Long COVID — an umbrella term for symptoms that persist or develop after a person recovers from COVID-19 — is one of the biggest mysteries currently facing the healthcare industry.
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Doctors and researchers are still trying to figure out why some people experience fatigue or shortness of breath, or more serious conditions like heart problems, for weeks or months after having COVID-19.
‘We really don’t know where the long COVID came from,’ says pediatrician Kimberly Giuliano, MD, adding that doctors are working on different theories to explain it.
“It could be the amount of virus someone had in their system, their overall health, their underlying genetics, or their health habits,” she says. “Long COVID is probably a combination of all of these factors, which is why it’s a bit difficult to determine exactly what is causing it or to prevent it. We cannot change our genes.
What are some of the long-term effects of COVID-19 on children?
Children can also experience long symptoms of COVID. Dr. Giuliano says the most common ones seen in children include:
- Difficulty concentrating.
- Mood swings.
But one of the hardest factors for parents and caregivers is that symptoms like these could signal something else wrong that has nothing to do with COVID-19.
“For example, a cough can be from COVID or from a new disease,” says Dr. Giuliano. “Or it could be from another symptom or problem in its entirety.
“It’s the same with mood disorders or difficulty concentrating,” she continues. “These are really common challenges that kids who have — and haven’t — had COVID can experience at any point in their lives.”
How long is COVID in children?
Dr. Giuliano says the above symptoms associated with long COVID are reported in “about 25% of children who have had COVID”, although she notes that studies “really vary in the number and frequency of symptoms” that they found.
“Some children will have long COVID symptoms for several weeks or months,” says Dr. Giuliano. “And then there are children who seem to have symptoms for much longer than that. The exact frequency is difficult to estimate. We just don’t have a lot of data on all of this.
Are long COVID symptoms in children different from symptoms in adults?
Both children and adults can experience long COVID symptoms or conditions, although researchers are still trying to determine how these symptoms differ in different age groups.
The United States Centers for Disease Control and Prevention (CDC) publish and update a long list of long COVID symptoms of conditions in adults. They also publish up-to-date studies and research on long COVID symptoms in children. For example, a August 2022 Report published by the CDC found that children with COVID-19 were “significantly more likely” to have symptoms such as “smell and taste disturbances, circulatory signs and symptoms, malaise and fatigue and musculoskeletal pain”.
However, this study was conducted between 2020 and early 2022, before children could be vaccinated against COVID-19. “There is data that shows people who have been vaccinated are less likely to have long COVID symptoms than people who have not been vaccinated,” notes Dr. Giuliano. “And that goes for children as well as adults.”
What are the persistent respiratory symptoms of COVID-19 in children?
In children, persistent respiratory symptoms after COVID-19 may include a cough that does not go away or shortness of breath after exercise or physical activity.
What is the treatment for children with long COVID?
So when should children see a doctor about treatment for suspected long-term COVID? Dr. Giuliano says an assessment makes sense if children have a symptom (or symptoms) after COVID that are:
- Linger for more than a week or two.
- Cause sleep problems.
- It is difficult for them to go to school.
- Preventing them from doing fun or social things that they usually enjoy.
She adds that a child’s symptoms will dictate treatment. “Something like a long term cough going to be treated very differently from someone who has trouble concentrating.
“Children who struggle with long-term coughs sometimes react to similar inhalers that we use to treat asthma — medications like albuterol or inhaled steroids,” says Dr. Giuliano. “If there are other symptoms that we think might be contributing to postnasal drip, antihistamines or nasal steroids might be another option to consider.”
When it comes to difficulty concentrating, Dr. Giuliano says doctors typically spend “a lot of time” discussing things like:
- Sleep habits.
- How often children use electronic devices like smartphones or video game systems.
- How much a child rests and relaxes
- How much time a child actually spends trying to do homework.
“There are a lot of little nuances that really help us dive into the best treatment options for children, because they may depend on some of the potential triggers or modifying factors,” she notes.
How long will children need treatment for long COVID?
When developing a lengthy COVID treatment plan, every child is different. “Your child’s pediatrician or family doctor will spend some time trying to understand the timeline related to COVID and the onset of symptoms,” says Dr. Giuliano. “They will also look at the frequency of these symptoms in children even before the infection starts. Then they will put all of these pieces together to determine the best treatment option.
One of the most important things a child can do is get the COVID-19 vaccine and then booster shots when eligible. “In the context of COVID, we often talk about preventing serious illnesses. And when we talk about serious illness, people think of hospitalizations and death,” says Dr. Giuliano. “But the long COVID is another reason to get vaccinated.
“Someone who’s had this experience of managing these symptoms for months would say it’s not a mild illness,” she adds. “Even if you don’t end up in the hospital, these symptoms can really have a significant impact on a child and their family.”
Unfortunately, we can’t prevent the long COVID – or determine who will experience it. But Dr Giuliano stresses that now is the time for parents and children to have a checkup and make sure everything is on track.
“It’s an opportunity to really do a comprehensive checkup on your child’s health,” she says. “That includes making sure they get the nutrition they need, are well rested and exercised. We control our exercise habits, sleep patterns, food choices and nutritional status, as well as whether to get vaccinated.