Long-range COVID-19 for children and adolescents – –

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Long-range COVID-19 for children and adolescents – –


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Experts are learning how apparently mild COVID-19 cases turned into long-term debilitating COVID-19 cases. Svetlana Gustova / Getty Images
  • Recent studies have shown that up to 1 in 4 people who have COVID-19 end up with long-haul COVID-19. But research is still ongoing.
  • Experts are also learning how long-range COVID-19 is affecting children and adolescents.
  • Long-term symptoms of COVID-19 can appear weeks after the initial infection, even if the initial infection is mild or asymptomatic. Symptoms can also change over time.

As COVID-19 cases are on the decline in the United States, experts continue to learn what the effects of a year-long global pandemic have been on our long-term physical and mental health.

In particular, attention has turned to people with long-range COVID-19, a syndrome that has appeared in people who have persistent symptoms after an acute case of COVID-19.

While most people with severe COVID-19 were adults, experts are learning how seemingly mild COVID-19 cases have turned into long-term debilitating COVID-19 cases.

Recent studies have shown that up to 1 in 4 people who have COVID-19 end up with long-haul COVID-19. But research is still ongoing.

Long-haul COVID-19, often referred to as “long VOC”, can involve a wide variety of symptoms, some of which:

  • fatigue
  • difficulty concentrating
  • shortness of breath
  • muscle aches
  • depression
  • anxiety

Symptoms can appear weeks after the initial infection, even if the initial infection is mild or asymptomatic. Symptoms can also change over time.

While much of the attention around the long-haul COVID-19 has focused on adults, first research shows that it can also affect children and adolescents.

In these cases, many children have seemingly mild cases which then lead to long-term COVID-19, which can be debilitating.

Researchers are still working to uncover the long-term cause of COVID-19 and identify the most effective treatment approaches.


For one family, the effects of the pandemic will not be over anytime soon, even if cases decline in the United States.

Molly Burch was 16 in March 2020, when she first developed symptoms of COVID-19.

“She started with a little cough on March 8, then on March 9 this cough got worse and she had a fever,” Molly’s mother, Ann Wallace, told Healthline.

Over the next 3 weeks, Molly’s symptoms got worse before getting better.

After her initial infection cleared, some of her symptoms persisted and months later new symptoms appeared.

“I thought she was better, but in August her symptoms came back with new shortness of breath,” Wallace said. “I remember it because it was his birthday; she was having trouble breathing, and it was incredibly alarming.

Molly’s acute illness may have subsided, but the teenager never fully recovered.

Climbing the stairs now leaves Molly breathless. A day at school leaves her exhausted.

Its symptoms are consistent with long-distance COVID-19, in which symptoms last for weeks or months after someone first contracts the virus that causes COVID-19.

“I feel like last week she’s better than she was the week before,” Wallace said. “But you never know with a long COVID. You may think you are in the clear and then get slammed.


One of the challenges of diagnosing long-distance COVID-19 is that many people who have contracted the virus have never been tested for it. Or they might not have been tested until after the virus was removed from their system.

Testing capacity was severely limited when Molly fell ill in March 2020. Her doctor presumed she had COVID-19 based on her symptoms, but she did not meet the narrow testing criteria that were then in place in her. Home State, New Jersey.

“Molly hadn’t left the country. She has not had contact with a known case of COVID. And she had a fever and cough, but no shortness of breath, ”Wallace recalls.

More than a week after Molly fell ill, Wallace also developed symptoms of COVID-19.

Both were finally tested on March 22: Wallace’s results were positive, but Molly’s were negative.

That’s not to say Molly didn’t have COVID-19. At the time she was tested, she was weeks into her illness – to a point where the virus is often no longer detectable.

“The place where we were tested said, ‘Molly is presumed positive,’” Wallace said. “The doctor originally said, ‘We think it’s COVID,’ and my positive test gave that extra credence. “


Like COVID-19 itself, long-haul COVID-19 is a new condition with many unknowns. Healthcare professionals had to learn on the go, which posed challenges for them and the people they treat, including Molly and Wallace.

“It’s not that people haven’t offered help. It’s just that in the beginning there was really no help to offer, ”Wallace said.

“And it’s always maddening, the difficulty in getting care for people with long-standing COVID,” she said.

Over the past year, more specialty clinics have opened across the country to provide rehabilitation support to people recovering from COVID-19.

Norton Children’s COVID-19 Pediatric Follow-up Clinic in Louisville, Ky., Focuses on treating children and adolescents in particular.

“We started noticing children who had persistent symptoms of COVID, and there was not a lot of data or resources to help some of these children,” said Dr. Daniel B. Blatt, infectious disease specialist. pediatric patients at the clinic. . “So we decided to create our own clinic to not only treat these children, but also to investigate the nuances of the syndrome. “


Before Blatt gives a child a long-distance diagnosis of COVID-19, he is looking for other potential causes of their symptoms.

Long-haul COVID-19 causes general symptoms, which means they’re similar to other conditions. For example, fatigue and shortness of breath can be caused by various infections.

“One thing we’re really good at as infectious disease physicians is figuring out if it’s a long COVID or a different infection that may look like a long COVID,” Blatt said.

“Then, either we will return the patient and follow-up in our clinic, or we will refer him to different sub-specialists according to his symptoms,” he continued.

For example, Blatt may refer a child to a pulmonologist or cardiologist if he is suffering from shortness of breath.

He could refer them to a psychologist or psychiatrist if they are suffering from anxiety or depression.

Molly’s doctor recently ordered chest x-rays and referred her to a cardiologist.


To help children and families cope with COVID-19 in the long term, Blatt said one of the most important things a healthcare professional can provide is emotional support and reassurance.

“Almost everyone we’ve had so far with a long COVID is improving over time,” Blatt said. “It’s scary and frustrating to have the symptoms that persist, but the assurance that they will get better helps alleviate a lot of the anxiety. “

Emotional support is also a key aspect of the care that Noah Greenspan, DPT, CCS, EMT-B, provides to patients at H&D Physical Therapy’s COVID-19 Rehabilitation and Recovery Center in Manhattan, New York. Greenspan is a cardiopulmonary and complex medical physiotherapist and founder of the Pulmonary Wellness Foundation.

“COVID-19 is a global pandemic,” Greenspan told Healthline. “The situation is constantly changing. The information is as good as the last news cycle, and the recommendations are constantly changing.

“That in itself is anxiety-provoking,” he continued. “Plus the isolation, the inability to take a test, deal with this serious illness. It’s a really tough time. “

Greenspan has treated Wallace’s own lingering symptoms after COVID-19, while also offering her support to manage her daughter’s health needs.

“One thing Noah has offered is this awareness of how families are affected, how I am affected by my daughter’s health, and how helping her get better is helping me as well,” Wallace said.


Children with long-distance COVID-19 also need the support of other members of the community, including school staff.

“I think we need principals to be mindful of children who have had COVID, so that they don’t get pushed too hard,” Wallace said.

Molly’s school recently took a blended learning approach, which means she has face-to-face classes 2 days a week and online classes the rest of the time. The academic demands were difficult for her to manage.

“Several weeks in a row she went to school on Wednesday and couldn’t get out of bed on Thursday,” Wallace said. “You know, the effort of going to school just knocked her out. “

Even when Molly attends online classes from home, it requires energy that she has little in the way of.

“We need housing, even when the kids are learning at home,” Wallace said.


Wallace would like people to take the risks of COVID-19 in children more seriously, including the long-term risk of COVID-19. The condition can have far-reaching effects on the health and well-being of a child.

“In a child’s life, being sick for a year is a big deal,” Wallace said. “Think about all the developmental milestones and social milestones that children go through in a year. “

Blatt told Healthline that the only way to avoid having long-range COVID-19 is to do what you can to avoid getting COVID-19 in the first place.

“And the best way to not get COVID is to get vaccinated,” he said.

the Centers for Disease Control and Prevention (CDC) recommends COVID-19 vaccination for adults and children 12 years of age and older. Researchers continue to study the safety and effectiveness of vaccines in young children, who are currently not eligible to be vaccinated.

The more adults and older children are vaccinated, the greater the protection offered to younger children.

Higher vaccination rates in a community help stop the spread of infection.

Wearing face masks also reduces the risk of transmission.

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