Journal of Medical Council of Iran
Volume 43 - Series of Sessions on Post-Acute COVID-19 Syndrome
jmciri 2025, 43 - Series of Sessions on Post-Acute COVID-19 Syndrome: 90-102 |
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Jaafarian A, Assari R, Ashrafi M, Movahedi , M, Mojtahedi H, Sadr M, et al . Post-COVID-19 syndrome in children. jmciri 2025; 43 (S1) :90-102
URL: http://jmciri.ir/article-1-3455-en.html
URL: http://jmciri.ir/article-1-3455-en.html
Akram Jaafarian 
, Raheleh Assari , Mahmoudreza Ashrafi , , Masoud Movahedi , Hanieh Mojtahedi , Maryam Sadr , Sara Assadiasl , Narjes Soleimanifar , Zolfaghari Mohammadali , Alireza Esteghamati , Rostamian Rostamian , Rohola Shirzadi , Mohammad Hossein Nicknam
, Raheleh Assari , Mahmoudreza Ashrafi , , Masoud Movahedi , Hanieh Mojtahedi , Maryam Sadr , Sara Assadiasl , Narjes Soleimanifar , Zolfaghari Mohammadali , Alireza Esteghamati , Rostamian Rostamian , Rohola Shirzadi , Mohammad Hossein Nicknam
Molecular Immunology Research Center, Tehran University of Medical Sciences, Tehran, Iran
Abstract: (77 Views)
Background: Post-Acute Sequelae of SARS-CoV-2 Infection (PASC) syndrome, often known as "long COVID", is a complex multisystem complication caused by SARS-CoV-2 infection that also widely affects children and adolescents.
Results: The prevalence of PASC in children varies between 1 and 27%, and risk factors such as older age, female gender, severity of acute infection, history of multisystem inflammatory syndrome of childhood (MIS-C), underlying diseases (such as asthma, allergies, and obesity), and reinfection play a key role in its occurrence. Neurological manifestations include brain fog, chronic fatigue, headache, mood and anxiety disorders, while vasculitic manifestations often present as MIS-C with coronary and other vascular involvement. Immunological mechanisms include chronic systemic inflammation, dysregulation of T and B cells, excessive activation of innate immune cells (such as neutrophils via NETosis and macrophages via the STING pathway), production of autoantibodies, and a tendency toward a Th2 response, which predisposes to exacerbation of allergic reactions. New studies emphasize that PASC can significantly impair children's quality of life and mental health by increasing the risk of severe anxiety, depression, and sleep problems.
Conclusion: Successful management of PASC requires a multidisciplinary approach, early diagnosis, supportive interventions, and targeted therapies. With the emergence of new variants such as Omicron and the effectiveness of vaccination in reducing the severity of PASC (up to 50% in adolescents), the prognosis has improved, but the need for longitudinal studies to develop novel treatments and prevention protocols remains.
Results: The prevalence of PASC in children varies between 1 and 27%, and risk factors such as older age, female gender, severity of acute infection, history of multisystem inflammatory syndrome of childhood (MIS-C), underlying diseases (such as asthma, allergies, and obesity), and reinfection play a key role in its occurrence. Neurological manifestations include brain fog, chronic fatigue, headache, mood and anxiety disorders, while vasculitic manifestations often present as MIS-C with coronary and other vascular involvement. Immunological mechanisms include chronic systemic inflammation, dysregulation of T and B cells, excessive activation of innate immune cells (such as neutrophils via NETosis and macrophages via the STING pathway), production of autoantibodies, and a tendency toward a Th2 response, which predisposes to exacerbation of allergic reactions. New studies emphasize that PASC can significantly impair children's quality of life and mental health by increasing the risk of severe anxiety, depression, and sleep problems.
Conclusion: Successful management of PASC requires a multidisciplinary approach, early diagnosis, supportive interventions, and targeted therapies. With the emergence of new variants such as Omicron and the effectiveness of vaccination in reducing the severity of PASC (up to 50% in adolescents), the prognosis has improved, but the need for longitudinal studies to develop novel treatments and prevention protocols remains.
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