Newlands, Fiona Alexandra Napier; (2024) A Mixed Methods Investigation of Post-COVID Condition in Children and Young People. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

BACKGROUND: Symptoms enduring after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have been termed Post COVID Condition (PCC). While our understanding of PCC in children and young people (CYP) has evolved, many questions remain unanswered. AIM: The aim of this PhD was to conduct a mixed methods investigation of PCC in CYP. CONTENT: The thesis begins with an introduction to PCC and considers the condition within the biopsychosocial model (Chapter 1). Findings from a systematic review and meta-analysis revealed a multitude of symptoms persisting in 25-60% of cases beyond 12 weeks post-infection (Study 1, Chapter 2). A subsequent study (n=1,001) found a substantial proportion of 18-20 years olds experienced symptoms in the months after a PCR test. These symptoms included tiredness, shortness of breath, headaches, and unusual chest pain. Loss of smell/taste was prevalent specifically among test-positives (Study 2, Chapter 3). Qualitative interviews with (n=17) CYP and their parents revealed issues related to uncertainties, identity shifts, and accessing support, highlighting the need for accessible and comprehensive services (Study 3, Chapter 4). An investigation into patients referred to PCC services (n=95) showed they reported more severe symptoms and greater impacts on daily life than those in the largest cohort study of PCC in CYP in England (Study 4, Chapter 5). A methodology was established to search for and map PCC services which highlighted geographical disparities in access and a lack of standardised symptom management approaches (Study 5, Chapter 6). NHS-England data suggested that referrals to paediatric PCC hubs were low and that demand for services decreased over time (Study 6, Chapter 7). CONCLUSION: The thesis concludes with a synthesis of the findings within the biopsychosocial model, emphasising the importance of comprehensive data collection for developing effective interventions to meet the evolving needs of affected CYP and their families.

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