Berlin / Freiburg With the increase in corona infections in children and adolescents, according to the assessment of a pediatric infectiologist, more long-term consequences are to be expected in these groups.
As a result of the relaxation of the measures, we expect more people to be affected with mostly diffuse, long-lasting health problems, said Markus Hufnagel from the Center for Pediatric and Adolescent Medicine at the University Clinic in Freiburg. Compared to the care situation in adults after an infection, pediatrics is not yet prepared for this.
Acute corona infections are often symptom-free in children, while serious disease progressions are rare even in adolescents. Long-term consequences are also reported in minors: These sometimes only set in months after the corona infection or worsened, Hufnagel describes.
In such cases, it is important for doctors to rule out the presence of other infections through tests. In order to be able to make outpatient offers to those affected, there are considerations on the establishment of special outpatient clinics for children and young people.
In the technical language, the phenomenon of Long Covid (Long COVID-19) or Post Covid (After COVID-19) is mentioned. Since COVID-19 vaccines have not yet been approved for children and adolescents, they are among the groups that will be susceptible to the virus for a few more months.
With the relaxation of the corona measures with school and daycare openings, possible late effects of the infection in these groups are moving into focus. According to data from the Robert Koch Institute (RKI), the proven corona cases in children and adolescents have been increasing for weeks.
The clinical picture is very variable, explains Hufnagel and lists possible consequences that could also occur in combination: These include chronic fatigue, general reduced performance and joint and muscle pain.
But also skin changes, like chilblains on the toes. On the other hand, persistent loss of smell and taste plays a subordinate role in children and adolescents compared to adults.
In general, the symptoms are not specific to SARS-CoV-2. This means that we are also familiar with such persistent health restrictions from other viral infections such as Pfeiffer’s glandular fever, emphasized Hufnagel. The problem should not be underestimated: the higher the total number of cases, the greater the number of people suffering from long-suffering.
The problem is currently getting bigger rather than smaller, we are already seeing significantly more post-Covid cases, said Hufnagel. These are more likely to be adolescent patients; Cases in the first ten years of life are much less common. As a rule, parents would suspect a connection with a corona infection, in some cases there is already evidence of antibodies.
There is no data from Germany on the subject so far, said Hufnagel, who, together with colleagues from the Dresden University Children’s Clinic, has established a register of the disease progression of all inpatient children and adolescents with SARS-CoV-2 infection of the German Society for Pediatric Infectious Diseases (DGPI).
A study in which households with corona cases were followed over a longer period of time showed that five percent of children and adolescents under 14 years of age still had at least one symptom three months after the infection. In adults, however, it affects up to one in three, said Hufnagel.
Estimates by British statisticians from the Office for National Statistics (ONS) also show that the burden appears to be significantly more pronounced in adults after they have been infected. While the proportion of those who still have at least one symptom such as cough, fever or fatigue five weeks after an infection is around 13 percent in the two to eleven year olds, it is 14.5 percent in the 12 to 16 year olds.
However, according to Hufnagel’s assessment, the generally stressful and exhausting pandemic situation does not only play a role when the long-term effects occur, and not just the virus alone. The lockdown is a major stress factor. If the pandemic situation improves, signs of fatigue are likely to improve in at least some of those affected. © dpa / aerzteblatt.de