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Can kids get “long COVID?”

Clinical Symptoms Families

A: We don’t know, but it may be possible.

People are described as having “long-Covid” or being a “long-hauler” if they continue to experience symptoms for weeks or even months. There are some case reports of children having prolonged symptoms after presumed COVID19 infection and much more research is needed to figure out how often this happens, why, and what can be done about it.

Thanks to Jessica from San Carlos, CA for asking about kids and long-term symptoms after #COVID19 infection. Let’s start with the good news: there are still fewer cases of COVID19 reported in children than adults. The bad news is that the number and rates of cases of COVID19 in kiddos is steadily rising. Just how many kids have or have had an infection is unknown (mostly because of a lack of widespread testing in this age group). The vast majority of sick kids will not be hospitalized, but rates of hospitalization are going up. (Hot off the press: New CDC report of COVID rates in kids)

Symptoms of COVID19 in children are the same as adults: think things like fever, fatigue, headache, cough, nausea or diarrhea, and runny nose. Many, many kids are asymptomatic or have mild symptoms that can be hard to tease apart from other common childhood illnesses, like flu, strep throat, and allergies. Children are less likely to develop severe illness than adults but very little ones (under the age of 1 year) and kids with underlying medical conditions (like diabetes or asthma) might be at higher risk. Kids can develop damage to the kidneys, heart, or lungs, blood clotting problems, or Multisystem Inflammatory Syndrome in Children (MISC-C).

What is not yet clear is how often or how likely it is for children to develop #longhauler symptoms after their COVID19 infection. A case report out of Sweden looked at 5 kids who had symptoms reported by their parents for more than 2 months after the infection. In these reports, all the kids were diagnosed clinically by their doctors and did not have testing to confirm the diagnosis. For months after their initial illness, the kids still had fatigue, shortness of breath, and heart palpitations or chest pain. There are also multiple Facebook groups and online support groups for children and families who are reporting long lasting symptoms. It’s important to remember that case reports help to bring attention to potential concerns, but they are not very good at drawing conclusions.

The big takeaway here is that this question clearly deserves way more study and attention. It will be important to know if #longCOVID is happening in kids (or if another explanation for these symptoms is found), how often it happens, and what to do about it. There are implications for school absenteeism and educational support, clinical care, mental health, and support and resources for children and their families.

Our best strategy to prevent our kiddos from suffering from long hauler symptoms is to protect them for infection in the first place. Help kids over 2 years old to wear a mask (check out our past post on how to help kids mask up), teach and role model handwashing, avoid crowds, and physically distance from folks outside your home. Vaccine trials are underway in children and we may have a vaccine for kids in fall or winter of 2021.

If your child does get sick, talk to your primary care clinician about how to take care of them and what things to look out for.

Swedish Case Report

BMJ Opinion “Counting long covid in children”

AAP Children and COVID19 Report

CDC Information for Pediatric Providers

JAMA Article on Pediatric Hospitalizations

Link to original FB post