Long-Term Effects of COVID-19 on Adolescents

Öz

Long-term effects are increasingly reported in adult patients with coronavirus disease-2019 (COVID-19) but there are not enough studies in adolescents. This study aimed to evaluate the long-term effects of COVID-19 in the adolescent population. Adolescent patients diagnosed with non-severe COVID-19 between October 2020 and January 2021 in our center were questioned in terms of long-term effects by telephone call. A total of 109 adolescent patients with non-severe COVID-19 were evaluated. In five of them at least of one myalgia/fatigue, cough, chest pain, palpitation, sleep disorderand psychiatric problems are seen as long‐term effects of COVID-19. These five patients had a median age of 16.4 years (range 11.5-17) and three of them are boys. The mean time that we evaluate these patients after diagnosis is 121.6±13.1 days. All of them categorized as ‘mild’ COVID-19 infection and none of them were hospitalized. Only one patient has the underlying disease ‘asthma’. Long-term COVID-19 symptoms can also be seen in otherwise healthy children after mild disease. Especially psychiatric complaints should not be ignored and pediatricians should be more careful in terms of these effects.

Anahtar Kelimeler

• adolescent
• coronavirus
• long COVID-19
• pandemic
• Turkey

COVID-19'un Adölesanlar Üzerindeki Uzun Dönem Etkileri

Öz

Yeni koronavirüs hastalığı-2019 (COVID-19) geçiren yetişkin hastalarda uzun dönem etkiler, giderek daha fazla bildirilmekte ancak adölesanlarda konuyla ilgili yeterli çalışma bulunmamaktadır. Bu çalışma, COVID-19'un adölesan hasta grubunda uzun vadeli etkilerini değerlendirmeyi amaçlamıştır. Merkezimizde Ekim 2020-Ocak 2021 tarihleri arasında ağır olmayan COVID-19 tanısı alan adölesan hastalar telefonla aranarak uzun dönem etkiler açısından sorgulandı. Ağır olmayan COVID-19 tanısı alan 109 adölesan hasta çalışmaya dahil edildi. Bu hastaların beşinde miyalji/yorgunluk, öksürük, göğüs ağrısı, çarpıntı, uyku bozukluğu ve psikiyatrik sorunların en az biri COVID-19'un uzun dönem etkileri olarak görüldü. Bu beş hastanın medyan yaşı 197 ay (138-204) olup üçü erkekti. Tanı konulduktan sonra hastaların değerlendirildiği ortalama süre 121,6±13,1 gündü. Tümü 'hafif' COVID-19 enfeksiyonu tanısı almış olup hiçbirinin hastane yatış öyküsü yoktu. Sadece bir hastada altta yatan hastalık 'astım' vardı. Uzun dönem COVID-19 semptomları, öncesinde sağlıklı olan adölesanlarda hafif hastalık kliniğinden sonra görülebilir. Özellikle psikiyatrik şikayetler göz ardı edilmemeli ve çocuk doktorları bu etkiler konusunda daha dikkatli olmalıdır.

Anahtar Kelimeler

• koronavirüs
• uzun COVID-19
• adölesan
• pandemi

Kaynakça

1. 1) Coronavirus disease (COVID-2019) situation reports 2021. Accessed April 17, 2021. https:// www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/
2. 2) Li Q, Guan X, Wu P, et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med. 2020;382:1199-1207.
3. 3) Zimmermann P, Curtis N. Coronavirus Infections in Children Including COVID-19: An Overview of the Epidemiology, Clinical Features, Diagnosis, Treatment and Prevention Options in Children. Pediatr Infect Dis J. 2020;39:355-368.
4. 4) Lazzerini M, Sforzi I, Trapani S, et al. Characteristics and risk factors for SARS-CoV-2 in children tested in the early phase of the pandemic: a cross-sectional study, Italy, 23 February to 24 May 2020. Euro Surveill. 2021;26:2001248.
5. 5) Jiang L, Tang K, Levin M, et al. COVID-19 and multisystem inflammatory syndrome in children and adolescents. Lancet Infect Dis. 2020;20:e276-e288.
6. 6) Hertting O. More research is needed on the long-term effects of COVID-19 on children and adolescents. Acta Paediatr. 2021;110:744-745.
7. 7) Feldstein LR, Rose EB, Horwitz SM, et al. Multisystem Inflammatory Syndrome in U.S. Children and Adolescents. N Engl J Med. 2020;383:334-346.
8. 8) Ludvigsson JF. Case report and systematic review suggest that children may experience similar long-term effects to adults after clinical COVID-19. Acta Paediatr. 2021;110:914-921.

9. 9) Dufort EM, Koumans EH, Chow EJ, et al. Multisystem Inflammatory Syndrome in Children in New York State. N Engl J Med. 2020;383:347-358.
10. 10) Guessoum SB, Lachal J, Radjack R, et al. Adolescent psychiatric disorders during the COVID-19 pandemic and lockdown. Psychiatry Res. 2020;291:113264.
11. 11) Adolescent health in the South-East Asia Region. Accessed June 10, 2021.https://www.who.int/southeastasia/health-topics/adolescent-health
12. 12) Demirbilek Y, Pehlivantürk G, Özgüler ZÖ, et al. COVID-19 outbreak control, example of ministry of health of Turkey. Turk J Med Sci 2020;50(SI-1):489- 494.
13. 13) Dong Y, Mo X, Hu Y, et al. Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China. Pediatrics. 2020.
14. 14) Ikincioğullari A, Kendirli T, Doğu F, et al. Peripheral blood lymphocyte subsets in healthy Turkish children. Turk J Pediatr. 2004;46:125-30.
15. 15) The Lancet. Facing up to long COVID. Lancet. 2020;396(10266):1861.
16. 16) Ghosh R, Dubey MJ, Chatterjee S, et al. Impact of COVID -19 on children: special focus on the psychosocial aspect. Minerva Pediatr. 2020;72:226-235.
17. 17) Cao W, Fang Z, Hou G, et al. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Res. 2020;287:112934.
18. 18) Carfì A, Bernabei R, Landi F; Gemelli Against COVID-19 Post-Acute Care Study Group. Persistent Symptoms in Patients After Acute COVID-19. JAMA. 2020;324:603-605.
19. 19) Mandal S, Barnett J, Brill SE, et al. 'Long-COVID': a cross-sectional study of persisting symptoms, biomarker and imaging abnormalities following hospitalisation for COVID-19 [published online ahead of print, 2020 Nov 10]. Thorax. 2020;thoraxjnl-2020-215818.
20. 20) Huang C, Huang L, Wang Y, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet. 2021;397(10270):220-232.
21. 21) Marques de Miranda D, da Silva Athanasio B, Sena Oliveira AC, et al. How is COVID-19 pandemic impacting mental health of children and adolescents? Int J Disaster Risk Reduct. 2020;51:101845.
22. 22) Meherali S, Punjani N, Louie-Poon S, et al. Mental Health of Children and Adolescents Amidst COVID-19 and Past Pandemics: A Rapid Systematic Review. Int J Environ Res Public Health. 2021;18:3432.
23. 23) Davido B, Seang S, Tubiana R, et al. Post-COVID-19 chronic symptoms: a postinfectious entity? Clin Microbiol Infect. 2020;26:1448-1449.