Въздействието на след COVID {% 7b1% 7d% 7d синдром в юноши % 3a a пилот проучване

Абстрактен

Фон: Post-COVID-19 syndrome has emerged as a long-term усложнение в възрастни и деца; its effect on юноши' performance in school is not well studied.

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Клик на хроничен умора синдром

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Цели: To study the physical/psychological impact of prolonged post-COVID-19 symptoms on school performance.

Методи: Това е a напречно сечение проучване използване Google Forms, a web-базирано напълно анонимизирано проучване на деца в степени 10-12.

Резултати: Проучването включено 54 студенти с а средно възраст от 16 години на когото 32 имаше COVID%7б%7б3%7г%7г. Две бяха хоспитализирани и 10 иха симптоми трайни повече от четири седмици. Често съобщавани хронични симптоми бяха умора и кашлица. Седем ученици напуснаха спорт%3б осем иха а намаляват в техните академични постижения. Юноши бидейки заразени повече от веднъж или не бидене напълно ваксинирани бяха повече вероятно да развият продължителни симптоми и се откажат спортни докато академично представяне в училище не беше засегнато. Три извън от 10 (30% 25) ученици които имаха COVID% 7b% 7b7% 7d% 7d и отговориха на въпросника докладваха не търсят помощ.

Заключение: Post-COVID-19 syndrome is associated with a decline in physical but not mental performance in school. Being infected more than once with SARS-CoV-2 seems to play an important role in the persistence of post-COVID-19 symptoms even though some adolescents are hesitant to seek medical or psychological care.

Категории: Инфекциозно Заболяване 

Ключови думи: Ковид-19, SARS-COV-2, School Performance, Long Hauler, Post-Acute COVID-19 

Въвеждането

Coronavirus disease 2019 (COVID-19), has been associated with significant worldwide morbidity and mortality [1]. The understanding of the long-term effects of COVID-19 (post-acute COVID-19 syndrome) is still evolving. The residual effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)  infection include fatigue, dyspnea, chest pain, cognitive disturbances, and arthralgia [2]. A study of 183 adults in the United States [3], showed that fatigue, dyspnea, and psychological distress, were present 35 days post-discharge in approximately 30% of patients. The severity of the acute illness in that study was shown to be associated with the persistence of symptoms [2]. The definition of a long hauler or a person suffering from post-acute COVID-19 has been suggested to include the persistence of symptoms beyond three or four weeks from the initial infection [4]. Until recently, published data on the prolonged effect of COVID-19 in children has been limited to multisystem inflammatory syndrome [5]. Persistence of postinfectious signs and symptoms (loss of taste or smell, cough, hair loss, chest pain, abnormal liver enzymes, skin rashes, fatigue and malaise, fever and chills, diarrhea, cardiorespiratory signs and symptoms, myositis, myocarditis, anxiety and requiring mental health therapy) beyond four weeks in children has been reported [6], however, the impact on school performance was not addressed. Our pilot study's main objective was to look at the physical/psychological impact of post-acute COVID-19 on children's school performance. Secondary objectives included looking for the correlation between prolonged symptoms (fatigue, dyspnea,  chest pain, cognitive disturbances, and arthralgia) and age, race, blood type, SARS-CoV-2 variant, the severity of initial infection, first or second infection and presence of a family history of prolonged symptoms.

Материали и методи% c2% a0

Our cross-sectional pilot study was designed to look at the physical and psychological impact of COVID-19 on children's school performance at a high school in Lebanon. The inclusion criteria included children from grades (10-12) attending high school. Exclusion criteria included children with mental disabilities precluding them from accurately answering the questionnaire. The survey questionnaire and protocol were approved by the New York Medical College General Medical and Behavioral Institutional Review Board (IRB) with approval number 15182. The survey was designed as a web-based (fully anonymized) survey using Google Forms (Google Inc., 2021) to ease distribution and completion. In cooperation with the school's administration, the survey link was shared with the students with the help of their teachers. We also requested the teachers to remind the students periodically to complete the survey. Participation was voluntary, and no incentives were provided to the participants. The fully anonymized data was obtained from Google Forms at the end of the survey time and stored safely in a password-protected file for further analysis. Statistical analysis was done using SPSS software version 27 (IBM Corp., Armonk, NY). Mean and standard deviations for all continuous variables, as well as, percentages for categorical variables were calculated. Chi-square testing was done to find if there is a significant relationship between different factors and post-acute COVID-19 and if the impact of COVID-19 in those who developed chronic symptoms was significantly different from those who did not have chronic symptoms. This article was previously posted to the medRxiv preprint server on April 27, 2020.

Резултати

Ние анкетирани 54 студенти% 2c 15 до 18 години стари% 2c 32 жени% 2c 45 кавказци % 2c и девет принадлежност към малцинство групи (азиатски % 2c черни % 2c и испанци). шест студенти пушени% 2fvaped. девет студенти не са напълно ваксинирани (не ваксинация или само една доза от иРНК ваксина). Тридесет и две (59.3% 25) докладвани като са имали COVID-19, и 7% 2f32 (21.8% 25) са били заразени повече от веднъж. Двадесет и един имаха COVID-19 между декември 2021 и май 2022 по време на скока на на Омикрон вариант (BA1), и 12 между април 2020 и май 2021. Две (6.2%) студенти бяха хоспитализирани. Четиринадесет студенти иха COVID-19 въпреки бидение напълно ваксинирани. Най-много чести остри симптоми бяха умора, главоболие, и треска.

While many reported a short illness, 10 (31.3%) students reported symptoms for more than four weeks (two students from six to nine months). The symptoms lasting over four weeks included fatigue or cough in 30%, dyspnea or depression/anxiety in 20%, difficulty concentrating, headaches, loss of smell or taste, and myalgia/arthralgia in 10%. Half of the children with symptoms lasting more than four weeks (long haulers)  had symptoms persisting after the first COVID-19, while the other half had prolonged symptoms after subsequent infections. Six out of 38 (15.8%) students reported that one of their family members was a long hauler. Seven out of 30 (23.3%) quit sports for the season. Eight out of 30 (26.6%) had a decline in their academic performance with worsening grades following COVID-19. Of the 10 students with prolonged symptoms, 60% were fully vaccinated and 60% had COVID-19 during the Omicron surge. Factors found to be associated with prolonged symptoms included having had COVID-19 more than once with a trend towards significance for not being fully vaccinated. Long haulers were found to be more likely to quit sports, however,  their school grades were not found to be significantly affected compared to students without post-acute COVID-19 syndrome (Table 1).

Използване на a visual scale (from 1 to 10) to describe their health, many students who had COVID-19 report some form of deterioration of their perceived general health status as seen in Figure 1.

Разискване

Our study is a pilot study based on a survey using a Google form to reach a large number of students in a short period while maintaining anonymity. This study involves a specific age and setting that is understudied. In a previous survey by the World Health Organization, the COVID-19 pandemic was noted to have a significant impact on school-aged children's mental health and their performance in school in a  general sense [7]. The impact of the infection itself and other associated factors was not studied. In our study, 16% of students were unvaccinated. While being unvaccinated was not statistically associated with developing prolonged symptoms that lasted more than four weeks, there was a trend toward significance (p=0.07). This is likely related to the small sample size of this study. Having COVID-19 more than once was significantly associated with prolonged symptoms. The underlying pathophysiology of this finding remains unclear and warrants further study. There was no association between having a long hauler family member and an increased risk of developing prolonged symptoms making it less likely that an underlying hereditary trait shared among certain family members could be playing a role. Unlike the study by Raos et al. that showed a correlation between outcome and admission to the intensive care unit during the acute illness phase and post-acute COVID-19, our study did not [6]. Other studies also showed a correlation between outcome and race [8], blood type [9], and infecting variant type [10], while ours did not and this is likely due to the small number of studied subjects.

Even though the COVID-19 pandemic affected the well-being of many children whether infected or not, the effect on those who develop prolonged symptoms seems to be far greater than the other groups. More kids in this group quit sports for the season, however, there was no decline in their academic grades compared to their peers, which warrants special attention on the physical impact of this complication. Race or sex or smoking/vaping were not shown to have a significant effect in this age group. In this study, 3/10 (30%) of participants who had COVID-19 (10 out of 32 responded to this question) have not sought medical attention which should not be taken lightly. The most common prolonged symptoms reported were fatigue,  cough, and central nervous system/mental disorder. Parents, teachers, and healthcare providers should be aware of the significant impact of post-acute COVID-19 on children with prolonged symptoms, warranting early screening and intervention promptly to maintain their kids' well-being.

Заключения

Имайки имаше повтарящи се COVID% 7b% 7b0% 7d% 7d инфекции се появява да бъде асоцииран с след остра COVID% 7b% 7b2% 7d% 7d синдром. Не битие напълно ваксинирани срещу SARS-CoV% 7b% 7b4% 7d% 7d не не се появи до напълно игра a защитна роля (само тенденции към значимост) евентуално поради появата на Омикрон вариант. Юноши чии симптоми последно повече от четири седмици са най-засегнати от един увеличен риск на спад в тяхната физическо благополучие и изпълнение в спорт в училище.

Много юноши не не търсят помощ за текущи симптоми дали физически или психологически. А по-големи проучване включващи няколко училище области е необходимо да оценят величината на това синдром което помага по-добре разпределят подходящи ресурси на най-засегнатите области.

Допълнително Информация 

Оповестявания

Човек субекти: Consent was obtained or waived by all participants in this study. New York Medical College General Medical and Behavioral Institutional Review Board (IRB) issued approval 15182. The protocol for 'The Impact of COVID-19 on School Aged Children, Other, 15182' has been verified by the New York Medical College General Medical and Behavioral IRB as Exempt according to 45CFR46.101(b) (2): (2) Tests, Surveys, Interviews on 06/22/2022. The following items associated with this protocol have been approved: Protocol 06/10/2022 Clean_ Research Proposal COVID19 in School_6_02_22.docx; Recruitment Materials 06/07/2022; Tracked Invitation to participate in the COVID-19 related health survey.docx 06/10/2022 Clean_ Invitation to participate in the COVID19 related health survey.docx; Data Collection Tool 06/10/2022; Impact of COVID19 in Schools-6_7_22.pdf. This email constitutes New York Medical College's permission to initiate the referenced study. Конфликти на интереси: In compliance with the ICMJE uniform disclosure form, all authors declare the follow: Плащане/services info: Всички автори имат декларираха че не финансова подкрепа беше получена от всяка организация за на подадена работа. Финансови взаимоотношения: Други релации: Всички автори имат декларират че има има няма нямат други връзки или дейности които биха могли да се появят да имат повлияха на подадени работа.

Препратки

1. Gupta A, Madhavan MV, Sehgal K, et al.: Extrapulmonary manifestations of COVID-19. Nat Med. 2020, 26:1017-32. 

2. Huang C, Huang L, Wang Y, et al.: 6-month последствия на COVID-19 in пациенти изписани от болница: a кохорта проучване. Lancet. 2021, 397:220-32. 

3. Jacobs LG, Gourna Paleoudis E, Lesky-Di Bari D, et al.: Persistence of symptoms and quality of life at 35 days after hospitalization for COVID-19 infection. PLoS One. 2020, 15:e0243882. 

4. Datta SD, Talwar A, Lee JT: A proposed framework and timeline of the spectrum of disease due to SARSCoV-2 infection: disease beyond acute infection and public health implications. JAMA. 2020, 324:2251-2. 

5. Santos MO, Gonçalves LC, Silva PA, et al.: Multisystem inflammatory syndrome (MIS-C): a systematic review and meta-analysis of clinical characteristics, treatment, and outcomes. J Pediatr (Rio J). 2022, 98:338- 49. 

6. Rao S, Lee GM, Razzaghi H, et al.: Clinical features and burden of post-acute sequelae of SARS-CoV-2} infection in children and adolescents. JAMA Pediatr. 2022, 176:1000-9. 

7. COVID-19 заболяване в деца и юноши: Научно кратко, 29 септември. (2021). 

8. Magesh S, John D, Li WT, et al.: Различия в COVID-19 резултати от раса, етническа принадлежност, и социално-икономически статус: a систематично преглед и мета-анализ. JAMA Netw Open. 

9. Zietz M, Zucker J, Tatonetti NP: Testing the association between blood type and COVID-19 infection,  intubation, and death. medRxiv. 

10. Mendiola-Pastrana IR, López-Ortiz E, Río de la Loza-Zamora JG, González J, Gómez-García A, López-Ortiz G: SARS-CoV-2 variants and clinical outcomes: a systematic review. Life (Basel).

【For more info:george.deng@wecistanche.com / WhatsApp:8613632399501】