Fatigue or exhaustion; gastro-intestinal symptoms; problems relating to neuro-cognitive functioning and physical functioning; cardiovascular symptoms; malaise after exertion; alterations in school and working life. These are the 'key' symptoms that define Long Covid in children. 7 areas in total. A team of experts, led by King's College London, in collaboration with the World Health Organization (WHO) and the in which the Pediatrics of the Agostino Gemelli Irccs University Polyclinic Foundation of Rome also took part. The study is published in the 'European Respiratory Journal'.
In their work, the international team also indicates which tools to measure these key symptoms. The study, the authors explain, is the result of a global harmonization effort to collect data in a homogeneous manner and speed up the progress of knowledge and the definition of the best intervention strategies for Long Covid in children and young people. The grounding of this common language, this “'Esperanto' of science”, as experts define it, will also shape future research on Long Covid. The panel of international experts who collaborated on the work includes Danilo Buonsenso, professor of Paediatrics at the Catholic University and medical director of the complex Paediatrics operational unit of the Gemelli. In the study, the expressions that characterize the condition that goes by the name of Long-Covid/Post Covid-19 in children and young people are identified and put in black and white, also reaching a consensus (with the 'Delphi consensus' methodology) on how to measure them.
While the majority of people who contract the infection recover quickly, a significant number of people develop persistent or recurrent symptoms, for more or less long periods. Children and teenagers are no exception, but most of the research conducted so far in the area of Long Covid has focused on adults, while pediatric studies are fewer. This is why the real prevalence of the syndrome in pediatric and adolescent age is practically unknown. However, experts point out, this does not mean that this condition can place a significant burden on those affected and on health services.
The research has defined a set of 'key' characteristics (Cos, Core Outcome Set) and associated measures (Coms, Core Outcome Measurement Set) for the evaluation of Long Covid in children and young people. The experts who developed these 'instructions for use' recommend that they also be used in future research to standardize the language and working methodology, in order to accelerate the understanding and development of 'evidence-based' treatments. -based' for Long Covid. Using a common scientific 'language' throughout the world increases the value of the data collected, allowing them to be compared with each other in a homogeneous manner and to compare results between different studies in order to then develop guidelines, the authors motivate.
Regarding the 'measurement' of signs and symptoms relevant to the identified areas, the researchers selected those that can be used universally, even in low-resource countries. Valid measurement 'tools' have only been identified for 4 areas (fatigue or exhaustion, gastro-intestinal symptoms, neuro-cognitive functioning, physical functioning), while work is still being done to identify the best ones for the remaining three areas.
“Our center – recalls Buonsenso – was the first in the world to document that even children and adolescents can develop Long Covid and we brought the first scientific evidence that these children have immunological, vascular and dysautonomic alterations, which distinguish them from patients recovered or healthy controls. With this latest international analysis, together with experts and representatives of patients and families, we have defined the main outcomes, in order to allow us to standardize our studies at a global level. This will allow us to share case studies and understand this condition is getting better and better, causing a serious deterioration in the quality of life of people affected by it.”
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