Healthcare use in 700 000 children and adolescents for six months after covid-19
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As reported by Zimmerman et al, what is labeled as "long-covid" seems regarding many children and adolescents without a clear relationship with acute SARS-CoV-2 infection (1). Two recent population studies conducted in Denmark (2) and Germany (3) showed that the prevalence and type of symptoms reported during the pandemic by children with and without a recent verified SARS-CoV-2 infection was similar. Remarkably, the first showed that school children without SARS-CoV-2 infection experienced significantly more concentration difficulties, headache, muscle and joint pain compared to peers with acute SARS-CoV-2 infection (2). Several others studies have highlighted that the pandemic has led to a worsening of anxious, depressive and post-traumatic symptoms in children and adolescents (4). Forced isolation, familial difficulties, concerns for relatives’ and friends’ health, loss of structures of support, school closures are considered responsible for the increase in mental health problems that we are experiencing.
We do not assume that all individuals who continue to experience symptoms after acute SARS-CoV-2 infection have mental health problems. Nevertheless, we should take into great consideration that this pandemic brings a huge burden of emotional distress and suffering in children and adolescents. By uncritically applying a label of long-COVID, we may risk mislabelling patients with mental health problems and, even worse, perpetuating and strengthening symptoms in predisposed subjects. In this perspective, the need to describe new medical conditions and label patients should not be considered without risks.
Subjects with persistent symptoms after SARS-CoV-2 acute infection represent a request for care that must be answered, systematically including a multidisciplinary approach aimed at regaining functioning, with a high level of suspicion for mental health problems (5). It is immediately necessary for a new holistic vision on what should be considered the socio-assistance project of care regarding emotional and relational discomfort.
We should not easily summarize and label with the term “long-COVID” all the long-term effects of this pandemic. Otherwise, we carry the risk that “long-COVID” becomes a “long negligence” on mental health problems in children and adolescents.
1. Zimmermann P, Pittet L F, Curtis N. Long covid in children and adolescents BMJ 2022; 376 :o143 doi:10.1136/bmj.o143
2. Borch, L., Holm, M., Knudsen, M. et al. Long COVID symptoms and duration in SARS-CoV-2 positive children- a nationwide cohort study. Eur J Pediatr 2022, 9 January. https://doi.org/10.1007/s00431-021-04345-z
3. Blankenburg J, Wekenborg MK, Reichert J et al. Comparison of mental health outcomes in seropositive and seronegative adolescents during the COVID19 pandemic. Sci Rep 2022;12:2246. https://doi.org/10.1038/s41598-022-06166-y
4. Molteni E, Sudre CH, Canas LS, et al. Illness duration and symptom profile in symptomatic UK school-aged children tested for SARS-CoV-2. Lancet Child Adolesc Health 2021;5:708–18. https://doi.org/10.1016/ S2352-4642(21)00237-6
5. Morrow AK, Ng R, Vargas G, et al. Postacute/Long COVID in Pediatrics: Development of a Multidisciplinary Rehabilitation Clinic and Preliminary Case Series. Am J Phys Med Rehabil 2021;100:1140-1147. doi:10.1097/PHM.0000000000001896
Competing interests: No competing interests
Fascinating article but figures in relation to whether children seek help beyond primary care may want to point out that in Norway the primary care Dr is the gate keeper to seeing a specialist; and culture in Norway is very deferential. So that more parents may well have wished to see a specialist but could not, for a variety of reasons including slow uptake in Norway on setting up centres specialised in long covid and linking it to autoimmune diseases like ME, Sjögren, CFS, etc
Competing interests: No competing interests
What is the difference between Long Covid and other postviral syndromes? I cannot see any.
Competing interests: No competing interests
Thank you to the authors for this thought-provoking editorial [1]. Zimmermann et al (2022) reveal long COVID-19 in children and adolescents, symptoms involving almost every organ system after SARS-CoV-2 infection. Concern has focused more on the potential long term effects of SARS-CoV-2 infection. Therefore, I believe that functional foods, especially Gingerae, play a role in fighting COVID-19.
Western medicine solves the issue of human organs, and traditional Chinese medicine solves the issue of human body system; however, functional food is to address the problem of human cells[2]. The 12 key functional components of barley grains and its grass not only play an important role in the prevention and treatment of more than 20 chronic human diseases but also interact with 30 other nutritional functional components to provide the possibility to solve hundreds of human diseases caused by cell undernutrition and their detoxification disorders [2]. These results support that the human has only new cell disease theory, which are made up of sixty million cells, more than 1,000 diseases are due to cell nutritional deficiencies and detoxification disorder caused by disease [3].
Amomum villosum is widely used as anti-inflammatory, for gastrointestinal protection, anti-obesity, anticancer, antioxidant, analgesic, for bacteriostasis, antidiabetic and anti-COVID-19, etc; its fruit (Amomi fructus=Sharen) seems to be the best functional food for COVID-19 treatment and gastrointestinal protection, as well as for prevention of other diseases [4]. Its traditional uses in treating malaria have contributed to the successful application of Tsaoko Fructus-containing prescriptions in the treatment and prevention of the current epidemic diseases, SARS and COVID-19 [5]. Therefore, functional foods, especially gingeric plants, may have a role in fighting long term COVID-19.
REFERENCES [1] Zimmermann P, et al. Long covid in children and adolescents. BMJ 2022; 376: o143.doi:10.1136/bmj.o143 [2] Zeng YW, et al. Molecular mechanism of functional ingredients in barley to combat Human chronic diseases.Oxidative Medicine and Cellular Longevity,2020, 2020:3836172, https://doi.org/10.1155/2020/3836172 [3] Francis R, Cotton K. Never be sick again: health is a choice, learn how to choose it, Health Communications, Inc, Deerfield Beach, FL, USA, 2002. [4] Zeng YW,et al. Chemical constituents of functional food Amomum villosum to combat human diseases. Current Chinese Science, 2022,2(1): doi: 10.2174/2210298101666210923124548 [5] Yang S, et al. Amomum tsao-ko Crevost & Lemarié: a comprehensive review on traditional uses, botany, phytochemistry, and pharmacology. Phytochemistry Reviews,2022; https://doi.org/10.1007/s11101-021-09793-x
Competing interests: No competing interests
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