Trends in long COVID and post-viral fatigue in children in primary care in England

Background Post-viral sequelae following the COVID-19 pandemic attention to post-viral fatigue and long COVID, but the impact on children and young people’s (CYP) primary care use is unknown. Aim To examine temporal, seasonal, and sociodemographic patterns in primary care consultations for long COVID and PVFS in CYP Design and settings We conducted a retrospective, population-based dynamic cohort study using Clinical Practice Research Datalink Aurum data for CYP aged <18 years in England, between 1 st January 2006 and 31 st December 2022 (from 1 st March 2020 for long COVID); a period covering the influenza A(H1N1)pdm09 and COVID-19 pandemics. Method Consultation rates per 100 000 child-years were calculated for long COVID and post-viral fatigue syndrome (PVFS) by calendar year, month, and sociodemographic characteristics. Trends, seasonal patterns, and differences between pandemic and non-pandemic periods (for PVFS) were described. Negative binomial regression was used to estimate associations with sociodemographic characteristics. Results The cohort included 7,442,572 CYP (3 624 692 registered in primary care during the COVID-19 pandemic). There were 6700 long COVID and 20,440 PVFS consultations. Long COVID consultation rates were highest in 2022 (140.3 per 100,00 child-years). PVFS consultation rates peaked in 2009 and 2022 (during H1N1 and COVID pandemics) with rates of 57.1 and 56.9 per 100 000 child-years, respectively. Consultation rates were highest among older CYP, girls, and those from least deprived areas. Conclusion Long COVID consultations were highest in 2022, and PVFS consultation rates peaked during 2009 and 2022. Our findings that rates were highest in less deprived areas and girls need further investigation.