Non-hospitalised Children & young people (CYP) with Long Covid (The CLoCk Study)

Uncertainties relate to diagnosis, prevalence, duration and treatment of post-COVID syndrome ( long COVID ) in children and young people (CYP). There is no diagnostic test nor definition for long COVID.

We do not know the physical, psychological and social consequences of long COVID and we need to define the clinical phenotype and longer-term physical/physiological/psychological changes to target therapeutic interventions.

Risk factors for acute COVID include: obesity, pre-existing co-morbidities, learning and neurological disabilities, mental health (MH) problems, BAME status.

The CYP likely to be most at risk of long COVID are teenagers as they represent the majority of CYP pre-COVID with persistent physical and MH symptoms post-viral infection. Ludwigsson (2020) reported five COVID positive CYP with median age 12 yrs with symptoms longer than 6 months.

The research questions: To describe the clinical phenotype of post-COVID symptomatology in test-positive CYP, using test-negative comparators Use these data to produce an operational definition of long COVID, necessary for any future epidemiological or interventional study Use this definition to establish the prevalence and natural course of long COVID in CYP to inform NHS services and health policy HYPOTHESIS: the type, prevalence and trajectory of symptoms in COVID positive CYP will differ significantly from the comparator group, allowing us to construct an operational definition of long COVID.

We plan a longitudinal cohort study of non-hospitalised CYP aged 11-17 yrs. We will approach 30,000 CYP, half of whom with proven COVID. We expect 6,000 to consent to help us. We will ask them whether they still have physical or mental health problems at 3, 6,12 and 24 months afterwards. The 3,000 CYP with a positive SARS-CoV-2 tests will be compared with 3,000 test-negative controls.

DELIVERABLES: we will access large numbers with proven COVID quickly to generate early outputs to inform future intervention studies and health policy.