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Backgrounds:

A growing number of studies report that individuals of all ages infected with SARS-CoV-2 may experience long-term persistent symptoms, known as long-COVID (LC) or post COVID-19 condition. The current study is one of the first attempts to examine the consequences of LC on children’s mental health and academic function.

Methods

We compared the mental health of 103 children diagnosed with LC to a control group of 113 children, aged 4-18 years. Groups were prospectively recruited from November 2020 to August 2021. The LC group included children presenting to a designated multidisciplinary clinic for LC at a tertiary center with microbiologically- proven SARS-CoV-2 infection. Parents completed mental health questionnaires, evaluating the child’s and the parent’s distress, functional impairment, and exposure to COVID-19 stressful events. Bivariate Pearson correlation tests were used to explore the relationships between the study’s variables. Two multiple regression analyses examined the variables contributing to children’s mental health scores.

Results:

Long COVID was associated with a higher functional impairment as children with LC exhibited a higher rate of online school absence, compared to controls. In addition, LC was associated with a higher rate of self-reported memory loss, compared to controls. However, other functional aspects such as peer relationships, engagement in physical activities, and emotional-behavioral problems did not differ between LC children and controls. Significant predictive factors for emotional-behavioral problems included parental concerns regarding their child’s functioning and economic difficulties

Conclusions/Learning Points:

LC was associated with impairments in some aspects of children’s cognitive-academic functioning, but not with emotional-behavioral problems. Thus, interventional programs addressing school attendance in this population are warranted. Also, addressing parents' economic stress and concerns to their children’s emotional adjustment during the pandemic are important for reducing pandemic-related emotional-behavioral problems among children.

Backgrounds:

To avoid closing schools during the Covid-19 pandemic, the European Centre for Disease Prevention and Control (ECDC) has defined guidelines for the school setting. These include: (1) safety, hygiene-related measures and physical distancing measures, which should be adapted to different contexts and should consider the prevention, while providing an optimal learning and psychosocial environment and (2) crucial accompanying measures of risk communication and of community engagement to include the voice of children and other stakeholders.

However, the practical implementation of both of these measures is not straightforward as they imply complex changes in schools, and, in order to address such complexity, the ECDC suggests the creation of community structures but there is a lack of guidelines on how to implement them.

Methods

In this paper we piloted a community structure with a participatory system analysis process where 44 teachers, 868 students and their families from 6 schools from Spain participated.

Results:

They came up with a total of 406 items of problems and opportunities to implement prevention measures which addressed the complexity of the challenge. The results were clustered in 5 categories (Figure 1) and for each of them the participants co-defined 58 recommendations, based on which we came up with a final list of 15 priority accompanying recommendations.

Conclusions/Learning Points:

We conclude that our approach could be used to develop inspiring guidelines to initiate community structures in schools to adapt the accompanying recommendations to each school setting context for more effective implementation of the prevention measures.

Acknowledgments

CERCA Programme/Generalitat de Catalunya 2017 SGR. Sentinel School Network Study Group of Catalonia. CONNECT project, funded from the European Union’s Horizon 2020 research and innovation programme under grant agreement no. 872814

Backgrounds:

An unbreakable relationship has been established between pneumococcal carriage and invasive pneumococcal disease (IPD), with IPD supposed to be the direct consequence of carriage dynamics. We aimed to assess the role of pneumococcal carriage dynamics and the viral epidemiology in the unprecedented IPD epidemiology related to non-pharmaceutical interventions (NPIs) implemented during the COVID-19 pandemic.

Methods

We performed a quasi-experimental interrupted time series analysis based on multiple national surveillance systems of pneumococcal carriage, respiratory syncytial virus (RSV) and influenza-related diseases, and IPD in children <15 years old in France. We estimated the fraction of IPD change after NPIs that was attributable to RSV, influenza and pneumococcal carriage dynamics, analyzed by a quasi-Poisson regression model.

Results:

Between November 2006 and April 2021, 5113 IPD cases were included and 6831 healthy children had a swab test. After NPI implementation, the IPD incidence decreased 63% (95%CI, -82% to -43%, P<.001, Figure) while the overall pneumococcal carriage rate did not significantly change (-12%, 95%CI, -37% to 12%, P=.32). We estimated that 53% (95%CI, 28% to 78%, P<.001) and 40% (95%CI, 15% to 65%, P=.002) of the decrease in IPD in the NPI period was attributable to the change in influenza and RSV epidemiology, respectively. Only 4% (95%CI, -7% to 15%, P=.49) was attributable to a change in pneumococcal carriage. We found similar results when analyzing only high and low-disease potential serotypes.

Conclusions/Learning Points:

The major decrease in pediatric IPD incidence after NPIs was related to a change in viral dynamics rather than pneumococcal carriage. The fundamental link between pneumococcal carriage and IPD is highly affected by viral epidemiology. Interventions targeting respiratory viruses, such as immunoprophylaxis or vaccines against RSV and influenza, may prevent a large part of pediatric IPD.