Preprint Article Version 2 Preserved in Portico This version is not peer-reviewed

The CSHQ-DE Questionnaire Uncovers Relevant Sleep Disorders in Children and Adolescents with Long COVID-19

Sarah Werner
,
Claus Doerfel
,
Richard Biedermann
,
Michael Lorenz
ORCID logo ,
Marius Rasche
,
Hans Proquitté
,
Lars Newman
* ORCID logo ,
Daniel Vilser
* ORCID logo
Version 1 : Received: 1 September 2022 / Approved: 6 September 2022 / Online: 6 September 2022 (10:01:25 CEST)
Version 2 : Received: 13 October 2022 / Approved: 14 October 2022 / Online: 14 October 2022 (10:13:22 CEST)

A peer-reviewed article of this Preprint also exists.

Werner, S.; Doerfel, C.; Biedermann, R.; Lorenz, M.; Rasche, M.; Proquitté, H.; Newman, L.; Vilser, D. The CSHQ-DE Questionnaire Uncovers Relevant Sleep Disorders in Children and Adolescents with Long COVID. Children 2022, 9, 1419. Werner, S.; Doerfel, C.; Biedermann, R.; Lorenz, M.; Rasche, M.; Proquitté, H.; Newman, L.; Vilser, D. The CSHQ-DE Questionnaire Uncovers Relevant Sleep Disorders in Children and Adolescents with Long COVID. Children 2022, 9, 1419.

Abstract

Acute SARS-CoV-2 infections in children and adolescents are usually mild. However, they can suffer from ongoing symptoms generally referred as long COVID. Sleep disorders are one of the most frequent complaints in long COVID although precise data are missing. We assessed the sleep behavior of children and adolescents who presented at our outpatient clinic between January 2021 and May 2022 with the Children's Sleep Habits Questionnaire (CSHQ-DE). We compared sleep behavior at three different time points: pre-COVID-19, post-COVID-19 at initial presentation and post-COVID-19 at re-presentation. Data from 45 patients were analyzed. Of those, 64% were female and the median age was 10 years (range 0-18 years). Asymptomatic or mild COVID-19 disease was experienced in 89% of patients, whilst 11% experienced moderate disease. Initial presentation occurred at a median of 20.4 weeks (6 weeks - 14 months) after infection. The CSHQ-DE score increased significantly from pre-COVID-19 (45.82+8.7 points) to post-COVID-19 (49.40+8.3 points; p=<0.01). The score then normalized at re-presentation (46.98+7.8; p=0.1). The greatest changes were seen in the CSHQ-DE subscale score "daytime sleepiness". Our data show that children and adolescents with long COVID often suffer from sleep disturbance. For most children and adolescents these sleep disorders decreased over time without further medical intervention, aside from a basic sleep consultation.

Keywords

long COVID; Post COVID-19 condition; sleep disorders, SARS-CoV-2; Coronavirus; children

Subject

Medicine and Pharmacology, Pediatrics, Perinatology and Child Health

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Comments (1)

Comment 1
Received: 14 October 2022
Commenter: Lars Newman
Commenter's Conflict of Interests: Author
Comment: -In the discussion section, we have sought to better classify the investigation results and implications for the future care of sick children.
-We have included the most important values in the conclusion. Two statements have been added to strengthen the conclusion.
-We have inserted a new table with patient characteristics, BMI and medical history. A description of this data was added to the results and analysis in the discussion. New tables were added for differentiation by age for both symptoms and CSHQ values.
-    Chapter 2 Materials and Methods, Section 2.3: Further description added to show which statistical analyses were conducted for the presenting symptoms. These are discussed later when assessing causes of sleep disorder.
-    Chapter 3 Results: Three new tables were added: 1- Patient characteristics, BMI and medical history. 2- Presenting symptoms as differentiated by age group. 3- CSHQ score differentiation by age group. Discussion of the first and second mentioned tables were provided. No discussion of the third mentioned table was provided. Multivariate regression analysis on presenting symptoms and DSHQ score showed no significant effect. Therefore, a statistical evaluation of smaller numbers within the age subgroup was not useful. This table may be included in the appendix if deemed more appropriate.
-    Chapter 5.1. Treatment Recommendations moved to Chapter 4.1.
-    Minor formatting changes to tables
-    Chapter 5 Limitations: Statement added relating to the strength of our investigation and added a further limitation (comorbid sleep disorders)
-    Chapter 4 Discussion: Analysis of the newly added tables
-    Sources reviewed and updated
-    Minor wording changes throughout
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