What We Know About Kids and Long COVID — And All the Things We Don’t

If your child has ever been infected with COVID, their symptoms may not stop there. Long COVID (aka symptoms you can experience weeks after infection) affect adults and kids too. But the physical and mental toll of long COVID on children is still semi-unknown, though some researchers and doctors are trying to change that.

We spoke to two experts: Dr. Alexandra Yonts, who (among other things) is the director of the Post COVID Program at Children’s National Hospital in Washington, D.C, and Dr. Rachel Gross, whose resume includes being a principal investigator for the pediatric studies for the RECOVER Initiative, which studies the long-term effects of COVID. 

What's the best way to prevent my kid from getting long COVID?

“Vaccination is the best way to prevent that,” Yonts said. “[The vaccine] has been demonstrated to be very safe. And if there's even a little bit of benefit for preventing long COVID or other [illnesses], then parents should really think about doing it…It is likely to help prevent more serious long-term complications that they don't wanna see their [child] go through. They want them to have a normal life. Don't risk that by not protecting them in every way that you can.”

But FYI: There isn’t enough info out yet on whether the vaccine fully protects you from developing long COVID. Yonts said some studies have shown promising results, but that more research still needs to be done. 

How common is long COVID in kids? 

The American Academy of Pediatrics has reported more than 13.8 million child COVID cases since the beginning of the pandemic. That’s almost 20% of all cases as of July 2022. 

But Yonts said it’s hard to get an exact count on how many children have been diagnosed with long COVID from that infected group because its definition has evolved over the last two years. The WHO currently defines long COVID as COVID-19 symptoms that are persistent three months after infection and last for at least two months. And based on this definition, Yonts said that less than 10% of kids infected have long COVID.

Which kids are most likely to develop long COVID symptoms?

TBD. Yonts said that in her clinic, the average patient age is 12. But she's seen kids as young as two and as old as 20. Plus a new study found there are more cases of long COVID in children above the age of 14.

“Myself and others in the pediatric long COVID realm, just like all of pediatric medicine, suspect that younger kids may be affected, but it's more subtle and harder to detect,” Yonts said. “It's one thing if your kid takes an extra nap or two after preschool, it's another if your former potential division one athlete can no longer get out of bed. Very different, but they could have the same thing. So that may be more of a reporting bias from the patients than a true [age] difference.”

Yonts mentioned another potential bias that she has heard reflected in other long COVID clinics, both pediatric and adult, is that patients are overwhelmingly white families.

“Which is a little bit at odds with what we know about COVID in general, that especially in the early phases [it] really disproportionately affected the Black and Latinx communities,” she said. “We have all talked about how we're surprised that we're not seeing more of those patients and suspect that it's due to lack of access, lack of [health] literacy, [and] lack of a physician partner that they know well enough that they can communicate with.”

What signs should I look out for if I suspect my child has long COVID?

According to Yonts and Gross:

• Fatigue. Yonts said that over 80% of her patients have it. 

• Decreased exercise tolerance.

• Headaches. 

• Cognitive dysfunction. Or what you may know as brain fog. Which could cause them to have difficulty paying attention or with their memory. Gross said you may be able to see this by changes in how your child is performing at school. 

• Shortness of breath. This could look like a cough, chest pain, or wheezing. 

• Gastrointestinal complaints. This could look like abdominal pain, constipation, diarrhea, nausea, or loss of appetite. 

• Weight loss or gain. This could be related to nausea or lack of appetite. Yonts said if your child lost their sense of smell or taste, and is starting to recover but has developed an abnormal taste or smell, this could be adding to weight fluctuation.  

What should I do if I think my child has long COVID? 

Talk to a pediatrician.

Yonts said to find a pediatrician that will support and validate your child’s symptoms. “Unfortunately, there are still doctors in the pediatric realm that don't believe long COVID exists. And so kids will get passed from specialist to specialist and nobody will be able to tell them anything. And a lot of these families are just looking for validation and any advice,” she said. 

Get your child speciality care.

If your child is having symptoms that are impacting a specific area of their body, get in touch with a specialist. For example: if your child is having chest pain or irregular heartbeats, seek out a cardiologist, Yonts said. 

Limit daily activities.

Yonts said to treat long COVID like a concussion recovery process, where you slowly increase daily activity (both physical and mental). She recommended paying close attention to whether your child’s symptoms improve or get worse. And if it’s the latter, back off and do a little bit less the next day until they can tolerate doing more. 

Seek out a long COVID clinic.

There are a number of different speciality care facilities across the country to help children (and adults) that have long COVID. But know that costs may vary per clinic and could be costly. 

Avoid re-infection.

“Every time you get infected, it's like rolling a dice,” Yonts said. “If you're going to high-risk situations, wear a mask. If your kid's not vaccinated, get them vaccinated.” And FYI: COVID-19 vaccines for children as young as six months old are finally here. 

How can long COVID impact my child in the long long term?

Again, TBD. Yonts said that most patients in her clinic have experienced some improvement, if not complete recovery. Her clinic focuses on physical medicine, rehabilitation, and psychology to address patients specific needs. And if they’re experiencing more specific symptoms, then they’ll see a specialist.

She said it’s too soon to tell if long COVID impacts puberty, but she worries about the impact on a child’s cognitive development. 

“If their lives are disrupted at a time when they're normally starting to think for themselves and starting to learn for themselves and build social networks, that may be really detrimental in that area and cause them problems into young adulthood,” she said.

theSkimm

Although there are some promising studies that are searching for a cure for long COVID, there isn’t one on the market yet. And probably won’t be in the near future. But you can take other safety measures, like vaccinating your child, masking up, and talking to your pediatrician if you’re suspicious that your child might be experiencing long COVID symptoms.