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Covid-19: Most symptomatic children recover within a week, study finds

BMJ 2021; 374 doi: (Published 04 August 2021) Cite this as: BMJ 2021;374:n1947

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  1. Elisabeth Mahase
  1. The BMJ

Most children who test positive for covid-19 and experience symptoms recover within a week, although a small proportion are unwell for more than four weeks, a study has found.1

The data, taken from the Covid Symptom Study and analysed by researchers at King’s College, London, included 1734 children (588 aged 5-11 and 1146 aged 12-17) who had a positive SARS-CoV-2 test result and calculable illness duration within the study timeframe (after 1 September 2020).

The most reported symptoms were headache (62.2%) and fatigue (55.0%), and the median illness duration was six days. A total of 77 children (4.4%) experienced symptoms for at least 28 days, and this was more common in older children (5.1% in older v 3.1% in younger.) Twenty five children had symptoms for at least 56 days.

The paper, published in the Lancet Child & Adolescent Health, found that in children who had symptoms for longer the symptom burden was said to be low after day 28 (median 2 symptoms).

Comparison with non-covid illnesses

The researchers also looked at 1734 children who tested negative for SARS-CoV-2 and matched them to children testing positive. The median illness duration in children who tested negative but had symptoms was three days, which was notably shorter than in children testing positive for covid-19.

Overall, just under half (46.4%; 805 of 1734) of children testing negative had fever, cough, anosmia, or a combination of these symptoms. Few children testing negative had an illness duration of 28 days or more (0.9%), but these children did have a greater symptom burden than those who tested positive for SARS-CoV-2 and whose illness duration was 28 days or longer.

The researchers said that the prevalence of non-SARS-CoV-2 respiratory viruses—such as influenza A, influenza B, parainfluenza, adenovirus, and respiratory syncytial virus—was unusually low over the 2020-21 winter in the UK.

The researchers concluded, “With the relaxation of social distancing in the UK, these illnesses might return towards their usual higher prevalences. Our data emphasise that other childhood illnesses might also have protracted burdensome courses, requiring consideration in post-pandemic service planning.”

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