Adolescents with Persistent Symptoms Following Acute SARS-CoV-2 Infection (Long-COVID): Symptom Profile, Clustering and Follow-Up Symptom Evaluation

Background: Few studies have evaluated long-COVID in adolescents. Methods: Cohort study. Demographics, clinical data, and the presence of 30 symptoms were collected with a modified WHO form. Mean values were compared by Student’s <i>t</i> test and proportions by the chi-square test or Fi...

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Main Authors: Marco Floridia, Danilo Buonsenso, Laura Macculi, Liliana Elena Weimer, Marina Giuliano, Flavia Pricci, Leila Bianchi, Domenico Maurizio Toraldo, Graziano Onder, The ISS Long-COVID Study Group
Format: Article
Language:English
Published: MDPI AG 2024-12-01
Series:Children
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Online Access:https://www.mdpi.com/2227-9067/12/1/28
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author Marco Floridia
Danilo Buonsenso
Laura Macculi
Liliana Elena Weimer
Marina Giuliano
Flavia Pricci
Leila Bianchi
Domenico Maurizio Toraldo
Graziano Onder
The ISS Long-COVID Study Group
author_facet Marco Floridia
Danilo Buonsenso
Laura Macculi
Liliana Elena Weimer
Marina Giuliano
Flavia Pricci
Leila Bianchi
Domenico Maurizio Toraldo
Graziano Onder
The ISS Long-COVID Study Group
author_sort Marco Floridia
collection DOAJ
description Background: Few studies have evaluated long-COVID in adolescents. Methods: Cohort study. Demographics, clinical data, and the presence of 30 symptoms were collected with a modified WHO form. Mean values were compared by Student’s <i>t</i> test and proportions by the chi-square test or Fisher test, with trends over time analysed using the chi-square test for trend. Potential risk factors independently associated with persisting symptoms were evaluated in a multivariable logistic regression model. Clustering of cases was analysed by two-step automatic clustering. Results: A total of 97 adolescents aged 12–17 (54.6% females, 45.4% males) were evaluated. After a mean interval of 96 days (SD 52) from acute infection, the mean number of symptoms (2.8 overall) was higher for pre-Omicron (3.2 vs. 2.5 in Omicron, <i>p</i> = 0.046) and moderate/severe acute infections (4.2 vs. 2.7 in mild, <i>p</i> = 0.023). Fatigue (62.9%) and dyspnea (43.3%) were the most common symptoms, followed by headache (28.9%), thoracic pain (22.7%), diarrhea (20.6%), palpitations/tachycardia (17.5%), articular pain (15.5%), difficult concentration (14.4%), muscle pain (12.4%), taste reduction (8.2%), smell reduction (8.2%), fever (6.2%), and skin disorders (5.2%). The symptom profile was similar in males and females but showed significant differences from that observed in concurrently followed adults. After a mean interval of 340 days from infection, 45.3% still presented symptoms, with persistence associated with higher number of initial symptoms. Two clusters were defined that differed in the phase of acute infection and the number and profile of symptoms. Conclusions: Long-COVID manifestations in adolescents may differ from those observed in adults. Polisymptomaticity may predict long-term persistence.
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spelling doaj-art-3b1274d4161c4132a1922a13b58aa1ac2025-01-24T13:27:02ZengMDPI AGChildren2227-90672024-12-011212810.3390/children12010028Adolescents with Persistent Symptoms Following Acute SARS-CoV-2 Infection (Long-COVID): Symptom Profile, Clustering and Follow-Up Symptom EvaluationMarco Floridia0Danilo Buonsenso1Laura Macculi2Liliana Elena Weimer3Marina Giuliano4Flavia Pricci5Leila Bianchi6Domenico Maurizio Toraldo7Graziano Onder8The ISS Long-COVID Study GroupNational Center for Global Health, Istituto Superiore di Sanità, 00161 Rome, ItalyDepartment of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00136 Rome, ItalyFondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00136 Rome, ItalyNational Center for Global Health, Istituto Superiore di Sanità, 00161 Rome, ItalyNational Center for Global Health, Istituto Superiore di Sanità, 00161 Rome, ItalyDepartment of Cardiovascular, Endocrine-Metabolic Diseases and Ageing, Istituto Superiore di Sanità, 00161 Rome, ItalyInfectious Diseases Unit, Meyer Children’s Hospital IRCCS, 50139 Florence, ItalyCardiorespiratory Rehabilitation Unit, Department of Rehabilitation, “V. Fazzi” Hospital, 73100 Lecce, ItalyFondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00136 Rome, ItalyBackground: Few studies have evaluated long-COVID in adolescents. Methods: Cohort study. Demographics, clinical data, and the presence of 30 symptoms were collected with a modified WHO form. Mean values were compared by Student’s <i>t</i> test and proportions by the chi-square test or Fisher test, with trends over time analysed using the chi-square test for trend. Potential risk factors independently associated with persisting symptoms were evaluated in a multivariable logistic regression model. Clustering of cases was analysed by two-step automatic clustering. Results: A total of 97 adolescents aged 12–17 (54.6% females, 45.4% males) were evaluated. After a mean interval of 96 days (SD 52) from acute infection, the mean number of symptoms (2.8 overall) was higher for pre-Omicron (3.2 vs. 2.5 in Omicron, <i>p</i> = 0.046) and moderate/severe acute infections (4.2 vs. 2.7 in mild, <i>p</i> = 0.023). Fatigue (62.9%) and dyspnea (43.3%) were the most common symptoms, followed by headache (28.9%), thoracic pain (22.7%), diarrhea (20.6%), palpitations/tachycardia (17.5%), articular pain (15.5%), difficult concentration (14.4%), muscle pain (12.4%), taste reduction (8.2%), smell reduction (8.2%), fever (6.2%), and skin disorders (5.2%). The symptom profile was similar in males and females but showed significant differences from that observed in concurrently followed adults. After a mean interval of 340 days from infection, 45.3% still presented symptoms, with persistence associated with higher number of initial symptoms. Two clusters were defined that differed in the phase of acute infection and the number and profile of symptoms. Conclusions: Long-COVID manifestations in adolescents may differ from those observed in adults. Polisymptomaticity may predict long-term persistence.https://www.mdpi.com/2227-9067/12/1/28COVID-19long-COVIDpost-COVIDsymptomssymptom clustersadolescents
spellingShingle Marco Floridia
Danilo Buonsenso
Laura Macculi
Liliana Elena Weimer
Marina Giuliano
Flavia Pricci
Leila Bianchi
Domenico Maurizio Toraldo
Graziano Onder
The ISS Long-COVID Study Group
Adolescents with Persistent Symptoms Following Acute SARS-CoV-2 Infection (Long-COVID): Symptom Profile, Clustering and Follow-Up Symptom Evaluation
Children
COVID-19
long-COVID
post-COVID
symptoms
symptom clusters
adolescents
title Adolescents with Persistent Symptoms Following Acute SARS-CoV-2 Infection (Long-COVID): Symptom Profile, Clustering and Follow-Up Symptom Evaluation
title_full Adolescents with Persistent Symptoms Following Acute SARS-CoV-2 Infection (Long-COVID): Symptom Profile, Clustering and Follow-Up Symptom Evaluation
title_fullStr Adolescents with Persistent Symptoms Following Acute SARS-CoV-2 Infection (Long-COVID): Symptom Profile, Clustering and Follow-Up Symptom Evaluation
title_full_unstemmed Adolescents with Persistent Symptoms Following Acute SARS-CoV-2 Infection (Long-COVID): Symptom Profile, Clustering and Follow-Up Symptom Evaluation
title_short Adolescents with Persistent Symptoms Following Acute SARS-CoV-2 Infection (Long-COVID): Symptom Profile, Clustering and Follow-Up Symptom Evaluation
title_sort adolescents with persistent symptoms following acute sars cov 2 infection long covid symptom profile clustering and follow up symptom evaluation
topic COVID-19
long-COVID
post-COVID
symptoms
symptom clusters
adolescents
url https://www.mdpi.com/2227-9067/12/1/28
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