Long COVID + Children

Jan 13, 2022

As more research becomes available on the topic of Long COVID in adults, evidence of Long COVID in children remains preliminary.

This gap in research may reflect the general notion that children face a lower risk of contracting any severe symptoms associated with acute COVID as well as the fact that  they are often asymptomatic or mildly symptomatic. As a result, Long COVID cases amongst this demographic seem to have been overlooked throughout the pandemic.

Despite this lack of research, children who suffer from acute COVID are still at risk of suffering from the symptoms of Long COVID. Identifying and quantifying these risks are crucial in informing larger social decisions, such as the reopening of schools. Data from the first study of Long COVID in children from the Gemelli University Hospital in Rome found evidence that suggested over half of the 129 children enrolled who developed COVID suffered at least one symptom after 120 days that significantly impaired their day-to-day activities. A second study from the UK Office for National Statistics presented a lower estimate; it found that 12.9% to 14.5% percent of the enrolled children still experienced symptoms five weeks after the acute phase of COVID.  Other studies place the prevalence of Long COVID symptoms in children somewhere between 4% to 66%.

While the symptoms presented by children suffering from Long COVID vary significantly, among the most frequently cited are headaches, fatigue, dyspnea (difficulty breathing), and muscle pain. Other problems included difficulty concentrating, gastrointestinal issues, anosmia (loss of smell), respiratory symptoms, and congestion. More critical cases of Long COVID involve the development of Multisystem Inflammatory Syndrome (MIS-C) and myocarditis. One study found that Long COVID patients reported a median of 4 ongoing symptoms.  

Generally, data from the studies that have been conducted on Long COVID in children tend to mirror larger trends in adult forms of Long COVID. For example female sex, pre-existing symptoms or allergies and mental health issues were linked to a greater number or intensity of sequelae.

In addition to the presentation of physical symptoms of Long COVID in children, reports show that the mental well-being of children is also of concern. These symptoms of Long COVID are likely to be connected to and amplified by acute-COVID-attributable symptoms, such as being deprived of social contact, self-determination, and playing team sports; struggling academically; or even watching family or friends suffering or dying from COVID. While the causes of Long COVID in children are still unknown, a popular hypothesis suggests a continual trigger of inflammation in the body is responsible for many of the symptoms presented by children. Unfortunately, the wide array of potential Long COVID symptoms makes it difficult for doctors to prescribe a single treatment for the condition. Parents report feeling frustrated by the lack of support from their children’s pediatrician. At present, experience with other chronic illnesses have helped to inform treatment strategies for Long COVID. As healthcare workers gain more experience with pediatric Long COVID, they should be able to develop more specific treatments. In the meantime, vaccinating children of an eligible age against COVID is a secure way to decrease the risk of developing either acute or Long COVID. Nevertheless, kids are still known to recover faster than adults from Long COVID, and in the majority of studies, symptoms were predominantly absent by the 12-week mark.

For inquiries related to the Long COVID Initiative, please contact long_covid_initiative@brown.edu