Geneva, February 16, 2023 – The World Health Organization has released a new clinical case definition for post-COVID syndrome or 'Long COVID' in children and young people.
Children and adolescents are more likely to have few or no symptoms, or to develop mild illness after contracting COVID-19. As a result, the impact and symptoms they experience in the post-acute period may differ. Children with post-COVID syndrome are more likely to experience fatigue, altered smell, and anxiety than healthy children. For both adults and children, the duration of symptoms (at least 2 months) and how soon after initial infection they begin (within 3 months) are common in the two definitions.
The new definition is based on the latest scientific evidence and was developed through an expert consensus process, including the involvement of patient advocates and clinicians. WHO used a consensus-seeking approach called a Delphi exercise, in which experts and patients responded to repeated surveys. This definition applies to children of all ages, taking into account age-specific symptoms.
WHO has initiated the process to develop a specific definition for children and adolescents because COVID-19 affects them differently than adults.
Definition
“Post-COVID syndrome in children and young people occurs in individuals with a history of confirmed or probable SARS-CoV-2 infection, when they experience symptoms that last for at least 2 months and initially occurred within 3 months of acute COVID-19. Current evidence suggests that symptoms more commonly reported in children and young people with post-COVID syndrome compared to controls are fatigue, altered sense of smell (anosmia), and anxiety. Other symptoms have also been reported. Symptoms generally impact daily functioning, such as changes in eating habits, physical activity, behavior, academic performance, social functioning (interactions with friends, peers, family), and developmental milestones. Symptoms may be new onset after initial recovery from acute COVID-19 or persist after the initial illness. They may also fluctuate or relapse over time. Workup may reveal additional diagnoses, but this does not exclude the diagnosis of post-COVID syndrome.”
About post-COVID
Anyone with COVID-19 can develop post-COVID syndrome, regardless of the severity of the illness, although it is more commonly reported in people with severe disease. The Institute for Health Metrics and Evaluation (IHME) estimated that by the end of 2021, 145 million people had developed post-COVID syndrome (3,7% of those infected with SARS-CoV-2), as defined by the WHO clinical case definition, with 15,1% of those (22 million) having persistent symptoms 12 months after the onset of infection.
There remains limited information on the condition in children and young people and on medium to long-term outcomes. The use of a standardised definition will contribute to a global understanding of prevalence and allow for more comparable research studies.
The WHO has in October 2021 the definition for post-COVID syndrome in adults released.
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