VCU-led research consortium identifies distinct long COVID symptoms in children and teens

By Caitlin Hanbury
School of Nursing

Despite extensive research, there is still a significant lack of understanding on the impact long COVID has on children and adolescents. But a nationwide study with contributions made by nurse scientists at the Virginia Commonwealth University School of Nursing is helping to set new standards in diagnosing and treating this condition.

Long COVID, also known as post-acute sequelae of SARS-CoV-2 infection (PASC), is characterized by symptoms that continue six weeks beyond initial COVID-19 infection. An estimated 65 million people are affected worldwide.

Published in the Journal of the American Medical Association (JAMA), the research provides crucial insights into the prolonged effects of COVID-19 infections, marking a significant advancement in understanding pediatric long COVID.

"This publication highlights the tremendous value of collaboration among experts from various fields, who have come together to better understand the complex nature of this condition," said Patricia Kinser, Ph.D., interim dean of the School of Nursing and one of the study's lead researchers. "This study is just one step in a broader effort to drive future research and implement care strategies that will make a tangible difference in the lives of those affected."

Kinser and Amy Salisbury, Ph.D., associate dean of research, scholarship, and innovation at the School of Nursing, are leading a multi-institutional research consortium focused on long COVID pediatric patients as part of the Researching COVID to Enhance Recovery (RECOVER) initiative, a nationwide study funded by the National Institutes of Health.

The RECOVER-Pediatrics study involved over 5,000 participants between the ages of 6 to 17, recruited from more than 60 health care and community care settings across the United States between March 2022 and December 2023. The study will continue following these participants while also actively recruiting new ones to expand its findings and further the research.

With a clearer understanding of pediatric long COVID symptoms, researchers and clinicians can now refine diagnostic tools and treatments. (VCU School of Nursing)

The study had several key goals. Those included identifying common long-term symptoms, how distinct patterns of symptoms - known as phenotypes - overlap across age groups and creating new guidelines to help health care providers more accurately diagnose and treat long COVID in pediatric and adolescent patients.

The published study reveals a significant prevalence of prolonged symptoms among participants with a history of COVID-19 infection. Among the 898 school-age children and 4,469 adolescents surveyed, 14 symptoms were found to be more prevalent in those who had a COVID-19 infection compared to those who had not been infected.

Distinct symptom patterns were also identified between age groups. For school-age children, neurocognitive problems, pain and gastrointestinal symptoms were particularly prominent. In contrast, adolescents experienced more frequent changes in smell or taste, pain, and fatigue or malaise.

The researchers used these findings to develop targeted guidelines for diagnosing and managing pediatric long COVID. These guidelines assist in identifying children and adolescents who are at high risk for long COVID and help address the associated decline in overall health and quality of life.

"This research represents a significant leap forward in our understanding of what long COVID looks like across age groups, laying the groundwork for improved diagnosis, treatment and quality of life for affected children and adolescents," Salisbury said.

The impact of this research extends beyond the study's immediate findings, paving the way for future work in several key areas.

With a clearer understanding of distinct symptom patterns associated with pediatric long COVID, researchers and clinicians can now refine diagnostic tools and treatment protocols tailored specifically for children and adolescents. In turn, this will drive the development of more effective, age-appropriate interventions and support systems to address their unique needs.

As the RECOVER initiative continues into the next phase, future research will explore the long-term trajectories of pediatric long COVID, investigate how symptoms evolve over time and their impact on quality of life. Additionally, researchers will seek to identify potential genetic factors that may predispose individuals to more severe or persistent symptoms, creating avenues for personalized treatment approaches.

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