THREAD LONG COVID & KIDS:

@LongCovidKids just published a survey of 510 children with long covid - what symptoms? how severe? how long-lasting?

I'll summarise main findings in this thread.

Shout-out to my postdoc @ferranespuny who analysed the data!

preprints.org/manuscript/202…
They wanted to find out about clusters of symptoms and severity.

Only children who had had symptoms for at least 4 weeks were included.

Parents of 510 children filled out the survey, 69% from the UK, 18% from the US. Almost 60% of children had confirmed Covid, 40% suspected.
Ages were skewed to older children, most common ages was 9-12 yrs old. 12% of kids were asymptomatic, 74% were managed at home. 44% of kids had no pre-existing health problem (80% had no pre existing mental health concern).
The two spikes in duration (~2 months and ~10 months) likely reflect the timing of the two large waves in the UK & US.

Many children has symptoms lasting 10 months or longer.
25% of children experience constant symptoms since infection while 50% had relapsing symptoms.

Most common symptoms were tummy pain, headache, muscle aches and fatigue.

95% of children had at least 4 continuing symptoms!
Over half of parents reported changes in their child's mood and sleep. 83% said their child had less energy.

Only 10% of children had returned to their pre-covid levels of activity, while 21% were unable to enjoy any activity.
There was no real difference in reported symptoms by whether covid was confirmed or not.

Perhaps more surprisingly, there was no difference in symptoms by whether children has pre-existing conditions or not.
60% of parents said their child had more difficulty concentrating and almost half said their child had difficulty remembering information.

Less than 30% of parents said their child hadn't had any mental health or cognitive issues since their Covid infection.
Remember - these are all parents who have already identified their child as experience long covid - so these percentages are NOT all children who have had covid.

That said, perhaps 5-10% of children do experience symptoms for more than 4 weeks. ()
While the large majority of children recover from Covid with no problems, some don't even if their initial illness was mild.

As we kids go back to school & while we wait for vaccines to be approved in kids, we need to acknowledge this as an issue & fund rigorous research.
This survey provides really important information about the types of symptoms children with long covid experience and highlights how long they can go on for.

This graphic from @dgurdasani1 is fab for how to keep schools safe - getting community cases low is at the heart!
Read the paper for more detailed methods & results!

The full survey asked can be seen here:
form.jotform.com/21043105152803…

preprint here
preprints.org/manuscript/202…

/END

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More from @chrischirp

7 Mar
LONG THREAD (21 tweets): As schools return this week in England, am I optimistic or pessimistic about Covid right now?

TLDR: Both - but veering pessimistic. But the policy shifts to move me into optimism are NOT that big!

Let’s start with the optimism & end with the worries.
2. The vaccine roll out is going amazingly well. Over 30% of adult population in England has now been vaccinated and we are on track to offer everyone a first dose by July – and perhaps even earlier. Uptake has also been much higher than anticipated.
3. Not just that, but the vaccines work better than expected. They are not only v effective at preventing illness, hospitalisation & death but are also effective at reducing transmission – this means vaxxed much less likely to spread covid to others.

vox.com/future-perfect…
Read 23 tweets
26 Feb
THREAD on COVID and DEPRIVATION:

As cases recede nationally, some areas remain stubbornly high. Many have been persistently high for months. Deprivation is an important aspect of this.

This is a tour of deprivation & covid & what it means

(21 tweets but pls read).
2. First, how is deprivation measured? Usually by the "Index of multiple Deprivation". This assigns a value to every neighbourhood (~7000 people) based on 7 domains of deprivation.

arcgis.com/apps/Cascade/i…
3. All neighbourhoods (technically MSOAs) are then ranked in order of deprivation and split into 5 equally sized groups ("quintiles"). Every person in population can then be assigned to one deprivation quintile from most deprived to least deprived based on where they live.
Read 21 tweets
23 Feb
1. LONG THREAD ON COVID, LOCKDOWN & THE ROADMAP:

TLDR: There’s a lot to like about the roadmap – but it could be & should be made much more effective.

Because this will be tying current situation to the roadmap, I’m concentrating on English data

Read on… (22 tweets - sorry)
2. Firstly, cases across England are falling. This is good news but the pace of reduction is slowing.

England has the highest case rate in the UK and the nations with lower case rates (on the order of 100 cases/100,000 pop/week) are plateauing even more
3. The worry is that the more transmissible new strain + many people still out at work, often in non-Covid safe workplaces, means it might be hard to get much below 100/100K/wk , esp in deprived areas, even under current restrictions.

The new strain now dominant everywhere.
Read 23 tweets
22 Feb
This article by @bealelab explaining the different Covid variants, possible impacts on vaccine effectiveness & future of the pandemic is quite simply one of the best I've ever read. lrb.co.uk/the-paper/v43/…

Some key bits highlighted below!!
This bit explains how vaccines tartget lots of different bits of Covid to provide protection - so that even if the virus gets better at one bit, vaccines can still work by stopping other bits. This is what the case with B117 (the Kent strain).
this section highlights the success of the UK vaccination programme so far
Read 5 tweets
21 Feb
THREAD ON LONG COVID & KIDS:

TLDR: I don't think we should ignore it.

ONS Infection survey updated its estimates for Long Covid a couple of weeks ago.

assets.publishing.service.gov.uk/government/upl…
It showed that 13% of under 11's and about 15% of 12-16 yr olds reported at least one symptom 5 weeks after confirmed Covid-19 infection.

ONS samples households randomly - so positive cases do not depend on having had symptoms & being tested.
Many have criticised this data because there is no comparator group of kids who had *not* tested positive for Covid and because some of the symptoms are common in childhood. (e.g. fever, cough)

These are perfectly valid criticisms and ideally we would have that.

BUT
Read 16 tweets
18 Feb
QUICK THREAD ON LATERAL FLOW DEVICE (LFD) TESTS:

LFD tests are mainly used for testing people without symptoms and PCR tests are used for those with (new) symptoms.

LFD tests now outnumber PCR tests every week. 1/4
Unsurprisingly positivity rates for PCR tests are much higher than for LFD tests. Reassuringly positivity rates are coming down in both cohorts.

BUT if we are relying more on more on LFD tests then we *must* use them carefully! 2/4
Firstly, they should NEVER be used as a "green light" to indicate no infection - only as a "red light" to indicate that you've got Covid and should isolate.

Do a confirmatory PCR for positive LFDs to minimise false positives & ENSURE support for isolation! 3/4
Read 5 tweets

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