Characteristics and predictors of persistent symptoms post COVID-19 in children and young people: a large community cross-sectional study in England

Objective: To estimate the prevalence of, and associated risk factors for, persistent symptoms post COVID-19 among children aged 5-17 years in England. Design: Serial cross-sectional study. Setting: Rounds 10-19 (March 2021 to March 2022) of the REACT-1 study (monthly cross-sectional surveys of random samples of the population in England). Study population: Children aged 5-17 years in the community. Predictors: Age, sex, ethnicity, presence of a pre-existing health condition, index of multiple deprivation, COVID-19 vaccination status, and dominant UK circulating SARS-CoV-2 variant at time of symptom onset. Main outcome measures: Prevalence of persistent symptoms, reported as those lasting c; months post-COVID-19. Results: Overall, 4.4% (95% CI 3.7-5.1) of 3,173 5-11 year-olds and 13.3% (95% CI 12.5-14.1) of 6,886 12-17 year-olds with prior symptomatic infection reported at least one symptom lasting c; months post-COVID-19, of whom 13.5% (95% CI 8.4-20.9) and 10.9% (95% CI 9.0-13.2), respectively, reported their ability to carry out day-to-day activities was reduced “a lot” due to their symptoms. The most common symptoms among participants with persistent symptoms were persistent coughing (27.4%) and headaches (25.4%) in children aged 5-11 years and loss or change of sense of smell (52.2%) and taste (40.7%) in participants aged 12-17 years. Higher age and having a pre-existing health condition were associated with higher odds of reporting persistent symptoms. Conclusions: One in twenty-three 5-11 year-olds and one in eight 12-17 year-olds post-COVID-19 report persistent symptoms lasting c; months, of which one in nine report a large impact on performing day-to-day activities.