Persistent pulmonary dysfunction seen in children with COVID

A small study showed that low-field MRI showed persistent pulmonary dysfunction in children and adolescents who had recovered from SARS infection or had long-term COVID-19.

in prospective clinical trials54 children and adolescents with previous SARS-CoV-2 infection—29 who recovered, and 25 with long-term COVID—were compared to nine healthy controls using low-field MRI.

Both ventilated and irrigated lung parenchyma (match V/Q, a measure of air and blood flow to the lungs) were 81% in healthy controls, but only 62% (s= 0.006 (in the retrieved group and 60%)s= 0.003) in the long COVID cohort, report Ferdinand Kinling, MD, of University Hospital Erlangen in Germany, and colleagues at rays.

Compared with healthy, uninfected controls, V/Q match was lower in post-COVID participants with infection within the past 180 days (63%, s= 0.03), 180 to 360 days (63%, s= 0.03) or more than 360 days (41%, s<0.001).

“While children develop a robust, reactive, and sustained immune response after SARS-CoV-2 infection, the pulmonary dysfunction observed in our study is an unexpected finding,” Knelling and colleagues wrote.

The researchers noted that capturing these images adds important information to the literature that children are not immune to lung dysfunction after infection with COVID-19.

They note, “In contrast to studies that rely mostly on surveys or self-reported findings, and suggest less severe infection and sequelae of COVID-19 in younger patients, our study demonstrates that extensive functional changes in the lung already exist in children.” and teens.”

Unique in this study, the researchers used low-field magnetic resonance imaging, a technology that has shown persistent damage to lung tissue in adult patients after COVID-19. The device has a force field of 0.55 Tesla with very quiet operating noise and lower energy absorption in the tissues, which allows imaging of a large number of children without anesthesia.

“We conceptualized this study when evidence of long-term or post-COVID cases in adults was mounting,” Knelling said in a statement. “This was also when the first patients with nonspecific symptoms were seen in our department and parents began to ask about an association with a previous infection.”

The researchers noted that it is difficult to determine the prevalence of lung disease in children after COVID, as well as difficult to quantify due to the inconsistent, symptom-based definitions of COVID and its limited applicability to children.

The mean age of participants with post-acute COVID-19 was 12; The median age for the control group was 10. The 25 participants with COVID met the World Health Organization criteria for symptoms that persisted for at least 12 weeks. All but one of the patients were vaccinated.

None of the COVID-19 group required hospitalization during the initial infection period. The median interval between positive SARS-CoV-2 RT-PCR tests and study participation was 222 days. A morphological anomaly was identified in one of the recovered participants.

This study did not compare results with other reference standards. In addition, the study used free breathing for all intervals, which was possible in 93% of the post-Covid-19 participants aged 5 years or older.

The study also lacked longitudinal data, and healthy control numbers were low. The researchers acknowledged that families with children who had been infected with Covid for a long time may have been more likely to participate in the study.

“A follow-up trial has already begun, and we are seeking to understand how the results change over time,” Knelling said. “In addition, we will take a closer look at the other organs to see how this relates to our results.”

  • Ingrid Heine He is a MedPage Today writer covering infectious diseases. She has been working as a medical reporter for over a decade. Follow

Disclosures

This work received funding from the Bavarian State Ministry for Science and the Arts.

A researcher disclosed a relationship with Siemens Healthcare GmbH. No other conflict of interest was disclosed.