Long COVID in Children and Adolescents: A Retrospective Controlled Cohort Study from Iran

Background : After recovering from the acute phase of COVID-19, some of the infected children manifest long COVID symptoms. The present study aims to identify long COVID symptoms in children and adolescents admitted to hospitals in Bushehr, Iran, during 2021 to 2023, and compare them with the non-affected group. Methods: This retrospective cohort study was conducted on 141 children and adolescents with COVID-19 and 141 non-affected peers. The data were collected using the data recorded in the patients’ records, conducting telephone interviews and completing the prevalent long COVID symptom form. Results: The mean age of the hospitalized children with COVID-19 was 79±5.24 months old, 57.4% of whom were boys. Also, 46 individuals of the infected group (32.6%) manifested long COVID symptoms. The most prevalent symptoms included fatigue (54.3%), impaired attention or concentration (41.3%) and depression or anxiety symptoms (34.7%). Significant correlation was found between disease severity and muscle and joint pain (P=0.025) as well as between length of hospital stay and cough (P=0.022), weight loss (P=0.047) and depression or anxiety symptoms (P=0.008). Older age [(6-11 y; OR=3.18, CI=1.03-9.88); (12≥ y; OR= 4.57, CI=1.40-14.96)] and having history of smoking or being exposed to secondhand smoke (OR= 12.45, CI= 3.14-49.36) were considered as risk factors for long COVID. Conclusions: Informing the public about smoking or being exposed to smoke as risk factors for long COVID, in addition to its other hazards, is of particular importance. Informing the healthcare staff and general public about the most prevalent symptoms of long COVID could be effective in timely diagnosis and treatment as well as reducing families’ stress burden.