Long COVID in Kids: What It Is and the Symptoms, Effects and Treatments for Children – What To Expect

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While there’s been a lot of attention paid to long COVID-19 in adults, many parents don’t realize that this condition can also impact younger patients. About 4 percent of children under the age of 14 experience symptoms of long COVID about a year after their initial infection, a June 2022 study published in The Lancet found. Trusted SourceThe LancetLong COVID Symptoms in SARS-CoV-2-Positive Children Aged 0-14 Years and Matched Controls in Denmark (LongCOVIDKidsDK): A National, Cross-Sectional StudySee All Sources [1] 
“While that might not seem like a lot, it’s important to remember that almost 15 million children have tested positive for COVID-19 since the start of the pandemic,” says Amy Edwards, M.D., medical director of the pediatric COVID recovery clinic at UH Rainbow Babies and Children’s Hospital in Cleveland, Ohio. “That means that potentially hundreds of thousands of kids have long COVID.” 
Here’s what parents need to know about the long-term effects of COVID, including why some kids get it and the symptoms to watch for.
Most people — both adults and kids — who get COVID-19 recover completely within three to four weeks. But sometimes, patients experience symptoms beyond that, even if they test negative for the virus. This is known as long COVID, or post-COVID conditions. 
Since long COVID is such a new condition, doctors still don’t know much about it. They’re also working hard to understand why some children who get COVID-19 bounce back quickly, while others go on to develop long COVID that can last for months, if not longer. Trusted SourceYale MedicineWhat Happens When Kids Get Long COVID?See All Sources [2] 
One theory behind long COVID is that COVID itself causes an auto-immune response where the body goes into overdrive and attacks itself. Another is that there’s lingering virus in the body.
Long COVID is also different from multisystem inflammatory syndrome in children (MIS-C), a rare inflammatory condition that affects some children two to six weeks after an initial COVID-19 infection. 
Long COVID symptoms in kids include:
Common symptoms also vary by age, according to a June 2022 study published in The Lancet Child & Adolescent Health. The study found that infants and toddlers mainly experienced mood swings, rashes and stomach aches, while older children experienced memory and concentration problems as well as mood swings and fatigue. 
But these symptoms may still be present in younger children who aren’t able to verbalize them, says Dr. Edwards. That’s why it’s important to look for more subtle cues, like your toddler getting frustrated with an activity they usually enjoy, like building with blocks.
Diagnosing long COVID can be challenging in kids, since some may have been asymptomatic when they contracted the virus and were never diagnosed. Doctors sometimes have to look closely at a child’s family history to see whether there were any known virus exposures. 
Antibody tests can indicate a past COVID infection, too. (There are tests that distinguish between antibodies from the COVID-19 vaccine and antibodies from actual exposure to the virus.) Trusted SourceChildren’s Hospital Los AngelesSpotting Long COVID Symptoms in ChildrenSee All Sources [4] 
If you suspect long COVID, it’s a good idea to get your child evaluated at a long COVID clinic, as they can run various tests to rule out other medical conditions that can cause similar symptoms, advises Dr. Edwards.
There’s no rhyme or reason as to why some kids get long COVID and others don’t. But a July 2022 study published in the journal JAMA Network Open reveals some clues. Trusted SourceJAMA Network OpenPost-COVID-19 Conditions Among Children 90 Days After SARS-CoV-2 InfectionSee All Sources [5] The researchers found that nearly 6 percent of children who showed up at the ER with COVID-19 reported symptoms of long COVID about three months later. Patients were more likely to develop long COVID if they had one of the following:
Another June 2022 study published in Scientific Reports found additional risk factors, which included: Trusted Source Scientific ReportsLong-COVID in Children and Adolescents: A Systematic Review and Meta-AnalysesSee All Sources [6]
Although research suggests teens are more likely to get long COVID than younger kids, that doesn’t mean babies and toddlers are invulnerable, stresses Dr. Edwards. 
“They may be experiencing symptoms of long COVID, but don’t have the language yet to express how they feel,” she explains.
Kids are also more likely to develop long COVID after a second infection, Dr. Edwards adds. “Oftentimes, the child will have had COVID, recover and then a few weeks later get sick again with another virus or strep,” she explains. “It seems like it’s that second insult that pushes them over the edge.”
New research suggests that it’s as common in kids as it is in adults. Kids and teens with COVID were 30 percent more likely to experience long COVID symptoms three months or more after their infection compared to those who didn’t get COVID — similar to what’s seen in adults, a November 2022 study published in PLOS Medicine found. Trusted SourcePLOS MedicinePost-COVID-19-Associated Morbidity in Children, Adolescents, and Adults: A Matched Cohort Study Including More Than 157,000 Individuals With COVID-19 in GermanySee All Sources [7] 
Long COVID is probably more common than both doctors and parents realize, says Gina Posner, M.D., a board-certified pediatrician practicing at MemorialCare Medical Group in Fountain Valley, California, and a What to Expect Medical Review Board member. 
“Unfortunately, I have a lot of kids in my practice who come in with complaints of feeling winded walking upstairs, or are exhausted, or have constant headaches after having had COVID-19 two to three months earlier,” she explains. “In my mind, it’s no coincidence that these symptoms started up a few weeks after they recovered from COVID, especially if we run a bunch of tests that come back normal. But parents often find it hard to believe because their child initially barely had any symptoms with COVID-19.”
There’s no cure for long COVID since doctors aren’t exactly sure what causes it. But there are treatments available to help with different symptoms. After your child is evaluated at a long COVID clinic, you’ll likely be referred to different specialists. These may include:
These doctors can all work with you and your child to come up with a treatment plan. For example, if your little one becomes short of breath when they are active, a cardiologist may do a heart workup, and a pulmonologist may do breathing tests to check oxygen levels. If both are normal, then the doctors may recommend physical therapy and/or a home exercise program to get your child back up to speed.
You may wonder how long post-COVID conditions last in kids. The good news is most kids with long COVID tend to get better and usually make a full recovery, reassures Rajeev Fernando, M.D., an infectious diseases specialist and a What to Expect Medical Review Board member. “We don’t see the damage to organs like the heart, liver and lungs that we see in adults,” he explains.
If you do suspect that your little one has long COVID, it’s important to listen to your instincts and if your pediatrician dismisses your concerns, find a long COVID clinic near you. 
From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When You’re Expecting. What to Expect follows strict reporting guidelines and uses only credible sources, such as peer-reviewed studies, academic research institutions and highly respected health organizations. Learn how we keep our content accurate and up-to-date by reading our medical review and editorial policy.
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