London School of Hygiene & Tropical Medicine

New data from the School Infection Survey (SIS) showed that 1.8% of primary school pupils and 4.8% of secondary school pupils experienced long COVID following their most recent COVID-19 infection (since March 2020).

The SIS project, which is jointly led by the London School of Hygiene & Tropical Medicine (LSHTM), Office for National Statistics (ONS) and UK Health Security Agency (UKHSA), used the ‘parent and pupil’ questionnaires (covering 15 March to 1 April 2022) and headteacher questionnaires (covering 23 March to 1 April 2022) to explore potential impacts of COVID-19 on the health and wellbeing of pupils in primary and secondary schools.

2,966 pupils and parents on behalf of 7,448 children responded, alongside 111 headteachers.

Analysis of mental health used parent-reported measures for primary school-aged pupils (years reception to year 6) and self-reported measures for secondary school-aged pupils (years 7 to 13).

Long COVID and mental health

The questionnaire data found that more secondary school age pupils who had a positive COVID-19 test since March 2020 experienced loss of smell or taste, cardiovascular symptoms or systemic symptoms (fever or high temperature) than those who reported not having had COVID-19 at all.

Responses also indicate that secondary school pupils who experienced long COVID following their most recent COVID-19 infection were significantly more likely to have a probable mental disorder (28.1%) than those who had not (12.3%).

Dr Patrick Nguipdop-Djomo, co-chief investigator of the study at LSHTM, said: “We still have a lot to learn about long COVID in children. While it is reassuring that it appears less frequent in this young population compared to adults, this report reminds us that it does exist and the variety of manifestations, so should not be neglected.

“It is also crucial to listen to the need of schools about the importance of academic catch-up and mental health promotion in this recovery period, for which they need to be supported.”

“We would like to renew our thanks to the schools, pupils and parents who have made these surveys possible. The data they shared with us will help improve our understanding of the impacts of COVID-19 on children and young people’s health and wellbeing, and how to better support them as we recover from the pandemic.

Dr Shamez Ladhani, Consultant Paediatrician at the UK Health Security Agency and the study’s chief investigator, said: “Since March 2020, more than 98 per cent of primary school pupils and more than 95 per cent of secondary school pupils surveyed that had COVID-19 did not experience persistent symptoms lasting 12 weeks or more from their last COVID infection.

“Most children and young people with COVID-19 experience mild symptoms and a short period of illness, and those with persistent symptoms will improve with time.

“We welcome similar studies for other viruses, with follow-up over a longer period to help us to understand how COVID-19 is different to other viruses in children and young people.

“Anyone concerned about ongoing symptoms or mental health for themselves or their children should contact their GP for support and advice.”

Long COVID, physical activity and eating behaviours

The parent and pupil questionnaires found that primary school pupils were more physically active than secondary school pupils, with 24.7% of primary school pupils reporting to be physically active for the recommended 60 minutes each day compared to 17.5% of secondary school pupils.

The team found no different in physical activity between those who had experienced long COVID and those who had not.

However, 41.4% of secondary school pupils who had experienced long COVID following their most recent COVID-19 infection answered ‘Yes’ to at least 2 of the 5 questions about experiencing eating difficulties. Of these, 41.9%, of female secondary school pupils answered ‘Yes’ to 2 or more questions about experiencing eating difficulties, compared to 17.5% of male secondary school pupils.

Professor Punam Mangtani, co-chief investigator of the study at LSHTM, said: “The full impact of long COVID is still relatively unknown. These findings add to our understanding of the possible indirect impacts of the COVID-19 pandemic on the wellbeing of children and young people.

“It is concerning that the majority of students in this study reported less daily physical activity than recommended for a healthy lifestyle, and a relatively high proportion reported behaviours associated with eating disorders.

“Further investigation is needed to provide appropriate support to children, their families and schools as we recover from the pandemic. We are grateful to the students, parents and schools who have volunteered for these surveys.”

Andrea Lacey, Senior Statistician at the Office for National Statistics, said: “Nearly a quarter of pupils in primary school reported getting the recommended 60 minutes a day of physical activity, compared to secondary school pupils, where just over 1 in 10 reported the same.

“Though we found no relationship between reported long COVID and physical activity, nearly half of secondary school pupils with long COVID reported experiencing eating difficulties.

“These insights would not have been possible without all the pupils and parents who completed our in-depth questionnaires, thank you for all your hard work.”

Data from the parent and pupil questionnaires are weighted to population totals for pupils in England. Headteacher questionnaire data are unweighted because of small sample sizes.

Publication

COVID-19 Schools Infection Survey, England: long COVID and mental health, March 2022. Office for National Statistics.

COVID-19 Schools Infection Survey, England: physical activity and eating behaviours, March 2022. Office for National Statistics.