Abstract：
BACKGROUND: Two sequelae of pediatric COVID-19 have been identified, the multisystem inflammatory syndrome in children (MIS-C) and the long COVID. Long COVID is much less precisely defined and includes all the persistent or new clinical manifestations evidenced in subjects previously infected by SARS-CoV-2 beyond the period of the acute infection and that cannot be explained by an alternative diagnosis. In this Intersociety Consensus, present knowledge on pediatric long COVID as well as how to identify and manage children with long COVID are discussed.
RESULTS: Although the true prevalence of long COVID in pediatrics is not exactly determined, it seems appropriate to recommend evaluating the presence of symptoms suggestive of long COVID near the end of the acute phase of the disease, between 4 and 12 weeks from this. Long COVID in children and adolescents should be suspected in presence of persistent headache and fatigue, sleep disturbance, difficulty in concentrating, abdominal pain, myalgia or arthralgia. Persistent chest pain, stomach pain, diarrhea, heart palpitations, and skin lesions should be considered as possible symptoms of long COVID. It is recommended that the primary care pediatrician visits all subjects with a suspected or a proven diagnosis of SARS-CoV-2 infection after 4 weeks to check for the presence of symptoms of previously unknown disease. In any case, a further check-up by the primary care pediatrician should be scheduled 3 months after the diagnosis of SARS-CoV-2 infection to confirm normality or to address emerging problems. The subjects who present symptoms of any organic problem must undergo a thorough evaluation of the same, with a possible request for clinical, laboratory and / or radiological in-depth analysis in case of need. Children and adolescents with clear symptoms of mental stress will need to be followed up by existing local services for problems of this type.
CONCLUSIONS: Pediatric long COVID is a relevant problem that involve a considerable proportion of children and adolescents. Prognosis of these cases is generally good as in most of them symptoms disappear spontaneously. The few children with significant medical problems should be early identified after the acute phase of the infection and adequately managed to assure complete resolution. A relevant psychological support for all the children during COVID-19 pandemic must be organized by health authorities and government that have to treat this as a public health issue.
RESULTS: Although the true prevalence of long COVID in pediatrics is not exactly determined, it seems appropriate to recommend evaluating the presence of symptoms suggestive of long COVID near the end of the acute phase of the disease, between 4 and 12 weeks from this. Long COVID in children and adolescents should be suspected in presence of persistent headache and fatigue, sleep disturbance, difficulty in concentrating, abdominal pain, myalgia or arthralgia. Persistent chest pain, stomach pain, diarrhea, heart palpitations, and skin lesions should be considered as possible symptoms of long COVID. It is recommended that the primary care pediatrician visits all subjects with a suspected or a proven diagnosis of SARS-CoV-2 infection after 4 weeks to check for the presence of symptoms of previously unknown disease. In any case, a further check-up by the primary care pediatrician should be scheduled 3 months after the diagnosis of SARS-CoV-2 infection to confirm normality or to address emerging problems. The subjects who present symptoms of any organic problem must undergo a thorough evaluation of the same, with a possible request for clinical, laboratory and / or radiological in-depth analysis in case of need. Children and adolescents with clear symptoms of mental stress will need to be followed up by existing local services for problems of this type.
CONCLUSIONS: Pediatric long COVID is a relevant problem that involve a considerable proportion of children and adolescents. Prognosis of these cases is generally good as in most of them symptoms disappear spontaneously. The few children with significant medical problems should be early identified after the acute phase of the infection and adequately managed to assure complete resolution. A relevant psychological support for all the children during COVID-19 pandemic must be organized by health authorities and government that have to treat this as a public health issue.
摘要：
背景：已经确定了小儿COVID-19的两个后遗症，儿童多系统炎症综合征（MIS-C）和长COVID。长COVID的定义不太精确，包括在急性感染期间之前被SARS-CoV-2感染的受试者中证明的所有持续或新的临床表现，这不能用替代诊断来解释。在这种跨社会共识中，讨论了有关儿科长COVID的知识以及如何识别和管理长COVID儿童的知识。
结果：尽管儿科中长型COVID的真正患病率尚未确切确定，似乎建议在疾病急性期结束时评估是否存在提示长COVID的症状，从这4到12周之间。如果存在持续性头痛和疲劳，应怀疑儿童和青少年的长期COVID，睡眠障碍,难以集中注意力，腹痛,肌痛或关节痛。持续的胸痛,胃痛,腹泻,心悸,和皮肤病变应被视为长COVID的可能症状。建议初级保健儿科医生在4周后访问所有怀疑或证实诊断为SARS-CoV-2感染的受试者，以检查是否存在先前未知疾病的症状。无论如何,应在诊断出SARS-CoV-2感染后3个月安排初级保健儿科医生的进一步检查,以确认正常或解决新出现的问题.出现任何器质性问题症状的受试者必须对其进行彻底评估，有可能的临床要求，在需要的情况下进行实验室和/或放射学深入分析。有明显精神压力症状的儿童和青少年需要由现有的当地服务机构跟进此类问题。
结论：儿童长期COVID是一个相关问题，涉及相当比例的儿童和青少年。这些病例的预后通常良好，因为其中大多数症状会自发消失。在感染的急性期后，应及早发现少数有重大医疗问题的儿童，并进行适当的管理以确保完全解决。在COVID-19大流行期间，必须由卫生当局和政府组织为所有儿童提供相关的心理支持，他们必须将这一问题视为公共卫生问题。
结果：尽管儿科中长型COVID的真正患病率尚未确切确定，似乎建议在疾病急性期结束时评估是否存在提示长COVID的症状，从这4到12周之间。如果存在持续性头痛和疲劳，应怀疑儿童和青少年的长期COVID，睡眠障碍,难以集中注意力，腹痛,肌痛或关节痛。持续的胸痛,胃痛,腹泻,心悸,和皮肤病变应被视为长COVID的可能症状。建议初级保健儿科医生在4周后访问所有怀疑或证实诊断为SARS-CoV-2感染的受试者，以检查是否存在先前未知疾病的症状。无论如何,应在诊断出SARS-CoV-2感染后3个月安排初级保健儿科医生的进一步检查,以确认正常或解决新出现的问题.出现任何器质性问题症状的受试者必须对其进行彻底评估，有可能的临床要求，在需要的情况下进行实验室和/或放射学深入分析。有明显精神压力症状的儿童和青少年需要由现有的当地服务机构跟进此类问题。
结论：儿童长期COVID是一个相关问题，涉及相当比例的儿童和青少年。这些病例的预后通常良好，因为其中大多数症状会自发消失。在感染的急性期后，应及早发现少数有重大医疗问题的儿童，并进行适当的管理以确保完全解决。在COVID-19大流行期间，必须由卫生当局和政府组织为所有儿童提供相关的心理支持，他们必须将这一问题视为公共卫生问题。
