shed some light on lung changes leading to persistent symptomatology after COVID infection.