Italian intersociety consensus on management of long covid in children

Italian Journal of Pediatrics

Chiara Azzari¹  Enrica Mancino²  Raffaella Nenna²  Stefania Zampogna³  Alfredo Guarino⁴  Annamaria Staiano⁴  Giuseppe Di Mauro⁵  Guido Castelli Gattinara⁶  Amelia Licari⁷  Gian Luigi Marseglia⁷  Luisa Galli⁸  Laura Lancella⁹  Fabio Midulla^1,10  Salvatore Leonardi^1,10  Fabio Cardinale^1,11  Valentina Fainardi^1,12  Susanna Esposito^1,12  Stefano Zona^1,13  Nicola Principi^1,14 

[1] Department of Health Sciences, Section of Pediatrics, University of Florence;Department of Maternal, Infantile and Urological Sciences, Sapienza University of Rome;Department of Pediatrics, Pugliese-Ciaccio Hospital of Catanzaro;Department of Translational Medical Sciences, Section of Pediatrics, University Federico II of Naples;Family Paediatrician, Local Health Unit;IRCCS Bambino Gesù Children Hospital;Maternal and Child Department, IRCCS Foundation Policlinico “S. Matteo” di Pavia;Paediatric Infectious Disease Unit, Meyer Children’s University Hospital, Department of Health Sciences, University of Florence;Paediatric and Infectious Disease Unit, Academic Department of Pediatrics, Bambino Gesù Children’s Hospital, IRCSS;Pediatric Respiratory Unit, Department of Clinical and Experimental Medicine, San Marco Hospital, University of Catania;Pediatric and Emergency Unit Giovanni XXIII Pediatric Hospital, University of Bari;Pietro Barilla Children’s Hospital, Pediatric Clinic, Department of Medicine and Surgery, University Hospital, University of Parma;Primary Health Care Department, Local Health Agency of Modena;Università degli Studi di Milano;

关键词: COVID-19;    Long COVID;    Mental health;    Pediatric infectious diseases;    SARS-CoV-2;   

DOI  :  10.1186/s13052-022-01233-6

来源: DOAJ

【 摘 要 】

Abstract Background Two sequelae of pediatric COVID-19 have been identified, the multisystem inflammatory syndrome in children (MIS-C) and the long COVID. Long COVID is much less precisely defined and includes all the persistent or new clinical manifestations evidenced in subjects previously infected by SARS-CoV-2 beyond the period of the acute infection and that cannot be explained by an alternative diagnosis. In this Intersociety Consensus, present knowledge on pediatric long COVID as well as how to identify and manage children with long COVID are discussed. Main findings Although the true prevalence of long COVID in pediatrics is not exactly determined, it seems appropriate to recommend evaluating the presence of symptoms suggestive of long COVID near the end of the acute phase of the disease, between 4 and 12 weeks from this. Long COVID in children and adolescents should be suspected in presence of persistent headache and fatigue, sleep disturbance, difficulty in concentrating, abdominal pain, myalgia or arthralgia. Persistent chest pain, stomach pain, diarrhea, heart palpitations, and skin lesions should be considered as possible symptoms of long COVID. It is recommended that the primary care pediatrician visits all subjects with a suspected or a proven diagnosis of SARS-CoV-2 infection after 4 weeks to check for the presence of symptoms of previously unknown disease. In any case, a further check-up by the primary care pediatrician should be scheduled 3 months after the diagnosis of SARS-CoV-2 infection to confirm normality or to address emerging problems. The subjects who present symptoms of any organic problem must undergo a thorough evaluation of the same, with a possible request for clinical, laboratory and / or radiological in-depth analysis in case of need. Children and adolescents with clear symptoms of mental stress will need to be followed up by existing local services for problems of this type. Conclusions Pediatric long COVID is a relevant problem that involve a considerable proportion of children and adolescents. Prognosis of these cases is generally good as in most of them symptoms disappear spontaneously. The few children with significant medical problems should be early identified after the acute phase of the infection and adequately managed to assure complete resolution. A relevant psychological support for all the children during COVID-19 pandemic must be organized by health authorities and government that have to treat this as a public health issue.

【 授权许可】

Unknown