SINGAPORE: Some studies overseas have put the prevalence of long COVID in children at anywhere from 4 to nearly 60 per cent of those who became infected with the virus.
But in Singapore, such a study — which would help to better manage children here who have had COVID-19 — has not been done yet.
That is about to change. KK Women’s and Children’s Hospital (KKH) is planning to embark on a study to determine whether long COVID is indeed a problem in young children and teenagers in Singapore.
Long COVID is the experience of lingering symptoms. And it can affect a child’s development if he or she has it.
“We do know that long COVID might potentially be a problem in children,” said KKH consultant Li Jiahui, who specialises in paediatric infectious disease. Hence the coming study will be “important”, she noted.
“And (children) might very well have symptoms that are really mild,” she added. “But they might otherwise be well enough to be attending school and not seek medical attention (for) these persistent symptoms.”
This means it is likely that some children have come down with long COVID, she noted.
The main aims of the KKH study are to determine how common it actually is and what “some of the risk factors are that can predispose a child or teenager to develop long COVID”, she said.
“(The study) will help us define the natural cause of long COVID in children. It will identify … how to better follow up on children who’ve had COVID-19.”
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Persistent symptoms, such as sleep difficulties and disturbances in concentration and memory, can potentially affect children’s development and learning, she said.
“We do need more studies to characterise these difficulties and symptoms. Right now we don’t know the … trajectory of long COVID.”
Most of the studies of long COVID in children are from the West, she noted. And their findings “may not be entirely applicable to our context” and may not give an “accurate representation” of long COVID in children in Singapore.
For one thing, Asian children may show particular symptoms differently. “Secondly, the symptoms may be partly attributable to various factors such as lockdowns, social restrictions, safe management measures, which differ from country to country,” she cited.
At the NCID’s long COVID clinic, which he runs and was started in November, he has heard people describe brain fog as a loss of concentration and having difficulty focusing throughout the day.
Hor Chor Kiat, for one, has “difficulty choosing certain words to describe certain things” at times.
He was among Talking Point viewers who replied to the programme’s call for questions and stories from people suffering from COVID-19 symptoms two months after they tested negative for the disease.
Some of them had what they thought were lesser known symptoms, such as ringing in the ears and a headache that lingered on from time to time.
There are also studies showing that long COVID affects women more than men.
Paradoxically, the immune system in women is “often better”, which probably means a higher risk of long COVID “because the immune system’s reactivity is continuing after the infection has resolved”, said Young.
But why do some people have such bad symptoms while others feel fine? And why do some people with mild initial symptoms also end up getting long COVID?
“We don’t really know what the exact trigger is,” he replied. “Something going wonky with the immune system is the most likely explanation.”
WATCH: Do you have long COVID? When COVID-19 symptoms linger (21:57)
What the data show, however, is that the elderly aged above 70 — a high-risk group for severe COVID-19 compared to younger patients — will also have more long COVID symptoms, pointed out Steve Yang, a consultant in The Respiratory Practice.
“If you’ve been in the ICU, if you’ve been on the ventilator … with a lot of scarring in your lungs, you’ll have a lot of long COVID symptoms,” he continued.
People can develop long COVID even if they are vaccinated. But vaccination helps: The evidence points to “around a 50 per cent reduction in the rates of long COVID”, noted Young.
According to the NCID, in findings published last year, one in 10 unvaccinated adult patients in Singapore had persistent symptoms six months after their initial infection.
The question of exercise was on the mind of Talking Point viewer Alif Adam, who felt that his muscles were taking longer to recover than before.
That experience is a typical one, observed Wong. “Even without COVID, just (by) resting at home for one month, most people will undergo deconditioning. There’ll be an element of the heart rate not being so good, muscles deteriorating,” he said.
“What long COVID does is it hinders the ability to tackle the deconditioning aspect.”
Most people, according to Young, will be “back to where they were” within three months of infection. But some will continue to struggle after that.
“I’ve seen a few patients in the long COVID clinic who’ve had symptoms that have gone on for more than a year,” he said.
“We could be talking about this … in two years’ time. It could be something that drags on for that long for a small number of people.”
Watch this episode of Talking Point here. The programme airs on Channel 5 every Thursday at 9.30pm.