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August 23, 2023

In The News: Children and Long COVID: How Many Are Affected?

Medscape reports the incidence of long COVID may more often cause one to think of adults and seniors, however, new research is shining the light on its affects in children. That research found around 16% of pediatric patients with COVID-19 will go on to develop symptoms lasting more than three months, which is the working definition of long COVID. One of the issues stressed early on is that symptoms in this age group can often be missed or misdiagnosed.

The number of children dealing with long COVID varies by source. One recent study estimated more than 25% of COVID-19 cases lead to long COVID. The American Academy of Pediatrics, meanwhile, puts its estimates of children who go on to have long COVID to range from as little as 2% to as much as 66%. In its ongoing COVID-19 efforts, the government has enrolled 10,000 children in the Recover Initiative. The number is set to double and plans to track a cohort into 2025 are underway.

Nearly a dozen U.S. hospitals have spun up long COVID clinics to address the needs of pediatric patients whose conditions have persisted after acute COVID-19 infection. One of the roles these clinics have taken on is to raise awareness, not only for parents and students, but also teachers and school nurses who may notice or recognize a child dealing with long COVID. An array of treatments is being explored on a case-by-case basis, to find the right treatment for the particular patient. One clinic included in the story notes a mix of approaches that includes rehabilitation, talk therapy, and off label use of Paxlovid. Others are trying special diets.

The long COVID clinic at UH Rainbow Babies and Children’s Hospital in Cleveland notes a warning sign of long COVID in children is fatigue. Doctors there are trying approaches like special diets, vitamin regiments and sleep aids. Many long COIVD patients are misdiagnosed with depression. And while some do experience depression and anxiety, the clinician warns not to treat it as solely a mental health problem. If a child or teen experiences a major change in normal functioning or has multiple COVID symptoms that don’t go away after several months, it isn’t in their heads. Parents and doctors should consider long COVID as a possible cause.

Amy Edwards, PIDS member and co-director of the mentioned Covid Recovery Clinic in Cleveland, commented on the story, “A lot of ID docs wonder what their role might be in this situation. Long COVID isn’t clearly an infectious issue (unless at some point we find evidence of chronic viral replication), but since it is caused by an infection these kids often end up in our offices. Running a chronic care clinic, like a COVID Recovery Clinic isn’t in the typical Pediatric ID doc’s job description and many don’t have the support or resources to try and get one started. But the number one thing peds ID docs can do to help these kids is to LISTEN to them and to BELIEVE them and to validate their illness. There is a lot of disbelief out there that this condition even exists (trust me, it does) and so these kids are constantly hearing that it is ‘just their anxiety’ or ‘just in their head’ or whatever. That is neither helpful nor true. Getting a proper diagnosis of long COVID and getting that validation that it isn’t ‘all in my head’ can go a long way towards helping these children adjust to having a chronic illness.”

**Dr. Edwards also shared a request if there are ID docs out there who want to hear about how they started their clinic or want her and/or Dr. Miller to come and talk about the clinic and how these children can be helped, she is willing and eager. The goal is to have more providers able to help with this overwhelming problem and she can talk about the things the clinic did wrong and right in those early days to help others avoid the problems they had. Please contact pids@idsociety.org if you need assistance reaching Dr. Edwards** 

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