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What did the project achieve?
“We’ve worked with teenagers with long COVID to create a new online treatment programme designed to improve their breathing patterns and reduce anxiety, helping them gradually return to their usual activities,” says Dr Samatha Sonnappa of the Royal Brompton Hospital in London. “We hope this research will ultimately lead to an effective tool that can be integrated into routine care and help improve the lives of children and young people with this debilitating condition.”
Thankfully, most children and young people infected with SARS-CoV-2 (the virus that causes COVID-19) have a short illness with mild or no symptoms. But some go on to experience long-lasting symptoms that affect their physical, mental or social well-being. Many young people with long COVID deal with breathlessness, chest pain, low mood or anxiety. These symptoms can make it more challenging to participate in school and social activities – making them feel disconnected from their education and friends.
Although the link between mental health and breathing pattern problems in long COVID is known, there is a lack of treatment approaches that address both these interconnected issues at the same time.
To help fill this gap, Dr Sonnappa and her team worked closely with several young people living with long COVID to design a holistic online treatment programme. It includes modules on breathing techniques, information about how the mind and body are connected, confidence-building exercises, coping strategies, and opportunities to connect with other young people facing similar challenges.
Once the programme was finalised, the researchers tested it in a small pilot study involving 33 children, aged 13 to 18 years. They divided the participants into two groups: one group received the usual care for long COVID, while the other received the usual care plus access to the new online programme.
“We’ve assessed breathing patterns, quality of life, well-being and day-to-day functioning in both groups,” says Dr Sonnappa. “We’re now analysing the results and plan to publish our findings soon.”
The co-designed programme is now available as an online resource. It features bespoke videos demonstrating breathing exercises, along with quotes and reflections from young people with long COVID about the challenges they’ve faced and what has helped them.
The researchers hope that the outcomes and learnings from this study can also help children and young people who have other respiratory conditions in the future.
This research was completed on
How are children’s lives affected now?
Thankfully, most children and young people infected with SARS-CoV-2 (the virus that causes COVID-19) will have a short illness with few or no symptoms. But some will develop long-lasting symptoms that impact their physical, mental or social well-being, interfering with their daily lives.
“Many children and young people with long COVID develop breathlessness – and they may also feel worried, sad, or unhappy,” says Dr Sonnappa. “These problems are often interconnected, can worsen each other, and cause children to miss school and social activities – making them feel disconnected from their education and friends.”
But this picture is complicated because some physical effects of stress and anxiety present as breathing difficulties – including breathlessness and chest pain, at rest or during exercise – which are symptoms commonly experienced by those with long COVID.
“Finding new ways to reduce breathlessness and anxiety associated with long COVID in children and young people is important – particularly as these problems can have a significant impact on their mental health and well-being,” says Dr Sonnappa.
How could this research help?
“Our goal is to develop an online treatment programme that can help improve breathing patterns and reduce anxiety in children with long COVID, enabling them to return to their usual activities,” says Dr Sonnappa.
The researchers will recruit 40 children with long COVID, aged 13 to 18 years, working with them to develop an online treatment programme – which will include breathing and relaxation techniques, and ways to manage anxiety based on mindfulness and cognitive behavioural therapy.
“The programme will also help children to understand the connection between mind and body, for example, how feeling anxious can cause breathlessness – and will provide an option to connect socially with other affected children,” says Dr Sonnappa.
The team will carry out a pilot study to assess whether the online programme provides greater benefits than the current standard treatment alone, by analysing information collected from mental health and quality of life questionnaires, breathing assessments, and participant feedback.
We hope this will ultimately lead to an effective new treatment that can help improve the lives of children with long COVID.
References
- 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
- 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
- Brackel CLH et al. Pediatric long-COVID: An overlooked phenomenon? Pediatr Pulmonol. 2021;56(8):2495-2502. DOI: 10.1002/ppul.25521
Research table
Project details
| Project Leader | Dr Samatha Sonnappa, MD PhD FRCPCH |
| Location | Paediatric Respiratory Medicine, Royal Brompton Hospital, London |
| Project Team |
Dr Terry Y Segal MBChB FRCPCH
Ms Charlotte Wells BSc MRes Professor Deborah Christie BSc PhD Dip Clin Psych Dr Liz Whittaker, MB BAO BCh MRCPCH DTMH PhD Dr Dasha Nicholls MBBS MD FRCPsych Ms Anna Gregorowski BSc Dr Deborah Woodman, BA DClin Psych |
| Other Locations |
Treatment and Rehabilitation for Adolescents and Children with Complex Conditions (TRACCS) service and Children and Young People’s Psychological Services, University College London Hospitals NHS Foundation Trust
Paediatric Respiratory Physiotherapy, Royal Brompton Hospital, London Section of Paediatric Infectious Diseases and Department of Child Psychiatry, Imperial College Healthcare NHS Trust Clinical Psychology, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Trust |
| Grant Awarded | |
| Grant Amount | £91,064 |
| Start Date | |
| End Date | |
| Duration | 24 months |
| Grant Code (GN number) | GN2923 |
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