New Report Looks at the Effects of Long COVID in Children – Parents

As the medical world continues to grapple with the complexities of the ever-changing COVID-19 virus, theres a growing focus on the potential long-term effects of the illness.

Now there's a new comprehensive analysis recently published in the American Academy of Pediatrics' (AAP) publication Pediatrics. They looked at research from previous scientific studies around the world to highlight what is currently known about long COVID and the potential effects it has on children. It is sometimes also called long haul COVID or Postaacute Sequelae of COVID-19 (PASC).

The review found that in some cases, long COVID can lead to neurological, gastrointestinal, cardiovascular, and behavioral issues months after acute infection.

Suchitra Rao, MD, a pediatric infectious disease expert at Childrens Hospital Colorado, and co-author of the review explains that occasionally, a persons immune response to fighting off a virus can be harmful.

It can start attacking its own cells inadvertently, which can lead to autoimmune and other post-infectious conditions, she says. The studies included in the review found those post-COVID conditions included type 1 diabetes, Graves disease, lupus, and Immune thrombocytopenia (ITP) or low platelets.

Long COVID, she cautions, can present in many different ways, affecting virtually any organ system.The review includes a range of studies that look at a variety of factors, such as the patients age, severity of initial infection, and hospitalizations.

Rachel S. Gross, MD, MS, a general pediatrician, clinical research investigator, and an Assistant Professor of Pediatrics at the NYU School of Medicine and Bellevue Hospital Center, is one of the dozens of pediatric clinicians and researchers participating in the National Institutes of Health-funded RECOVER (Researching COVID to Enhance Recovery) Initiative. It aims to improve the diagnosis, treatment, and prevention of long Covid in children.

Dr. Gross says while the research currently indicates that long COVID is more prevalent in adults, its a common misconception that children are not at risk.

According to the Centers for Disease Control and Prevention (CDC), long COVIDin both children and adultsis when a person has symptoms that last weeks, months, or even years after their COVID infection. It can include symptoms they had during the infection that lingers or new symptoms that they didnt have beforeand these symptoms can even come and go.

Sometimes, long COVID can happen to people who had a mild COVID-19 infection or didn't even know they had the virus to begin with. Some may also start to feel better after an initial infection and then begin having symptoms again.

According to RECOVER,there are more than 40 symptoms of long COVID in children and young adults. Children who have long COVID can have any mix of them.

Some of the most common symptoms of long COVID in children include fatigue, brain fogor trouble concentrating on daily tasks, headaches, and sleep issues.It may also affect what a child can do during the day, like how they play or if they can go to school. They may also have trouble walking or standing, including walking up stairs, worsening of symptoms after being active, or needing to rest more.

Dr. Gross says the impact of long COVID on childrens mental health is also well-documented, and these symptoms can include mood changes, feeling sad, anxious, angry, or stressed.

More severe cases can include prolonged cardiac complications like myocarditis (MIS-C) and arrhythmias.Long COVID in those with pre-existing conditions may experience aggravated or worsening of those conditions, particularly those with respiratory issues like asthma, according to the CDC.

Long COVID does not look the same in everyone, with different people experiencing different symptoms. In children, who are still growing, this is especially true, says Dr. Gross. Thats why RECOVER is conducting research to learn why this happens, how to treat it, and ways to prevent it.

Data from the National Health Interview Survey published by the CDC shows the prevalence of long COVID in children in 2022 was about 1.3% while the estimate in adults was closer to 7%.

According to the RECOVER Initiative though, estimates appear higher. The review, which gathered data from the start of the pandemic in 2019, says 10-20% of children who had an initial COVID infection developed long COVID, and that it affected up to 5.8 million children.

Dr. Rao says there is still much to be learned about why some patients experience long COVID symptoms but not others and more clinical trials are needed to evaluate the effectiveness of treatments for the illness in children. She says the current COVID vaccine, along with booster shots, have helped reduce and prevent the risk of long COVID-19.

There are trials underway exploring whether longer courses of antiviral treatments during the acute phase of infection may decrease the risk of long COVID, but it is not recommended at this time, she explains.

For children who do experience long COVID, getting lots of rest can help in the recovery process and may help symptoms from getting worse.

Doctors also say recovery should include:

Experts say if you notice your child having lingering or new symptoms following a COVID-19 infection, it is important to consult with a health care professional. Parents and caregivers can make an appointment with their childs doctor to talk about their concerns or talk about these issues during their childs regular visits.

It is also recommended to keep a log of the start of symptoms, the severity, and anything that may make their child feel better or worse.

For more information on symptoms of Long COVID, and how parents and caregivers can speak with a pediatrician, please see the RECOVER Pediatric Long COVID Tip Sheet.

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New Report Looks at the Effects of Long COVID in Children - Parents