A recent pediatric study suggests that repeated COVID infections increase the likelihood of developing long COVID. According to the research, children and young people infected a second time were twice as likely to experience lingering symptoms compared to those who only had the virus once. Long COVID after a reinfection was linked to higher risks of heart problems, kidney damage, cognitive difficulties, and other complications, according to an analysis published in The Lancet Infectious Diseases by researchers at the Perelman School of Medicine, University of Pennsylvania.“Many believed that reinfections would be milder or carry fewer long-term consequences, but we found that the risks extend across a range of health issues, challenging assumptions that children recover quickly,” said Bingyu Zhang, a PhD student in Applied Mathematics & Computational Science at Penn. “These findings can help guide clinical decisions, encourage vaccination, and inform how resources are directed to care for COVID patients.”The study examined health records from around 407,000 children across 40 pediatric hospitals. Among those with just one documented COVID infection, there were roughly 904 cases of long COVID per million over a six-month period. However, for children who had contracted the virus twice, that number jumped to 1,884 per million, effectively doubling the risk.Focusing On The Youngest PatientsMost research on long COVID, also known as post-acute sequelae of SARS-CoV-2 infection (PASC), has focused on adults. This study aimed to understand the long-term effects on children and adolescents under 21, particularly during the omicron wave, which predominated between late 2021 and early 2022. Omicron and its subvariants continue to circulate, causing infections and reinfections in young populations today.“The findings reinforce one of the strongest reasons I give families and physicians for vaccination: fewer infections mean lower chances of long COVID,” said Dr. Ravi Jhaveri, head of Pediatric Infectious Diseases at Ann & Robert H. Lurie Children’s Hospital of Chicago.Heightened Risk For Serious ConditionsThe researchers also analyzed the likelihood of specific complications after a second infection. Children who had COVID twice were more than three times as likely to develop myocarditis, a potentially dangerous inflammation of the heart muscle. Other significant risks included a doubled chance of blood clots, severe kidney damage, abnormal heart rhythms, heart disease, and extreme fatigue.“Examining the public health consequences of COVID, including long COVID, helps us pinpoint which children are more vulnerable and ensures they receive proper monitoring and care,” explained Dr. Jeffrey Morris, director of Biostatistics.The importance of large-scale studiesThis study is part of the NIH-funded RECOVER initiative, which investigates COVID’s long-term impacts. Pooling data from multiple hospitals and patients across the country allows researchers to study trends and outcomes in diverse populations, creating a clearer picture of long COVID in children.According to senior author Yong Chen, PhD, the project’s scale and coordination are crucial. “Without this infrastructure and sustained support, we wouldn’t have access to such comprehensive pediatric data or be able to evaluate long COVID rigorously,” he said.Next steps for researchThe team plans to continue tracking pediatric patients over longer periods, study whether new COVID variants affect long-term risks, and explore ways to prevent severe complications. They also aim to identify which children are most at risk, so families and clinicians can better protect them from the lasting effects of reinfections.
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