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Legacy of COVID-19 infection in children: long-COVID will have a lifelong health/economic impact
  1. Daniel Munblit1,2,
  2. Frances Simpson3,
  3. Jeremy Mabbitt4,
  4. Audrey Dunn-Galvin2,5,
  5. Calum Semple6,
  6. John O Warner1
  1. 1 Paediatrics, Inflammation, Repair and Development Section, National Heart and Lung Institute, Imperial College London, London, UK
  2. 2 Paediatrics and Paediatric Infectious Disease, I M Sechenov First Moscow State Medical University, Moskva, Russian Federation
  3. 3 Psychology, Coventry University, Coventry, UK
  4. 4 Studybugs, Brighton and Hove, UK
  5. 5 Paediatrics, Cork University, Cork, Ireland
  6. 6 Women's and Children's Health, University of Liverpool, Liverpool, UK
  1. Correspondence to Professor John O Warner, Paediatrics, Imperial College London, London SW7 2BX, UK; j.o.warner{at}

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Studies have repeatedly shown that children less frequently and less severely manifest acute COVID-19 infection1 However, as with the whole of the world population, children have been subjected to the direct and indirect effects of lockdowns, restricted education and social interactions, with potential lifelong impacts on mental and physical health.2


It has become apparent from follow-up of adults who had been hospitalised with the infection that lingering, and sometimes debilitating symptoms and signs, are relatively common.3 Even those with milder infections have reported persistent problems often known as long-COVID. Studies of this ill-defined syndrome in adults have begun to characterise constellations of symptoms and signs. While some are clearly directly due to organ damage during the acute phase of the illness (persistent lung function deficits; cardiovascular, renal and neurological problems), others are less easily attributed, including fatigue, poor concentration, shooting pains and impaired quality of life seen more frequently in women rather than men.4 A Lancet editorial, ‘Facing up to long COVID’, highlighted the increasing number of people suffering prolonged symptoms after recovery from the acute phase of COVID-19 infection. The editorial asks for research to elaborate on the risk factors, clinical features, diagnosis, management and outcomes.5 A similar editorial, ‘Meeting the challenge of long COVID’, has appeared in Nature Medicine.6 Sadly, …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests All authors have been directly involved in the design and running of COVID-19 infection research studies. DM, AD, JOW and CS are members of the ISARIC paediatric long-COVID working group. All authors assert that there are no conflicts of interest which directly affect the production of this manuscript. JOW declares that he has received grants for research and bursaries for Scientific Advisory Board membership, lectures and conferences from Danone/Nutricia, Airsonett and Friesland Campina. CS declares that he is a minority shareholder in Integrum Scientific, Greensboro, North Carolina, USA being chair of the Infectious Disease Scientific Advisory Board. He has grants from MRC, NIHR and Health Protection Research Unit in Emerging & Zoonotic Infections, University of Liverpool. FS as indicated in the text is co-founder of 'Long-COVID Kids'.

  • Provenance and peer review Not commissioned; externally peer reviewed.