{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T22:02:39Z","timestamp":1791496959596,"version":"4.3.4"},"reference-count":26,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>During the COVID-19 pandemic, a reduction in quality of life and physical and mental health among children and adolescents has been reported that may be associated with SARS-CoV-2 infection and\/or containment measures.<\/jats:p><\/jats:sec>Objective<\/jats:title>To assess the association of SARS-CoV-2 seropositivity with symptoms that may be related to myalgic encephalomyelitis and\/or chronic fatigue syndrome (ME\/CFS) among children and adolescents.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This substudy of the cross-sectional SARS-CoV-2 seroprevalence surveys in Germany (SARS-CoV-2 KIDS) was performed in 9 pediatric hospitals from May 1 to October 31, 2021. Pediatric patients were recruited during an inpatient or outpatient visit regardless of the purpose of the visit. Parental questionnaires and serum samples were collected during clinically indicated blood draws. The parental questionnaire on demographic and clinical information was extended by items according to the DePaul Symptom Questionnaire, a pediatric screening tool for ME\/CFS in epidemiological studies in patients aged 5 to 17 years.<\/jats:p><\/jats:sec>Exposures<\/jats:title>Seropositivity was determined by SARS-CoV-2 IgG antibodies in serum samples using enzyme-linked immunosorbent assays.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Key symptoms of ME\/CFS were evaluated separately or as clustered ME\/CFS symptoms according to the DePaul Symptom Questionnaire, including fatigue.<\/jats:p><\/jats:sec>Results<\/jats:title>Among 634 participants (294 male [46.4%] and 340 female [53.6%]; median age, 11.5 [IQR, 8-14] years), 198 (31.2%) reported clustered ME\/CFS symptoms, including 40 of 100 SARS-CoV-2\u2013seropositive (40.0%) and 158 of 534 SARS-CoV-2\u2013seronegative (29.6%) children and adolescents. After adjustment for sex, age group, and preexisting disease, the risk ratio for reporting clustered ME\/CFS symptoms decreased from 1.35 (95% CI, 1.03-1.78) to 1.18 (95% CI, 0.90-1.53) and for substantial fatigue from 2.45 (95% CI, 1.24-4.84) to 2.08 (95% CI, 1.05-4.13). Confinement to children and adolescents with unknown previous SARS-CoV-2 infection status (n\u2009=\u2009610) yielded lower adjusted risks for all symptoms except joint pain ME\/CFS\u2013related symptoms. The adjusted risk ratio was 1.08 (95% CI, 0.80-1.46) for reporting clustered ME\/CFS symptoms and 1.43 (95% CI, 0.63-3.23) for fatigue.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>These findings suggest that the risk of ME\/CFS in children and adolescents owing to SARS-CoV-2 infection may be very small. Recall bias may contribute to risk estimates of long COVID-19 symptoms in children. Extensive lockdowns must be considered as an alternative explanation for complex unspecific symptoms during the COVID-19 pandemic.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2022.33454","type":"journal-article","created":{"date-parts":[[2022,9,27]],"date-time":"2022-09-27T15:01:21Z","timestamp":1664290881000},"page":"e2233454","source":"Crossref","is-referenced-by-count":11,"title":["Association of SARS-CoV-2 Seropositivity With Myalgic Encephalomyelitis and\/or Chronic Fatigue Syndrome Among Children and Adolescents in Germany"],"prefix":"10.1001","volume":"5","author":[{"given":"Anna-Lisa","family":"Sorg","sequence":"first","affiliation":[{"name":"Institute of Social Paediatrics and Adolescent Medicine, Division of Paediatric Epidemiology, Ludwig-Maximilians-University Munich, Munich, Germany"},{"name":"University Children\u2019s Hospital, Eberhard Karls University, Tuebingen, 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Hospital, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Hufnagel","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine, Medical Faculty, University Medical Centre, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Lander","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University Hospital and Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes G.","family":"Liese","sequence":"additional","affiliation":[{"name":"University Hospital of Wuerzburg, Division of Paediatric Infectious Diseases, Department of Paediatrics, Wuerzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Niehues","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Helios Klinikum Krefeld, Krefeld, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Verjans","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Wetzke","sequence":"additional","affiliation":[{"name":"Centre for Paediatrics and Adolescent Medicine, Hannover Medical School, Excellence Cluster RESIST (Resolving Infection Susceptibility), Deutsche Forschungsgemeinschaft, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Stojanov","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Faculty of Medicine, Technical University Munich, Munich, 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What is ME\/CFS? Updated April 12, 2022. Accessed April 12, 2022. https:\/\/www.cdc.gov\/me-cfs\/about\/index.html"},{"key":"zoi220953r12","doi-asserted-by":"crossref","unstructured":"Roessler? M, Tesch? F, Batram? M, . Post COVID-19 in children, adolescents, and adults: results of a matched cohort study including more than 150,000 individuals with COVID-19.? medRxiv. Preprint posted online October 22, 2021. doi:10.1101\/2021.10.21.21265133","DOI":"10.1101\/2021.10.21.21265133"},{"key":"zoi220953r19","doi-asserted-by":"crossref","unstructured":"Miller? F, Nguyen? V, Navaratnam? AMD, . Prevalence of persistent symptoms in children during the COVID-19 pandemic: evidence from a household cohort study in England and Wales.? medRxiv. Preprint posted online June 2, 2021. doi:10.1101\/2021.05.28.21257602","DOI":"10.1101\/2021.05.28.21257602"},{"key":"zoi220953r26","doi-asserted-by":"crossref","unstructured":"Sorg? AL, Hufnagel? M, Doenhardt? M, . Risk of hospitalization, severe disease, and mortality due to COVID-19 and PIMS-TS in children with SARS-CoV-2 infection in Germany.? medRxiv. 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