Adolescents experience long-lasting symptoms during the COVID-19 pandemic

Disease and treatment 12. apr 2022 3 min Senior Researcher and Clinical Professor Selina Kikkenborg Berg Written by Kristian Sjøgren

A nationwide study in Denmark shows that many adolescents experience long-lasting symptoms regardless of whether they test positive for SARS-CoV-2. The study also reveals that the adolescents not testing positive have lower quality of life than those who have tested positive.

The COVID-19 pandemic is still raging globally, and researchers are still striving to understand how it affects people’s physical and mental health.

Many people experience long-lasting symptoms, and many adolescents have not yet regained their previous level of mental health.

A new nationwide study in Denmark shows that many adolescents have long-lasting symptoms whether they test positive or not.

The same study shows that the pandemic has reduced adolescents’ quality of life, and even more for those not testing positive than for those testing positive.

“We carried out this nationwide study because there has been no good overview of how adolescents have experienced long COVID symptoms. People have said that adolescents’ symptoms have been mild, but some have difficulty recovering. Our study shows that some adolescents have long-lasting effects and that the pandemic has reduced the well-being of all adolescents in Denmark,” explains a researcher behind the study, Selina Kikkenborg Berg, Senior Researcher and Professor of Cardiology, Heart Centre, Rigshospitalet, Copenhagen.

The research has been published in The Lancet Child & Adolescent Health.

All adolescents testing positive invited to participate

The researchers sent a questionnaire on physical and mental well-being to all 24,315 adolescents 15–18 years old in Denmark testing positive for SARS-CoV-2 on PCR from 1 January 2020 to 12 July 2021.

Those testing positive were matched with a control group of 97,257 adolescents not testing positive who also received the questionnaire.

The respondents were 6,630 adolescents testing positive and 21,640 controls.

The participants averaged 17.6 years old, and 58% were girls.

The researchers wanted to determine how the adolescents testing positive were faring more than 8 weeks later, the criterion for long COVID symptoms according to WHO.

“Previous studies indicated that many adolescents have long COVID but had no control group for comparison,” says Selina Kikkenborg Berg.

Many without a positive test experience long COVID

The most common long COVID symptoms are headache, fatigue, loss of appetite, difficulty breathing, memory problems and difficulty concentrating.

Among adolescents testing positive, 62% said they had experienced at least one symptom for 8 weeks or more.

Nevertheless, 57% of the adolescents not testing positive reported the same symptoms.

Although both figures seem very high and similar, this corresponds to an odds ratio of 1.22 for the increased risk of having long COVID symptoms for more than 8 weeks.

“We cannot compare this with anything before the pandemic, but we think these are very high numbers for different types of symptoms experienced by both those testing positive and those not,” explains Selina Kikkenborg Berg.

Adolescents also experience long COVID

Selina Kikkenborg Berg says that the study indicates that many adolescents have poor well-being, with 57% of those not testing positive reporting long-lasting symptoms.

She indicates that some of the symptoms may result from the extended isolation of many adolescents, but other symptoms may stem from the fact that many of the adolescents not testing positive have been infected without knowing it.

“But can adolescents experience long COVID symptoms? Yes, the numbers show this,” says Selina Kikkenborg Berg.

Poorer well-being among adolescents not testing positive

Another interesting result is that the adolescents testing positive have better mental health than those not testing positive.

This applies to mental well-being, social well-being and school absence during the pandemic. Selina Kikkenborg Berg says that twice as many adolescents not testing positive had poor well-being than those testing positive.

“This is worrying, and one interpretation is that the adolescents who have tested positive feel liberated because they do not have to constantly worry about getting COVID-19 or transmitting the virus to grandparents or other vulnerable people,” explains Selina Kikkenborg Berg.

Girls more severely affected than boys

A final conclusion is that girls reported long-lasting symptoms twice as often as boys, regardless of testing status.

However, this is consistent with other studies showing that girls and women often have worse self-rated health than boys and men and are also more health conscious.

“This is well known and lasts until menopause, and this applies to experiencing long-lasting symptoms regardless of testing status,” says Selina Kikkenborg Berg.

Adolescents have suffered

Selina Kikkenborg Berg thinks that Denmark and other countries have severely challenged adolescents and that the effects are becoming visible.

They have had to self-isolate, not infect others and take responsibility for older and vulnerable people and the economy, and they have suffered.

“Many adolescents have not coped well with schools being closed and not being able to see their friends, play sports and live their usual lives. They may not have been hardest hit by the pandemic but still experience many health risks that affect their mental health for a long time,” concludes Selina Kikkenborg Berg.

Long COVID symptoms in SARS-CoV-2-positive adolescents and matched controls (LongCOVIDKidsDK): a national, cross-sectional study” has been published in The Lancet Child & Adolescent Health. The Novo Nordisk Foundation awarded grants to Selina Kikkenborg Berg in 2020 for the project Heart and Mind and in 2020 through its emergency coronavirus programme.

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