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Observational Study
. 2025 Apr 9:16:1466201.
doi: 10.3389/fimmu.2025.1466201. eCollection 2025.

Long COVID in pediatric age: an observational, prospective, longitudinal, multicenter study in Italy

Susanna Esposito  1 , Matteo Puntoni  2 , Michela Deolmi  1 , Greta Ramundo  1 , Giuseppe Maglietta  2 , Marco Poeta  3 , Stefania Zampogna  4 , Claudia Colomba  5 , Agnese Suppiej  6 , Fabio Cardinale  7 , Samantha Bosis  8 , Elio Castagnola  9 , Fabio Midulla  10 , Carlo Giaquinto  11 , Paola Giordano  12 , Giacomo Biasucci  13 , Valentina Fainardi  1 , Francesco Nunziata  3 , Roberto Grandinetti  1 , Anna Condemi  5 , Giuseppe Raiola  14 , Alfredo Guarino  3 , Caterina Caminiti  2 ; Long-Covid-Ped Italian Study Group
Affiliations
Observational Study

Long COVID in pediatric age: an observational, prospective, longitudinal, multicenter study in Italy

Susanna Esposito et al. Front Immunol. .

Abstract

Introduction: This observational prospective longitudinal multicenter study examines the occurrence and characteristics of long COVID (LC) in the Italian pediatric population.

Methods: Conducted across 12 Pediatric Units in Italy from January to March 2022, the study involved 1129 children diagnosed with SARS-CoV-2 infection. Data were collected via self-administered questionnaires at 1-3 months, 3-6 months, and 6-12 months post-infection, with LC defined as symptoms persisting for at least 2 months and occurring 3 months post-diagnosis.

Results: Results revealed that 68.6% of children reported at least one post-COVID symptom, with 16.2% experiencing LC. The most frequent symptoms included respiratory issues (43.4%), neurological and cognitive dysfunction (27.7%), gastrointestinal symptoms (22.1%), fatigue (21.6%), and sleep disturbances (18.8%). Age and gender differences were significant, with older children and females more prone to cardiovascular and neurological & cognitive dysfunction.

Discussion: The study highlights that LC in children presents similarly to adults, though less frequently. The occurrence of LC was lower compared to adult populations, likely due to the generally milder course of COVID-19 in children. The findings underscore the need for targeted follow-up and support for affected children, especially considering the long-term persistence of symptoms. Further research is necessary to explore the impact of COVID-19 vaccines on pediatric LC and the effects of different SARS-CoV-2 variants. These insights are crucial for developing strategies to manage and mitigate long-term impacts in children recovering from COVID-19.

Keywords: SARS-CoV-2; long COVID; neurological dysfunction; pediatric infectious diseases; post-COVID symptoms.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Figures

Figure 1
Figure 1
Time-to-event analysis of long COVID symptoms according to gender (A) and age group (B).
Figure 2
Figure 2
Time-to-event analysis of specific long COVID symptoms according to gender (A), respiratory symptoms; (B), neurological & cognitive dysfunction; (C), fatigue; (D), gastrointestinal symptoms).
Figure 3
Figure 3
Time-to-event analysis of specific long COVID symptoms according to age group (A), respiratory symptoms; (B), neurological & cognitive dysfunction; (C), fatigue; (D), gastrointestinal symptoms).
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