Becker's Clinical Quality & Infection Control

19 PATIENT SAFETY & OUTCOMES 6 notes on long COVID-19 in children By Erica Carbajal W hile many studies have focused on the prevalence of long COVID-19 among adults, with estimates indicating between 10 percent and 30 percent of COVID-19 patients affected by lingering symptoms, not as much re- search has focused on how it affects children who have had the virus. Anecdotal reports suggest many young people experience lingering neurological, physical and psychiatric symptoms aer a COVID-19 infection, raising concerns about school performance, e New York Times reported Aug. 8. Five more notes: 1. A study cited at an April congressional hearing by Francis Collins, MD, PhD, director of the National Institutes of Health, found between 11 percent and 15 percent of youth infected with the virus may become long-haulers, the Times reported. 2. e Times spoke with several young teens experiencing prolonged symptoms such as severe fatigue, cognitive mix-ups or brain fog, anxiety and other issues disrupting their school performance. For instance, Will, a 15-year-old tennis play- er from Dallas whose COVID-19 infection kept him bedridden for 35 days, described a number of cognitive issues when he re- turned to high school classes, such as brain fog causing him to see "numbers floating off the page in math." e student also described forgetting to turn in assignments he'd already completed and mixing frag- ments of French and English. "I handed it to my teacher, and she was like 'Will, is this your scratch notes?'" he told the Times. "Am I going to be able to be a good student ever again? Because this is really scary." 3. Some physicians have found children who initially had mild or asymptomatic infec- tions still experience lingering symptoms. "e potential impact is huge," said Avindra Nath, MD, chief of nervous system infec- tions at the National Institute of Neurologi- cal Disorders and Stroke. "I mean, they're in their formative years. Once you start falling behind, it's very hard because the kids lose their own self-confidence too. It's a down- ward spiral," he told the Times. 4. At Boston Children's Hospital's post- COVID-19 program, most patients were never hospitalized and recovered at home, "and then they have symptoms that just never go away — or they seem to get totally better and then a couple of weeks or a month or so aer, they develop symptoms," Molly Wilson, MD, a neuroinfectious diseases specialist at the hospital, told the news outlet. Some studies have indicated older children are more likely to report long-term issues. e Times cited a U.K. study that found 9.8 percent of children aged 2 to 11 experienced lingering COVID-19 symptoms five weeks later, while 13 percent of 12- to 16-year- olds said the same. Aer 12 weeks, those figures fell to 7.4 percent in the younger group and 8.2 percent in the older group. Some researchers predict that aer puberty, hormones could amplify immune responses — a potential explanation for why higher proportions of older children experience persistent symptoms. 5. e highly contagious delta variant, first detected in India and now the domi- nant U.S. strain, drove pediatric cases and hospitalizations up, with children under 12 still ineligible for vaccines. Since the start of the pandemic, about 5 million U.S. children have tested positive for COVID-19, accord- ing to the American Academy of Pediatrics. Children made up between 1.6 percent and 4.1 percent of total cumulative COVID-19 hospitalizations as of Sept. 2. n Patients who report unfair treatment from physicians delay care, study finds By Erica Carbajal N early 76 percent of U.S. adults who reported feeling treated or judged unfairly in a healthcare setting within the 12 months prior to being surveyed said it caused care disruptions, according to findings from the Urban Institute published Aug. 9. Researchers used data from the Urban Institute's December 2020 Well-Be- ing and Basic Needs Survey to conduct the analysis. The nationally repre- sentative survey included more than 7,500 adults aged 18 to 64. Overall, 3.2 percent of respondents reported feeling treated or judged unfairly because of their race or ethnicity in a healthcare setting in the past 12 months. Black and Hispanic adults were more likely to report experiencing discrimination within healthcare settings than their white counterparts, the findings showed. Of those who said they were treated or judged unfairly by their healthcare provider, 75.9 percent said it disrupted their receipt of healthcare; 39 percent said they delayed care as a result; nearly 35 percent looked for a new provid- er; and 11.4 percent said they didn't follow the provider's recommendations. At the same time, more than one-third of those who reported unfair treatment said they took action to address the treatment or judgment, including 19.2 percent who reported speaking to their provider about the treatment, nearly 17 percent who filed a complaint and 9.4 percent who took other action. "Our findings show patients who feel treated or judged unfairly because of their race or ethnicity when seeking healthcare face consequences that can directly harm their health," researchers said. "Several strategies can help providers improve their behavior and attitude toward patients to mitigate these negative consequences, including expanding provider education and training about racism and bias, encouraging culturally competent and effec- tive care, and diversifying the healthcare workforce." n

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