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Long COVID is still not fully understood, but it’s evident that some children are experiencing ongoing effects well after their initial COVID-19 infection.
Throughout the pandemic, one of the few reassurances for parents has been that COVID-19 typically results in mild cases for children, with fatalities being extremely rare. Research indicates that the death rate from COVID among children is under 0.03%, and hospitalization rates hover below 2%. In fact, the actual hospitalization rate might be even lower, as many cases include children hospitalized for unrelated reasons who test positive for the virus.
As we reach the two-year mark of the pandemic, it’s clear that a significant number of children have contracted COVID-19. Following the omicron variant surge in February, the CDC revealed that approximately three-quarters of children had been infected. While the majority recover without serious issues—often without showing any symptoms—some children continue to suffer debilitating symptoms weeks after their infection resolves.
Although only a small fraction of children who contract COVID-19 develop long COVID, the sheer number of infections means that the total of those facing long-term symptoms is growing. The lack of clear diagnostic criteria for long COVID complicates matters, as it has been linked to over 200 distinct symptoms, many of which are subjective and difficult to quantify, such as fatigue, sleep issues, and problems with concentration.
A comprehensive review published in The Pediatric Infectious Disease Journal evaluated 14 studies on long COVID in children and adolescents, revealing significant variations in reported symptoms and their duration. Six out of the 14 studies indicated that older children, particularly adolescents, are more likely to report long COVID symptoms, while three studies suggested a higher prevalence in females. Interestingly, among the five studies that included control groups of uninfected children, three revealed that persistent symptoms were more common in those who had COVID-19, indicating that two studies found uninfected children were experiencing symptoms like headaches, fatigue, sleep disturbances, and abdominal pain as well.
Researchers suspect that pandemic-related stress may contribute to some of these symptoms, making it challenging to determine which symptoms are genuinely caused by long COVID. A separate study analyzing data from 21 COVID-19 studies across Europe, Asia, Australia, and South America found that around 25% of children with symptomatic COVID-19 go on to develop long COVID.
In adults, it’s estimated that about 30% of individuals with COVID-19 will experience long-term symptoms. While the exact figures for children remain unclear, both kids and their parents often recognize when something feels off. “I feel this is a largely undiagnosed issue,” said Dr. Emily Johnson, who works at a pediatric long COVID clinic at Children’s Health Hospital in Houston.
Adding to the complexity, children may start showing long COVID symptoms weeks after recovering from an asymptomatic infection. When they seek medical help, tests often return normal, despite ongoing issues. Dr. Johnson reported seeing cases where symptoms lead to school absences and declining grades. Symptoms vary widely, from fatigue and cognitive difficulties to heart palpitations and gastrointestinal problems. A frequently reported symptom among children is post-exertional malaise, which means that simple activities can significantly drain their energy. “It’s as if they have a single energy reservoir that must be managed carefully for school, play, and even watching TV,” Dr. Sarah Thompson, who runs a pediatric long COVID clinic at Community Health Center in Cleveland, explained.
Children with long COVID also face challenges such as having their symptoms dismissed by some healthcare providers and lacking access to specialized clinics for support. “They often hear, ‘It’s all in your head. You’re just depressed,’” noted David Miller, a pediatric integrative medicine specialist. “However, the number of affected children is growing, and not all of them are trying to avoid school.”
While medical experts continue to investigate the extent and treatment of long COVID in children, parents can take action. First, advocate for your child if you suspect they are experiencing symptoms of long COVID, and seek out a provider who will take your concerns seriously. Additionally, ensure your children are vaccinated, as this remains the best defense against the potential suffering caused by long COVID. For more information on similar topics, check out this other blog post.
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In summary, while long COVID in children is a growing concern with no clear answers, awareness and advocacy are crucial. Parents should remain vigilant for symptoms and ensure children receive appropriate care and vaccinations to mitigate risks.