Spectrum, Progression of Symptoms in Pediatric Patients With Long COVID
In this video, Dina Kamel, MD, discusses pediatric long COVID, including the spectrum and progression of symptoms in children, the impact of the vaccine against COVID-19 on long COVID symptoms, and a possible model of care for a multidisciplinary approach to the treatment of pediatric patients with long COVID.
Additional Resources:
Kamel, D. Clinical spectrum of pediatric long COVID and impact of COVID-19 vaccines on the clinical course. Talk presented at: IDWeek 2023. October 11-15, 2023. Accessed October 4, 2023. https://idweek.org/
For more IDWeek 2023 content, visit the Resource Center.
TRANSCRIPTION:
Dina Kamel, MD: My name is Dina Kamel. I'm one of the pediatric infectious diseases fellows at Children's Hospital Los Angeles. I'm pleased to be talking to you today about my presentation about long COVID in children.
Consultant360: Please provide an overview of your presentation at IDWeek 2023 titled “Clinical Spectrum of Pediatric Long COVID and Impact of COVID-19 Vaccines on the Clinical Course.”
Dr Kamel: Long COVID has been recognized nowadays, as a wide constellation of symptoms that affect adults, as well as pediatrics, after the COVID-19 infection. In our Long COVID Center at Children's Hospital Los Angeles, we are interested in following up with those patients and providing them with the best quality of care through multidisciplinary teamwork.
So, we were interested as a team in studying this spectrum of symptoms in long COVID and seeing the progression of symptoms over time. We were also interested in studying the impact of COVID nineteen vaccine to see if there is any change in the symptoms in relation to the vaccination, with the thought that it might be a potential therapeutic intervention in the future.
C360: What were the results of your study?
Dr Kamel: We followed 107 patients in our clinic from December 2021 to April 2023. And males and females were equally affected. Teenagers were the most common group affected. We identified the mean age as 14 years of age. In our prospective cohort, we identified the most common symptoms were fatigue and headache. Fatigue was reported as 95%, and headache as 75% of the patients. There are other symptoms that were also significantly affecting the children, such as dizziness, brain fog, chest pain, palpitation, joint pains, as well as GI symptoms. At the initial presentation to our clinic, 57 patients had already been vaccinated against COVID-19, and 35 out of them were vaccinated after the onset of COVID. We were interested in following up with this subgroup of patients, those 35 patients who were vaccinated after the long COVID symptoms to see if there is a relation between the progression or improvement of symptoms to this vaccine, and we identified that 52% of the patients reported having the same symptoms. However, 43% of them reported improvement, but the rest were still dealing with ongoing worsening of their symptoms.
C360: Why is pediatric long COVID and the impact of COVID-19 vaccines important to study right now?
Dr Kamel: As you know, in the post-pandemic era, there are a lot of physical and mental changes that affect people. Children were most vulnerable to this change due to social-life isolation and school performance, everything was affected for almost 2 years. Not only mental health is something that we should be aware of, but also the physical changes that children deal with after being infected with COVID-19 under the spectrum of the long COVID. We are seeing an increasing number of patients, dealing with those symptoms and some of them are suffering and their quality of life is really affected, so that's why it's important to address prolonged COVID at this time.
C360: How does this study contribute to existing research on pediatric long COVID and COVID-19 vaccines?
Dr Kamel: This study contributes a lot to the already existing knowledge about long COVID in children. Most of the studies published in the literature address long COVID in adults, and there are ongoing clinical trials. But that is unlike pediatrics. Little is known thus far, so we believe that this study, as well as our ongoing studies, will quickly impact the existing knowledge, and we'll add on the existing knowledge about the whole spectrum of long COVID and the progression of symptoms in pediatrics. Our goal is that in the future, we are able to have a model of care, through multidisciplinary teamwork, providing the best care and support to our patients and their families throughout their journey.
C360: What were the limitations of your study?
Dr Kamel: We understand that there are some limitations in our study that we are working on for future studies, and these include more detailed epidemiological data, as well as an objective assessment of the quality of life. We're also working on addressing the vaccination effect in a more systematic approach.
C360: What is next for research on this topic?
Dr Kamel: Longer perspective follow-up is our next step in this research. We're following these patients closely every 3 to 6 months, following up on the symptoms and asking them from their perspective, what they think is the best help for their symptoms. And in this case, we were able to help the rest of our patients. Also, we work in multidisciplinary teams with all other subspecialties included in long COVID. So, this is our next step. I'm also studying vaccines in a more systematic approach is one of our other goals. And our goal is to provide a good model of care or the best model of care so that we can be one of the centers that provide, this service to the patients suffering from long COVID, and, also, you know, the families are also suffering with their children, of course.
What were the overall take-home messages from your presentation and from our conversation today?
Dr Kamel: I would say that a long COVID in children is now a well-recognized health problem. I encourage all pediatricians to be aware of this constellation of symptoms and have their patients seen in one of the long COVID centers so that they are able to be closely followed up and if there is any therapeutic intervention in the future, we will be able to provide it for those patients.