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Japanese youths suffering fatigue from aftereffects of COVID infection

A 13-year-old boy with COVID-19 aftereffects is in a lethargic state as he rides the train to go to the hospital, as seen in this photo provided by his family.

TOKYO -- Many young people in Japan have been suffering from serious aftereffects from COVID-19 infection, even those who only initially showed mild symptoms.

    The various aftereffects of COVID-19 include symptoms of hair loss, smell disorders and fatigue, and there are many points that remain unclear. The Mainichi Shimbun delved into the current state of COVID-19 aftereffects among the young generation, amid concerns that patients suffering from such symptoms will increase following this summer's fifth coronavirus wave.

    "I feel like I'm living in an alternate world," muttered a nurse's 13-year-old son as they were taking a meal. The 50-year-old woman living in the city of Ebina, Kanagawa Prefecture, was startled to hear this from her second oldest son, a second-year student in junior high, who is the only family member currently suffering from strong fatigue, taste disorders and other aftereffects even after three months have passed since the entire family of five contracted the coronavirus in late August and the boy was diagnosed with "mild symptoms."

    The nurse's son spends many days confined to bed throughout the whole day, and has apparently not been able to go to school for the most part after the start of the second term. The nurse could not hide her concern, and said, "You shouldn't underestimate (the coronavirus) because they're kids or because they had light symptoms. What's going to happen to his life moving forward? My child has been unable to go to school due to the coronavirus."

    A 16-year-old first-year high school student from Aichi Prefecture whose family is believed to have been infected with the coronavirus in May last year has also been suffering from symptoms including dizziness for over a year. The family doctor diagnosed the girl with a neuroimmune disease called myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), a type of aftereffect involving a prolonged state of fatigue so intense that it raises difficulties in leading a regular life.

    The female student gets tired and has to stay in bed just by taking a bath. As it became difficult for her to attend school, she had no choice but to choose a correspondence-style high school. "I have nothing but concern regarding what's going to happen in the future, including college entrance exams and job hunting. I'm also worried about how long my aftereffects will last. I end up wondering why I had to get infected," said the girl.

    There are quite a few young people who have been experiencing aftereffects following coronavirus infection. In October, a total of 809 inquiries regarding aftereffects were made in Tokyo. When viewing the total number of cases from the end of March, when the consultation window was opened, young people make up a large proportion, with individuals in their 20s and 40s accounting for 20% and those in their 30s accounting for 17%. Okayama University Hospital, which set up an outpatient department specializing in COVID-19 aftereffects in February, apparently saw an increase in young patients following this summer's fifth wave. Deputy director Fumio Otsuka commented, "During the fifth wave, there was a great number of infections among the young generation for whom vaccinations had not yet been moved forward. The tendency for young people to be more sensitive to aftereffect symptoms may also have something to do with this."

    There is also data suggesting that aftereffects are prevalent especially among young people. According to a survey revealed by Tokyo's Setagaya Ward in November, which obtained responses from 3,710 individuals, 53% of people in their 30s and 47% of those in their 20s suffered aftereffects following coronavirus infection, while aftereffects were experienced among 35% of people in their 80s and 39% of those in their 90s.

    While it is said that young people are less likely to develop severe symptoms following infection, as many as about 60% of patients with mild symptoms and around 30% of asymptomatic patients complained of aftereffects. Fifty-four percent of women complained of such problems, exceeding the male percentage of 42%. A survey by the National Center for Global Health and Medicine, which was disclosed in October, also found that twice as many women suffered fatigue aftereffects than men, and three times as many suffered from hair loss. It also revealed that taste and smell disorders were more likely to occur among young people and those with less weight.

    In October, the World Health Organization defined COVID-19 aftereffects as a condition that occurs "three months from the onset of COVID-19 with symptoms that last for at least two months and cannot be explained by an alternative diagnosis." There is a wide array of symptoms, including fatigue, shortness of breath, coughing, smell and taste disorders, hair loss, and a decline in cognitive ability. The Ministry of Health, Labor and Welfare is currently creating guidelines on medical care for COVID-19 aftereffects, but there are many aspects that have yet to be elucidated, including the mechanism on how such symptoms are developed, and treatment methods have not been established at present.

    However, there have also been promising research for treatment. A U.K. study found that symptoms improved among some patients after they received coronavirus vaccines. Hideki Ueno, human immunology professor at Kyoto University, who researches about aftereffects, said that while the reason is unknown, "it is highly possible that immunity is a factor connected with aftereffect symptoms." He surmised that "if vaccines that arouse immunity are administered, and investigations on which symptoms they are effective on are pushed forward, it may be helpful for treating aftereffects."

    (Japanese original by Naomi Hayashi and Yuki Nakagawa, Lifestyle and Medical News Department)

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