Long COVID in Kids: Symptoms, Risk Factors, Prevention

TThere are many outstanding questions regarding Long COVID. Is it common? Is it possible to get it in some individuals and others not? Do effective treatments exist?

The questions surrounding Long COVID in children are endless. It wasn’t until earlier this year that experts even reached a consensus definition for pediatric Long COVID to use in research: one or more symptoms that last at least 12 weeks after a case of COVID-19, affect daily life, and can’t be explained by an alternate diagnosis.

“There are a whole host of things that we’re just trying to figure out,” says Dr. Kathryn Moffett, who is co-leading a study at West Virginia University School of Medicine that will track children over four years to better understand how many kids get Long COVID and why. “More research is done in adults, but we need answers in kids.”

Here’s what researchers know so far.

Is Long COVID a common condition in children?

Different estimates have been made for the number of children who develop Long COVID based on different studies. A June review of research was published in Scientific Reports, based on 21 previously published studies, concluded that about 25% of kids and adolescents who contract COVID-19 have symptoms that last at least four weeks—on par with the reported one in five U.S. adults who currently has Long COVID symptoms after an infection. The individual studies were different depending on the way they were constructed and classified Long COVID. Also, how vaccinated kids were and many other factors.

Study published in the Journal Aug. 12, 2012. Pediatrics The same conclusions were reached when we looked at hundreds of kids who weren’t vaccinated, but had been admitted to hospital for COVID-19 and MIS-C. This is an inflammatory condition that can be associated with COVID-19. Two to four months after the initial visit, approximately 25% still had health issues.

“The messaging has been, ‘Kids, if they get [COVID-19], will be fine,’” says study co-author Dr. Adrienne Randolph, a critical care specialist at Boston Children’s Hospital. “Yeah, most of them. But if your kid gets severe COVID-19, they’re at risk of having symptoms months later.”

Randolph’s study looked specifically at unvaccinated children sick enough to be hospitalized—a rare outcome for kids who get COVID-19—so it’s impossible to extend the findings to all kids. Randolph states that fatigue and headaches are common in the face of pandemic stress. However, not all studies can determine how much is due to Long COVID and other factors.

A Danish study, for example, was published in the Lancet Child & Adolescent Health in June looked at infants through 14-year-olds who tested positive for COVID-19 but hadn’t necessarily been hospitalized, and compared them to similar-aged children who hadn’t tested positive. The kids who got COVID-19 were more likely to report lasting symptoms like rashes, difficulty concentrating, and mood swings—but not by much. Among kids ages 4 to 11, for example, 38% of those who’d had COVID-19 had symptoms lasting more than two months, compared to 34% of those who hadn’t had COVID-19. The study authors noted that “​​long COVID symptoms are the same as some ailments that are common in children,” which can make the disease difficult to study.

How can Long COVID be diagnosed in children?

It Scientific Reports Research found mood problems, sleep disorders, and fatigue were the most prevalent Long COVID symptoms in children. However, symptoms reported varied from headaches and nasal congestion to memory loss and inability to exercise.

An August report from the U.S. Centers for Disease Control and Prevention (CDC) looked at health records for a large group of children ages 0 to 17—more than 780,000 who’d had COVID-19, and more than 2.3 million who hadn’t—from March 2020 to January 2022. A previous COVID-19-related infection was more common in children. They were also more likely to report later symptoms like nausea and vomiting, muscle pain, fatigue, mood swings and circulatory problems. By the end of the study period, kids who’d had COVID-19 were also more likely to have developed cardiovascular problems, kidney failure, and diabetes, but those conditions were rare in both groups.

Are there any risk factors that could lead to Long COVID among children?

While researchers still struggle to answer this question, they have some clues. Russian researchers published a study in European Respiratory Journal found that children with allergic diseases—including asthma, eczema, and food allergies—and who were hospitalized for COVID-19 were at greater risk of lasting symptoms than hospitalized kids without these conditions. It is important to know that there are many factors which can affect the severity of symptoms. Scientific Reports Research also identified obesity and older age as risk factors. According to research, children with severe diseases are more susceptible to developing Long COVID than kids who only have milder cases.

How can they avoid Long COVID for their children?

Long COVID cannot be prevented if one isn’t infected. Getting vaccinated also reduces the risk of developing Long COVID after an infection, though it’s not clear to what extent. Moffett believes that this should serve as a motivation for parents to vaccinate their children. According to CDC data from Aug. 10, just 30% of U.S. 5-11-year-olds had been fully vaccinated. For children under 5, the numbers are lower. A Kaiser Family Foundation analysis of data from government sources found that less then 3% had received at minimum one dose by July 20.

In order to prevent complications, it is important that children who are infected do not go outside. Children with Long COVID, such as those who have been diagnosed by chronic diseases groups like #MEAction or Long COVID Families, may benefit from additional rest and reduced activity.

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