Post–COVID-19 Condition in Children

To examine the incidence of post coronavirus disease 2019 (COVID-19) condition (PCC or long COVID) in a cohort of children using a population-based sample that was recruited before severe acute respiratory syndrome coronavirus disease 2 (SARS-CoV-2) infection.There were 1026 children recruited from the community in Alberta, Canada from August 2020 to March 2021. Participants were 8 to 13 years of age, with a mean age of 10.5 (SD 2.1 year), and were equally divided between male and female participants. Approximately two thirds reported living in an urban location compared with one third reporting rural housing. Pre-existing or current comorbidities included allergies (35.7%), anxiety (20.5%), asthma (17.0%), and attention deficit disorder (10.3%). Children with known COVID-19 before study recruitment were excluded.Parents prospectively reported their child’s symptoms every 2 weeks throughout the study duration (76 weeks), as well as any positive SARS-CoV-2 PCR test results. PCC was defined as new symptoms starting within 3 months of positive SARS-CoV-2 PCR test and persisting for a minimum of 8 weeks. Symptoms were considered resolved if a minimum of 4 weeks (including nonconsecutive weeks) were symptom-free.After exclusions, only 1 child met criteria for PCC; this child reported resolution of symptoms after 14 weeks postinfection. Over half (n = 572) of those recruited did not report a positive PCR test within the study time frame. Of those who did have a positive test, 224 reported between 2 and 6 weeks of symptoms after COVID-19, and 30 had no symptoms 0 to 2 weeks after COVID-19. There were 150 lost to follow-up (reported <8 weeks of data after COVID-19). The most common symptoms reported following COVID-19 infection were rhinitis (62%), sore throat (68%), headache (52%), cough (42%), fever (41%), and fatigue (35%). Presence of any of these symptoms before COVID-19 were associated with longer duration of symptoms after infection. No current or past medical conditions were associated with symptom persistence after infection.There was a very low incidence of PCC in this cohort (0.4%). The majority of children reporting a positive SARS-CoV-2 polymerase chain reaction had resolution of post-COVID symptoms within 6 weeks. Presence of comorbid asthma, allergies, anxiety, and attention deficit disorder were not associated with increased incidence of PCC.Much remains unknown about the risk of long COVID in children infected with SARS-CoV-2. Using parent-proxy symptom reporting, this study reports a very low incidence of PCC in a cohort of Canadian children ages 8 to 13. There was no increased risk of PCC associated with pre-existing or comorbid conditions, including asthma and anxiety. Presence of symptoms like cough and fatigue before SARS-CoV-2 infection was associated with longer duration of these same symptoms postinfection. Although limited because of parent reporting and lack of more objective measures (eg, serology to assess potential SARS-CoV-2 infection before enrollment), this study suggests that PCC in children is rare, and that most children fully recover from infection within 6 weeks of infection.