Anyone who has dealt with fatigue, brain fog, shortness of breath or the array of other symptoms that persist months after recovering from SARS-CoV-2 infection, understand the frustrations of experiencing Long COVID. Though COVID-19 is not as present in our lives as it was a few years ago, the CDC reports that millions of people in the U.S. have been affected by Long COVID, and it remains a serious health concern.
This chronic condition is more common among people who have had severe COVID-19 illness or those who are unvaccinated; Long COVID can occur in people of all ages including children. Though symptoms can vary, children who have Long COVID may experience functional limitations, including illness-related chronic absenteeism from school. Although more research is needed to understand why some people get Long COVID, staying up to date on COVID-19 vaccination is the best way to prevent the infection that may lead to Long COVID.
Dr. Uzma Hasan, Regional Director of Pediatric Infectious Diseases at Northern New Jersey Barnabas Health Medical Group, helped open the first pediatric Long COVID clinic in the country. She is also part of an NIH funded RECOVER study looking at the causes of Long COVID. Dr. Hasan’s initiatives around pediatric Long COVID have helped inform the way doctors across the country address this potential threat to children’s health. As parents and children prepare to return to school, we turned to Dr. Hasan to help understand the signs and symptoms of Long COVID among children and discover ways to prevent it.
Identifying Long-COVID Symptoms in Children
One of the biggest misconceptions about Long COVID is that it only occurs in children and adults who have experienced severe COVID-19 infection. But this isn’t true. “Surprisingly, we see a lot of kids coming in who have either asymptomatic COVID infection or mild COVID symptoms that wind up with Long COVID symptoms,” Dr. Hasan explains. “And they often have multi-system manifestations.”
This means the symptoms that Dr. Hasan encounters in her practice among children are widespread. Besides brain fog and fatigue, symptoms often include GI problems, rapid heartbeat, dizziness, lightheadedness, aversion to smells and trouble keeping food down. In the New York, New Jersey area where Dr. Hasan practices, she has even seen more exotic presentations ranging from children with ringing in their ears, facial paralysis, cardiac enzyme elevation and co-infections, like mono.
Additionally, Dr. Hasan mentions that she has seen an increasing number of children and teens who developed mental health problems, like anxiety and depression, because of the impact that the physical symptoms from Long COVID have on them. “Teens who had previously aced high school or college courses start struggling with basic math or having trouble staying focused,” she says. “They have multiple days of absences and have trouble functioning in a school setting.”
As researchers continue to study Long COVID, a few risk factors have been identified that may explain why certain children are more likely to develop Long COVID symptoms. “We found that children who had a history of atopy, a group of allergic conditions like seasonal allergies, asthma or eczema, were more prone to develop Long COVID,” she said. “We also noticed that children who had prolonged fevers from COVID-19 infection would show up later with persistent symptoms.”
Help Treat and Prevent Your Child’s Long COVID
As a pediatric physician, Dr. Hasan is cautious when prescribing COVID-19 treatments for her patients, stressing that, “we are always super careful about introducing new drugs to children and only do so if we have robust data.” Dr Hasan adds that she tends to suggest anti-viral treatment and other proven treatments when they are diagnosed with COVID-19. These treatments include monitoring symptoms, getting plenty of rest and fluids, and staying away from others while symptoms persist. “But any child who has COVID-19 symptoms for over a month really should see their doctor so they can determine the treatment plan that is best for them."
Long COVID is diagnosed based on a patient’s history and findings from a physical examination. There is no testing that can be used to definitively diagnose or rule out Long COVID. Treatments for Long COVID can vary for each person and the recovery is individually tailored based on the person’s specific symptoms and health needs.
Dr. Hasan emphasized that one of the best things parents can do to help prevent their child from Long COVID is to make sure that they stay up to date on receiving COVID-19 vaccinations. “I strongly recommend the vaccine to my patients because it significantly reduces the risk of developing Long COVID,” she remarked.
If your child has been diagnosed with Long COVID, or is experiencing symptoms such as brain fog, fatigue, lightheadedness and GI issues, it is important to communicate these issues with school personnel. A school nurse, teacher and/or principal are good places to start the conversation about which accommodations may be necessary to support your student in an academic setting. Oftentimes, these can be outlined in a school health plan that is shared with school personnel to best support your child.
Dr. Hasan continues to work with other experts on a RECOVER trial, studying Long COVID symptoms during early childhood, that will hopefully lead to better treatments and prevention for Long COVID for children in the future.
To learn more about Long COVID including symptoms, managing treatment and finding support, visit our website.
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