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expert reaction to study looking at long COVID symptoms in children up to age 14

A study published in the Lancet Child & Adolescent Health looks at long COVID symptoms in SARS-CoV-2-positive children aged 0–14 years and matched controls.


Dr Jeremy Rossman, Honorary Senior Lecturer in Virology, University of Kent, said:

“Whist children are less likely than adults to suffer from severe acute COVID-19 disease, severe infections do occur and children can develop the persistent symptoms of Long Covid, regardless of the severity of the initial infection.  Recent studies have estimated that the rate of Long Covid disease may be as high as 43% globally, resulting in an estimated 3.1% of the UK population experiencing persistent symptoms following SARS-CoV-2 infection, as reported by the ONS.  However, the majority of these studies have focused on adults, with limited data on Long Covid prevalence in children.  In February, Prof Selina Kikkenborg Berg and colleagues reported on the rate of persistent symptoms in children aged 15-18 in Denmark, finding that children with confirmed SARS-CoV-2 infections were nearly 5% more likely to report at least one persistent symptom lasting 2 months or more.  In a new study just published in Lancet Child and Adolescent Health, the authors expand their analysis to children aged 0-14 years old.

“The current study used a survey to examine the rate of Long Covid symptoms for Danish children with a confirmed SARS-CoV-2 infection (nearly 11,000 children).  Cases were compared to a control group, matched on age and sex, that never tested positive for the virus.  Similarly to their previous results in older children, the authors found that children with confirmed infections were more likely to experience persistent symptoms, compared to children in the control group.  The increased rate of persistent symptoms ranged from 13% in children 0-3 to approximately 5% in children 4-11.  Whilst these rates may seem small, the continually high rate of COVID-19 transmission in many countries will result in a significant number of children suffering from a disease that can be severely debilitating, has no treatments at present, and can last for an indefinite period of time (some Long Covid patients, both adults and children, have had persistent symptoms for two years).  Additionally, the rate of children affected by Long Covid, may actually be worse than that reported in the current study, as young children are less likely to have or report symptoms of the acute disease and so some infections in children may be missed with the current study design that requires a confirmed diagnostic test.  This important study highlights the pressing need for Long Covid research and the continued prevention of COVID-19 infections in children, as well in as adults.”


Dr Michael Absoud, Honorary Reader, Department of Women & Children’s Health, King’s College London, said:

“The findings from this large Danish study reflect experience on the ground from those working in child health and education, and confirms findings from other large UK case-control studies (including from the Office for National Statistics).  Overall, when compared to those who tested negative to SARS-CoV-2, slightly more children with Covid-19 had more persistent symptoms, and reassuringly recovered with time.

“The most striking finding of this study is the higher quality of life and lower anxiety scores in older children who had tested positive for COVID-19.  This provides further confirmation, that although mercifully children are resilient to the direct impacts of COVID, they have been significantly impacted by the indirect impacts of the pandemic (school closures, repeated quarantines, and reduced therapies) and anxiety inducing media messaging.  It is likely that society has under-estimated longer term impact of the pandemic disruption rather than the virus on all children, and the urgent need for recovery of health and wellbeing services.

“These findings add to different measures used in the recent ONS release, which found in children who met the UK CLoCK study definition for Long Covid, 28% had a probable mental disorder (compared to 12% who didn’t experience Long Covid).  This likely reflects the high burden of difficulties with emotional wellbeing in children with persistent symptoms, and the bi-directional interplay of the often neglected mind-body relationship.

“With the majority of children now having been infected with SARS-CoV-2, the impact of persistent symptoms is likely to decrease with time, and the population burden is likely to shift even more towards indirect impacts.

“Nonetheless it is still important to identify the small proportion of children who are taking longer to recover from COVID, whilst supporting all children with persistent symptoms regardless of cause.  Not being able to attend education and leisure activities should be seen as an emergency for all children, regardless of the reason.”




‘Long COVID symptoms in SARS-CoV-2-positive children aged 0–14 years and matched controls in Denmark (LongCOVIDKidsDK): a national, cross-sectional study’ by Selina Kikkenborg Berg et al. was published in the Lancet Child & Adolescent Health at 23:30 UK time on Wednesday 22 June 2022.

DOI: 10.1016/S2352-4642(22)00154-7



Declared interests

Dr Michael Absoud: “No conflicts.”

Dr Jeremy Rossman is a Trustee of the non-profit advocacy and support charity, Long Covid Kids and Friends.





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