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Abstract
Objectives To describe the physical and mental health of children and young people (CYP) 6 months after infection with SARS-CoV-2 and explore whether this varies by COVID-19 vaccination.
Design A non-hospitalised, national cohort of people aged 11–17 years old with PCR-confirmed SARS-CoV-2 infection and PCR negatives matched at study invitation, by age, sex, region and date of testing who completed questionnaires 6 months after PCR testing. The questionnaire included 21 symptoms and standardised scales (eg, EQ-5D-Y and Chalder Fatigue Scale).
Results 6407 test-positive and 6542 test-negative CYP completed the 6-month questionnaire: 60.9% of test-positive vs 43.2% of test-negative CYP reported at least one symptom 6 months post-test; 27.6% of test-positive vs 15.9% of test-negative CYP reported 3+ symptoms. Common symptoms at 6 months were tiredness and shortness of breath among both test-positive and test-negative CYP; however, the prevalence of both was higher in test-positive (38.4% and 22.8%, respectively) compared with test-negative CYP (26.7% and 10.9%, respectively). 24.5% test-positive vs 17.8% test-negative CYP met the Delphi research definition of long COVID. Mental health, well-being, fatigue and health-related quality of life scores were similar among test-positive and test-negative CYP 6 months post-test. Similarly, symptomatology was similar among COVID-19-vaccinated and COVID-19-unvaccinated test-positive and test-negative CYP.
Conclusions Six-months post-PCR testing, CYP who tested positive for SARS-CoV-2 had similar symptoms to those who tested negative, but test-positive CYP had higher symptom prevalence. Mental health, well-being, fatigue and health-related quality of life were similar among test-positive and test-negative CYP, and symptoms at 6 months were similar in COVID-19 vaccinated and unvaccinated.
Trial registration number ISRCTN 34804192.
- adolescent health
- child health
- COVID-19
- paediatrics
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Twitter @SPintoPereira, @shamezladhani
Collaborators Additional co-applicants on the grant application and CLoCk Consortium members (alphabetical): Marta Buszewicz; Trudie Chalder; Esther Crawley; Bianca De Stavola; Shruti Garg, University of Manchester; Dougal Hargreaves, Imperial College London; Anthony Harnden, University of Oxford; Michael Levin, Imperial College London; Vanessa Poustie, University of Liverpool; Terry Segal, University College London Hospitals NHS Foundation Trust; Malcolm Semple, University of Liverpool; Kishan Sharma (deceased), Manchester University NHS Foundation Trust; Olivia Swann, University of Edinburgh; Elizabeth Whittaker.
Contributors TS conceived the idea for the study, submitted the successful grant application and drafted the manuscript. SPP designed and conducted the statistical analyses for the manuscript, accessed and verified the data and drafted the manuscript. SPP acts as guarantor for the manuscript. RS contributed to the design of the study, submitted the ethics and R&D applications and drafted the manuscript. MDN conducted the statistical analysis for the manuscript, accessed and verified the data and drafted the manuscript. NKR assisted with the statistical analysis for the manuscript, accessed the data and reviewed the manuscript. KM adapted the questionnaire for the online SNAP survey platform. RS accessed and verified the data, designed the participant sampling and data flow. TF contributed to the design of the study and reviewed the manuscript. IH contributed to the design of the study and reviewed the manuscript. SNL developed the study methodology, operationalised the regulatory and recruitment ideas for the study and revised the manuscript. EYC assisted with the references for the literature review and contributed to the manuscript. LF-S assisted with the drafting, formatting of the manuscript and references. ED conducted the PPI meetings, contributed to and reviewed the manuscript. All members of the CLoCk Consortium made contributions to the conception or design of the work and were involved in the funding application and this manuscript.
Funding Funded by the Department of Health and Social Care, in their capacity as the National Institute for Health Research (NIHR), and by UK Research & Innovation (UKRI) who has awarded funding (grant number COVLT0022). All research at Great Ormond Street Hospital NHS Foundation Trust and UCL Great Ormond Street Institute of Child Health is made possible by the NIHR Great Ormond Street Hospital Biomedical Research Centre. SPP is supported by a UK Medical Research Council Career Development Award (ref: MR/P020372/1).
Disclaimer The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, UKRI or the Department of Health.
Competing interests TS is Chair of the Health Research Authority and therefore recused himself from the Research Ethics Application. Trudie Chalder is a member of the National Institute for Health and Care Excellence committee for long COVID. She has written self-help books on chronic fatigue and has done workshops on chronic fatigue and post-infectious syndromes.
Provenance and peer review Not commissioned; externally peer reviewed.
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