During the COVID-19 pandemic children have been perceived as a group not being especiallyaffected, with less being infected, low symptom burden and low mortality. A smallproportion however develop life-threatening hyperinflammation (mis-c) and at least oneDanish child has died from this condition. Since the fall of 2020 international awarenesshas been raised by parents reporting that their children experience gastrointestinalissues, chest pain, headaches, fatigue, joint/muscle pain, sore throat, dizziness, nauseaand fever for months following COVID-19 infection.In this study the investigators aim to investigate the proportions of possible long covidin the 45.000 Danish children that has been tested positive for covid-19. Theinvestigators know from the Danish Covid-19 surveillance data that 300 has been admittedto the hospital within the first 2 weeks after diagnosing. However, no knowledge abouthow many visits the participants have to the ER and GP compared to children withoutcovid-19 as well as hospital admissions within the first year and medical prescriptionswithin the first year. This knowledge can give the investigators an indication of howaffected these children are on the long term. Furthermore, data has been collected aboutthe long-term symptoms in adults, but not children, and it now seems obvious that thisdata are needed to fully understand the disease and orchestra the relevant medicalattention for children during the covid-19 pandemic.
Objectives
WP 1 Objective: to investigate long COVID symptoms after 3,6,9 and 12 months in children
tested positive for SARS-CoV-2 compared to children without a positive test.
WP 2 Objective: to describe whether there is a difference in the number of visits to
general practitioner, emergency department and hospitalizations in children with and
without SARS-CoV-2. In addition, which co-morbid diagnoses are given 3,6,9 and 12 months
after diagnosis with COVID and which drugs are prescribed.
Methods
Design: National register study and questionnaire survey.
Outcomes
WP1: Long-term COVID-19 symptoms in children will be identified from questionnaires.
WP2: To determine the difference in number of contacts to the general practitioner,
emergency departments and hospitalizations in both children with and without SARS-CoV-2,
an identification from COVID-19 data linked with LPR3 and SSR will occur. Identification
of co-morbidities will be identified from LPR3 and prescribed drugs are available from
LMDB.
Statistical analyses
WP1: To investigate parent and child reported long COVID symptoms numbers and percentages
will be presented followed by multiple logistic models offered as odds ratios (OR) with
95% confidence intervals (CI).
WP2: Multiple regressions models presented as OR with 95% CI will be used to examine the
differences in contacts regarding the general practitioner, emergency departments,
hospitalizations, co-morbidities and prescribed drugs in children with and without COVID.
All analyses will be stratified by age groups and gender.
Population
Exposure: To be identified as an exposure for the current study, children from 0-18 years
with at least one positive SARS-CoV-2 test will be identified from COVID-19 data from
January 2020 until the last updated version. To be able to identify the parents who will
receive the questionnaires the investigators will also need CPR-data on the children's
parents.
Non-exposure: Children from 0-18 years without a positive SARS-CoV-2 test for the entire
period of January 2020 until the last updated version will be identified from the Danish
Civil Registration System. To be able to identify the parents who will receive the
questionnaires the investigators will need CPR-data on the parents.
Variables
COVID-19 data will enable information on children with and without positive SARS-CoV-2
tests. The parents who will receive questionnaires will also be identified from this
register likewise will data on death, sex and age.
The Temporary Danish National Patient Register (LPR3) will provide data on the number of
emergency visits, hospitalizations and co-morbidities.
The Danish Health Insurance Register (SSR) offers numbers of contacts with the general
practitioner.
The Danish Medicines Registry (LMDB) enables the investigators to link prescribed drugs.
All registers will be updated monthly by The Danish Health Authorities and the
investigators will need data extraction in the period 2020 until the last updated version
from all the above-mentioned registers.
Publications of results
All results will be published in international scientist journals as well as the hospital
webpage and press releases.
Perspectives
This will be the largest investigation of long COVID in children to date. Denmark has
excellent registers and logistics for questionnaires providing a unique opportunity to
report on children's health care seeking behavior and symptoms after being infected with
COVID-19. Children are an overlooked group during the pandemic and these data will
provide essential information for health care staff, politicians and parents.
Other: LongCOVIDkidsDK
Exposure: To be identified as an exposure for the current study, children from 0-18 years
with at least one positive SARS-CoV-2 test will be identified from COVID-19 data from
January 2020 until the last updated version. To be able to identify the parents who will
receive the questionnaires we will also need CPR-data on the children's parents.
Inclusion Criteria:
- must be included in the covid-19 monitoring database
Exclusion Criteria:
-
Rigshospitalet, Copenhagen University Hospital
Copenhagen, Denmark
Selina K Berg, PhD, Principal Investigator
29190623