Long-term symptoms of coronavirus (long COVID-19) in children
This chapter deals with the long-term effects of COVID-19 infection in children.
While children may share many similar long-term effects as some adults, I will focus in this chapter on children.
What is long COVID-19?
We are used to think of viral infections as short episodes. We get sick, we rest, we take some medications, get better and get back to our things.
But during the COVID-19 epidemic physician around the world started to hear from their post COVID-19 patients of many disturbing and persistent symptoms. So, long COVID is long and persistent symptoms of infection with COVID-19 that are not included in the acute phase of disease and are not direct complications of the acute disease such as MISC-C/PIMS. There is no specific time for meeting the definition for persistent symptoms, but long COVID should be considered in patients with symptoms that persist more than 2-3 months after the acute infection.
Children rarely suffer from COVID-19 symptoms during the acute disease, so are they protected against long term effects?
Very interesting point.
We are used to think that people with a more severe disease have a higher risk of persistent symptoms related to the infection, complications or the hospitalization. However, we noticed that even children with mild symptomatic infection or truly asymptomatic infection may experience long COVID-19 effects.
What is the incidence of long COVID-19 in children?
There is no such exact number since nobody checked it prospectively on a large cohort of children and it depends on the symptom you are looking for. On my personal point of view, and although I was skeptical when I heard the first descriptions, I think it is common. More common than I believed.
What are the symptoms of long COVID-19 in children?
Symptoms are diverse and are similar in adults and children:
Fatigue, muscle pain and headache.
Skin rashes and joint pain.
Gastrointestinal complaints including diarrhea, vomiting anorexia and nausea.
Inability to resume normal exercise capacity, chest pain including palpitations and dyspnea.
Concentration and memory problems (“brain fog”).
Are there any tests which can help in the diagnosis of long COVID in children?
Unfortunately, not.
Remember that if the child experience respiratory or cardiac manifestations shortly after COVID-19 infection, than it is important to diagnos lungs or heart involvement during the acute infection. But otherwise, while many of these children, as well as adults, go through many medical investigations or tests, there is no specific diagnostic test for long COVID-19.
If there are no diagnostics tests, then isn’t long COVID-19 just in the heads of these children?
No, it is not.
I see previously healthy children, many of them athletes which do want to get back to their normal lives and activities and just can’t. These are not bored, lazy, manipulative children.
What can you do to relief symptoms of long COVID-19 in children?
Unfortunately, there are still no specific treatments for long COVID-19 in children or adults. Only acceptance, reassurance, support, sympathy and time. Be patience since most of the children will get better spontaneously.
I strongly recommend trying not to dig in the symptoms and running from one test to another. That may cause the disease to last for a longer period of time and interfere with spontaneous recovery.
I strongly recommend trying to get the child back to normal activity, most important back to school, sports and friends.
Psychological intervention may be also helpful in some families since adjustment disorder to this new situation may accompany this condition. This may give the child and his parents tools for coping until spontaneous recovery will kick in. Again, you have to remember that the need for psychological support doesn’t mean that those children are lazy or cry-babies.
Some behavioral therapies (breathing exercise for example), may be helpful.
Find this thin line between giving the child his space due to the lack of energy and encourage him to go back to normal activity.
How long is long COVID?
In most of the cases symptoms last for weeks to few months and then subside gradually.
Be optimistic and try not to fall into depressed area. Things usually get better during time. I believe that together, with the acceptance of the difficulties of your child, supporting this usually temporary period, your child can fully recover.
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