New Study Shows the Frequency of Long COVID in Children

Though mask mandates and lockdowns are largely a thing of the past in the U.S., COVID-19 is still spreading. And even after an individual tests negative or clears quarantine, they may still experience long-term symptoms, a phenomenon known as long-COVID or post-COVID conditions (PCC).

Children are not immune, though it's been unclear how often PCC occurs in pediatric patients. For the first time, a new, international study is offering insights into how often kids experience long COVID-19, or post-COVID conditions (PCC), and which pediatric patients have the highest risk.

Researchers from Canada's University of Calgary surveyed families of 1,884 children who tested positive for COVID-19 in the emergency room. The data came from eight countries and 36 emergency departments. The authors narrowed the definition of PCC to "any persistent, new, or recurrent health problems reported in the 90-day follow-up survey."

The large cohort study found that 5.8% of children who tested positive for COVID-19 experienced PCC after 90 days. But PCC was more commonly seen in children:

• who were hospitalized for at least 48 hours
• identified a minimum of four symptoms during their initial trip to the emergency room
• ages 14 and up

Of children hospitalized for 48 hours or more, 9.8% developed PCC, compared to 4.6% of pediatric patients discharged from the ER.

Researchers also found pediatric patients with PCC most commonly reported experiencing fatigue or weakness. A cough, breathing difficulty, or shortness of breath were the second-most commonly identified symptoms.

"Our finding that children who had multiple COVID-19 symptoms initially were at higher risk for long COVID is consistent with studies in adults," co-principal investigator Dr. Todd Florin, MD, MSCE, from Ann & Robert H. Lurie Children's Hospital of Chicago and Northwestern University Feinberg School of Medicine said in a press release.

Unfortunately, Dr. Florin says there is no known treatment for PCC in children.

"More research is needed in this area," Dr. Florin said in the press release. "However, if symptoms are significant, treatment targeting the symptoms is most important. Multidisciplinary care is warranted if symptoms are impacting quality of life."

Researchers did note the study had some limitations. For example, they relied on open-ended surveys for data collection, and caregivers may have underreported symptoms. They also did not conduct an antibody test at the 90-day mark to confirm the presence of COVID-19 infection in the control group. The study also only included patients enrolled before January 20, 2021, so it did not evaluate PCC in individuals who contracted new and emerging variants, such as Omicron. It also did not include children who did not go to the ER.

The authors also did not mention the vaccination status of the participants, but most children did not have access to the vaccine while the study was conducted. The CDC and American Academy of Pediatrics recommend children ages 6 months and older receive vaccinations. Both organizations recommend most people 6 years and older get their first booster at least five months after the final dose in the primary series. Immunocompromised children and teens should receive a booster three months after completing their primary series.

Though children are less likely to die from the disease, they can contract it. And CDC data reports more than 1,300 fatalities in people 18 and under since the pandemic began in 2020.