What you need to know

According to the Centers for Disease Control and Prevention, symptoms of Long COVID affect as many as one in five adults who get COVID-19. But very little is known about how often children who get COVID-19 develop Long COVID or how severely it affects them.

In a study supported by the National Heart, Lung, and Blood Institute (NHLBI) and the Researching COVID-19 to Enhance Recovery (RECOVER) Initiative, researchers looked at de-identified health records from 2020 and 2021 and found that Long COVID was uncommon in patients under 21, pediatric symptoms of Long COVID can differ from adult symptoms, and there are several risk factors associated with children’s development of Long COVID.

What did the researchers learn?

Researchers reviewed the electronic health records of hundreds of thousands of children who took a COVID-19 test in 2020 and 2021. These records were drawn from PEDSnet, which has collected data from several of the country’s largest children’s health care organizations. The patients’ ages ranged from less than 1 year old to 21 years old, and the average age was 8 years old. Most of the health records (62.6%) belonged to children who were between 1 and 11 years old.

About 9% of the children who took a COVID-19 test had a positive result. The researchers found that about 4% of children who tested positive experienced lingering symptoms that could be attributed to COVID-19 between 1 and 6 months after infection.

Common symptoms for children that also occur in adults were changes in taste or smell, a cough, coldlike symptoms, and heart inflammation. Some young people also experienced tiredness, chest pain, and chills. However, children were less likely than adults to have neurological symptoms such as headache, tingling pain, and brain fog or memory loss. Symptoms for children also included hair loss, skin rashes, diarrhea, and abnormal liver enzymes.

The study data suggest that some risk factors for Long COVID in children include being 5 years old or younger, having a severe case of COVID-19, and having underlying medical conditions.

Why is this research important?

For clinicians to best manage cases of COVID-19 in children and give them appropriate care, it is essential to understand the risk factors for Long COVID, as well as how often it happens, what its symptoms and systemic features are, and how long it lasts. That children and adults experience some different symptoms has ramifications for defining, treating, and preventing Long COVID in different age groups.

Where can I go to learn more?

Long COVID may be less common in children

• NHLBI outlines the findings of this study.

Long COVID and Multisystem Inflammatory Syndrome in Children (MIS-C)

• The cause of MIS-C is not yet known, but many children who develop MIS-C previously had COVID-19.

When Kids Get Sick After COVID-19 Goes Away

• NIH is funding the Long-Term Outcomes after the MUltisystem Inflammatory Syndrome In Children (MUSIC) Study, part of the CARING for Children with COVID program, to understand MIS-C in children.

Sources

Rao, S., Lee, G. M., Razzaghi, H., Lorman, V., Mejias, A., Pajor, N. M., Thacker, D., Webb, R. Dickinson, K., Bailey, L. C., Jhaveri, R., Christakis, D. A., Bennett, T. D., Chen, Y., & Forrest, C. B. (2022). Clinical features and burden of postacute sequelae of SARS-CoV-2 infection in children and adolescents. JAMA Pediatrics, 176(10), 1000–1009. https://doi:10.1001/jamapediatrics.2022.2800