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Long COVID: understanding how COVID-19 affects the brains of children with persistent symptoms

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Updated on

What did the project achieve?

Some children and young people who have had COVID-19 experience persistent symptoms, including extreme tiredness, headaches, loss of smell and difficulties with concentration, that affect their daily lives. However, because long COVID is still a relatively new condition, researchers do not yet fully understand why some young people develop ongoing symptoms while others recover completely. 

“Most research into long COVID has so far focused on adults – and this project helped to address that gap,” says Dr Nathalie MacDermott of King’s College London. “This is essential if we are to develop a better understanding of the condition in children and young people, and identify new management strategies to give them the best possible chance of making a good recovery.”

This study investigated whether children and young people with long COVID have subtle brain changes that might indicate current or previous mild inflammation, which could help explain some of their symptoms. The researchers recruited 66 children and young people to take part, with many undergoing a magnetic resonance imaging (MRI) scan to examine their brain structure in detail.

“We compared brain scans from 31 young people with moderate-to-severe long COVID with 15 participants who had fully recovered from COVID-19 with no lasting symptoms,” says Professor Jonathan O’Muircheartaigh. “We found differences in the average brain scans of the two groups, although these changes varied between individuals, and we cannot tell whether they were present before infection.”

The researchers now plan to investigate how these brain changes relate to the symptoms experienced by children and young people with long COVID. In addition, they are analysing blood samples collected from all participants to look for differences in immune activity between different groups.

“Although this work is still at an early stage, it is an important step towards improving our understanding of long COVID in children and young people – and how the condition may differ from that seen in adults,” says Dr MacDermott. “Our initial findings suggest there may be detectable brain differences in children and young people with and without long COVID, which may help explain some of the symptoms experienced.”

This research was completed on

Children and young people may experience persistent symptoms after COVID-19 that affect their physical, mental or social wellbeing, interfering with their daily lives. Some estimates indicate up to one in 50 children infected with SARS-CoV-2 develop long COVID, while other studies suggest it could be as many as one in seven. [1,2] Dr Nathalie MacDermott of King’s College London is looking for brain changes in children with long COVID that could help provide clues into the underlying disease processes. Establishing how COVID-19 affects the brains of young people with this condition could enable earlier diagnosis and lead to new strategies to support their long-term recovery.

How are children’s lives affected now?

Although COVID-19 in children and young people is usually a short illness with few or no symptoms, some children continue to experience symptoms at least 12 weeks after infection with SARS-CoV-2 (the virus that causes COVID-19).

“The most common symptoms described by children with long COVID are extreme tiredness, headache, loss of smell, and finding it hard to concentrate,” says Dr MacDermott.

But currently, it is unclear how the virus causes persistent symptoms in some children – and what the long-term consequences are for young people affected by long COVID. One possibility is that some symptoms may be caused by ongoing mild inflammation in the brain.

“As long COVID is such a new illness, there are still a lot of unanswered questions,” says Dr MacDermott. “We urgently need to study children experiencing prolonged illness to gain a better understanding of the disease process, the likely long-term outcomes and find out how best to help them.”

How could this research help?

“We aim to find out if children and young people with long COVID have detectable brain changes that suggest they have or may have had, some mild inflammation in their brain – which could put them at risk of long-term neurological problems,” says Dr MacDermott.

The researchers will carry out brain scans on 80 children, aged 10 to 17 years, with moderate to severe long COVID – and then compare these with those from children with a severe inflammatory condition caused by COVID-19, and children who have either fully recovered from COVID-19 or never had the illness.

“We will determine if there are any changes in brain volume or structure in children and young people with long COVID,” says Dr MacDermott.

Establishing if children with long COVID have a loss of brain volume and small structural changes – similar to those seen in children with other conditions that cause inflammation of the brain and spinal cord – will provide important new insight into the underlying disease processes.

We hope our results will lead to new tests to identify children and young people with brain changes associated with long COVID – and new treatment strategies to give them the best possible long-term outcome.

Dr MacDermott

References

1. Molteni, E. Illness duration and symptom profile in symptomatic UK school-aged children tested for SARS-CoV-2. Lancet Child Adolesc Health. 2021;5(10):708-718. DOI: 10.1016/S2352-4642(21)00198-X

2. Stephenson T et al. Long COVID – the physical and mental health of children and non-hospitalised young people 3 months after SARS-CoV-2 infection; a national matched cohort study (The CLoCk) Study. Preprint from Research Square 2021; DOI: 10.21203/rs.3.rs-798316/v1

Research table

Project details

Project Leader Dr Nathalie E MacDermott, PhD MRPCH
Location Department of Women and Children’s Health, King’s College London
Project Team Dr Ming Lim, PhD MRCP MRCPCH
Dr Jonathan O’Muircheartaigh, PhD
Dr Yael Hacohen, PhD MRCPCH
Other Locations Department of Paediatric Neurology, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Trust
Department of Perinatal Imaging and Health, King’s College London
Department of Neuroinflammation, Institute of Neurology, University College London
Neuroimmunology Centre, Great Ormond Street NHS Trust
Grant Awarded
Grant Amount £99,753
Start Date
End Date
Duration 24 months
Grant Code (GN number) GN2925

 

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