A new report raises concerns about long Covid illness in children

A new report raises concerns about long Covid illness in children

A large analysis published Wednesday in the journal Pediatrics highlights the long toll COVID can take on children, in some cases leading to neurological, digestive, cardiovascular and behavioral symptoms in the months following acute infection.

“Long Covid in the United States, in adults and children, is a serious problem,” said Dr. Ziad Al Ali, chief of research and development at the VA St. Louis Healthcare System and a clinical epidemiologist at Washington University in St. Louis. Lewis, who is studying the case but was not involved in the new report. He said the paper, which was based on several studies of long Covid in children, was “important” and showed that the condition could affect multiple organ systems.

The new review indicated that between 10 and 20 percent of children in the United States who had COVID had long-term COVID. However, Dr. Suchitra Rao, a pediatric infectious disease expert at Children’s Hospital Colorado and co-author of the research, acknowledged that there were “a lot of caveats” with the prevalence estimates used to arrive at that number. For example, some of the included studies only looked at a very small proportion of children hospitalized with Covid. Like adults, children who have had more severe cases of Covid are more at risk of continuing symptoms or new complications.

The Centers for Disease Control and Prevention puts the prevalence of long Covid at closer to 1 percent of children who have had Covid. (The estimate in adults is 7 percent.)

In general, most parents shouldn’t be concerned about their children getting long COVID, said Dr. Stephen Freedman, a professor of pediatrics and emergency medicine at the University of Calgary-Cumming School of Medicine. “I don’t get asked often, if ever, ‘Is my child now at risk for long Covid?’ “After we diagnose them with a severe infection.” “I think that’s appropriate.”

Long Covid can be difficult to study, partly because it is difficult to diagnose, because the symptoms are so wide-ranging. It may be more difficult to make a diagnosis in children because symptoms may appear differently than they do in adults. Young children may also not have the language to describe what they are feeling, so researchers advised parents to look for changes in behavior.

Fatigue, brain fog and headaches are among the most common symptoms of long Covid in children. While these problems are sometimes on the mild end of the spectrum, they can prevent children from fully participating in school or recreational activities. Young children may also act frustrated because they cannot do what they used to do easily. Experts say most symptoms improve within a year, but for some children they can last longer.

It’s still unclear what the long-term impact of these prolonged symptoms will be on children’s development, said Dr. Laura Malone, director of the Pediatric COVID-19 Rehabilitation Clinic at the Kennedy Krieger Institute in Baltimore.

In severe cases, some children develop long-term respiratory and cardiovascular problems, including myocarditis. Dr Al Ali said diabetes and other autoimmune disorders can also emerge in the wake of Covid infection, although these “tend to be much less prevalent in children” than mild symptoms.

Dr. Sindhu Mohandes, an infectious disease specialist at Children’s Hospital Los Angeles, said persistent and severe symptoms can appear even in children with mild infections.

That was the case for Lucas Daigneault, whose first Covid infection of 2021 involved little more than a stuffy nose. Lucas, then 15 years old, recovered and returned to school for practices and student council meetings. But months later, he began struggling to walk the halls of his high school in Littlestown, Pennsylvania. He felt pain in his head and chest. He felt dizzy and nauseous.

“It was a quick fall,” said his mother, Karen Denault. Neither Lucas nor his mother thought his problems could be related to his brief bout with Covid. But on the recommendation of a relative, he went for an evaluation at the Kennedy Krieger Clinic in Baltimore. There, he was diagnosed with long Covid and postural orthostatic tachycardia syndrome, a cluster of symptoms that lead to extreme fatigue and can occur among people with long Covid.

There are no approved medications to treat long Covid, so doctors focus on managing symptoms and helping patients function daily. Some doctors will prescribe medications to treat problems such as headaches and muscle pain.

Dr. Al-Muhandis, who was also involved in reviewing the research, said that much of the work she and other doctors are doing is about validating the experiences of these young patients. “Many were previously very healthy, so oftentimes, everyone tends to be suspicious of their symptoms,” she added.

Dr. Malone said schools should make accommodations for children who are struggling, including breaks during the day and extra time for tests.

Small changes helped Lucas. For example, it was difficult for him to push himself out of bed, so he started sleeping upright to make it easier. At his doctor’s suggestion, he would sometimes dangle his feet off the bed and write his name with his toes to improve blood flow. His doctor also prescribed several medications, including a blood pressure medication, to help manage symptoms such as fatigue and brain fog.

Lucas is now a freshman at Princeton, and most of his symptoms have improved. When he toured colleges, his mother often pushed him in a wheelchair. Last weekend, she came to campus to watch him play club basketball.

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