COVID-19 does not appear to impact long-term lung function in children, young adults
Lung function in children and young adults was not impaired after COVID-19, apart from those who had severe COVID-19, according to two studies presented at the virtual European Respiratory Society International Congress.
“ Ida Mogensen, MD, postdoctoral fellow at the Karolinska Institute in Stockholm, said during her presentation. “
“The COVID-19 pandemic has raised questions about if and how the lung is affected after clearance of the coronavirus infection, especially in young people from the general population with less severe disease,” Ida Mogensen, MD, postdoctoral fellow at the Karolinska Institute in Stockholm, said in a press release. “Until now, this has not been known.”
Lung function in young adults
Mogensen and colleagues evaluated 661 participants (mean age, 22.6 years) born from 1994 to 1996 in Sweden from the population-based BAMSE cohort with available pre-pandemic (2016 to 2019) and pandemic (October 2020 to May 2021) lung function, inflammation and blood eosinophil measurements.
In the cohort, 178 (27%) participants had antibodies against SARS-CoV-2, indicating previous COVID-19 infection. The researchers reported no difference in lung function among participants with or without previous COVID-19 with respect to blood eosinophil count, fractional exhaled nitric oxide (FeNO), allergic sensitization or inhaled corticosteroid use.
In addition, there were no differences between those who were seronegative or seropositive in mean change in FEV1 (1.2% vs. 0.75%, respectively; P = .28), change in FVC (1.4% vs. 1.3%, respectively; P = .76) or FEV1/FVC ratio (–0.011 vs. –0.013, respectively; P = .36).
Among participants with asthma (n = 123), 24% were seropositive. In this group, change in FEV1 was higher among seronegative patients compared with seropositive patients (2.2% vs. 0.07%; P = .063), according to the results.
The researchers concluded that “COVID-19 infection did not have a negative impact on lung function in a young general population.”
“These results are reassuring for young adults. However, we will continue to analyze data from more people. In particular, we want to look more closely at people with asthma as the group in this study was fairly small,” Mogensen said in the release. “We are also curious as to whether the length of time after the infection is important, as well as the severity of disease and symptoms.”
Lung function in children, adolescents
Anne Schlegtendal, MD, specialist in pediatric and adolescent medicine and pediatric pulmonology at University Children’s Hospital at Ruhr-University-Bochum in Bochum, Germany, and colleagues evaluated 73 children and adolescents aged 5 to 18 years from August 2020 to March 2021 to assess long-term COVID-19 effects.
“There is widely varying evidence on persisting symptoms after COVID-19 in children,” Schlegtendal said during her presentation. “In adults, pulmonary function can show long-term impairment of spirometry values and diffusion capacity.”
Researchers performed multiple-breath washout, body plethysmography and diffusion capacity testing after an average of 2.6 months following COVID-19. These results were compared with those from a control group of 45 children who did not have COVID-19 but may have had other infections.
Infection was considered severe if patients had breathlessness, fever greater than 38.5°C for more than 5 days, bronchitis, pneumonia or were hospitalized for more than 1 day.
Nineteen (27.1%) children and adolescents reported persistent or new symptoms following COVID-19. Of these, eight (11.4%) reported at least one respiratory symptom; six had ongoing breathing issues and two had persistent coughing.
The researchers reported no significant differences in frequency of abnormal pulmonary function tests in participants with and without COVID-19 (16.4% vs. 27.7%, respectively; OR = 0.54; 95% CI, 0.22-1.34). Researchers observed abnormal pulmonary function in two participants with persistent respiratory symptoms.
In other results, patients with severe infection, whether SARS-CoV-2 or another infection, had reduced FVC in multivariate analysis (P = .045), according to the results.
Schlegtendal and colleagues concluded: “Pulmonary function is rarely impaired in children and adolescents after COVID-19, except of those with severe infection. The discrepancy between persistent respiratory symptoms and normal pulmonary function suggests a different underlying pathology such as dysfunctional breathing.”
“These findings should offer some reassurance to children, adolescents and their families. Severity of infection proved to be the only predictor for mild lung function changes, and this is independent of a COVID-19 infection,” Schlegtendal said in the release. “The discrepancy between persistent breathing problems and normal lung function suggests there may be a different underlying cause, such as dysfunctional breathing, which is a problem that has also been identified in adults.”
References:
- Mogensen Ida. Abstract OA4053. Presented at: European Respiratory Society International Congress; Sept. 5-8, 2021 (virtual meeting).
- Press Release.
- Press Release.