SAN ANTONIO – Leading doctors are reporting long COVID is affecting many kids, even if they had a mild illness or were asymptomatic. Serious issues are lingering for months or even years, so top experts have compiled guidelines on how to diagnose and treat long COVID in children.
Since long COVID was recognized as an issue, the American Academy of Physical Medicine and Rehabilitation (AAPM&R) has gathered top specialists and published protocols for each long COVID symptom.
AAPM&R has published papers on fatigue, respiratory issues, cognitive issues, and cardiac symptoms. Last week, new guidance was released with a specific focus on pediatric cases of long COVID.
Since the beginning of the pandemic, children were less of a concern when it came to COVID. However, doctors are reporting long COVID is affecting many kids.
Even if they had a mild illness or were asymptomatic, serious issues are lingering for months or even years.
“Some of the most common long COVID symptoms that children experience are fatigue, attention or concentration problems, headaches, lightheadedness, sleep issues, persistently elevated temperature, and mental health concerns such as anxiety and depression,” said the publication’s lead author, Dr. Amanda Morrow.
Dr. Morrow is a Rehabilitation Physician at Kennedy Krieger Institute and an Assistant Professor of Physical Medicine and Rehabilitation at the Johns Hopkins School of Medicine.
She was one of 30 specialists nationwide who came together to make guidelines on pediatric long COVID cases.
One main difference between kids and adults with long COVID is the cardiovascular symptoms.
“While cardiovascular complications are common in adult patients with long COVID, chest pain in children with long COVID is rarely due to a cardiovascular issue. Still, it’s important for providers to confirm that chest pain or shortness of breath is not due to complications of acute COVID-19 infection or a manifestation of MISC where there may be an actual cardiac pathology,” Morrow said.
There is also a major difference in the ability of pediatric patients to specify what’s happening in their bodies.
“Young children and children with disabilities may have difficulty describing symptoms,” Morrow said.
That’s why it’s crucial for everyone in a child’s life to pay close attention if they’ve had a COVID infection in the past.
“Parents, caregivers, teachers, and coaches are the front line in observing changes in children that may be related to long COVID,” Morrow said.
The guidance directed doctors to look for symptoms that overlap multiple organ systems, rule out other possible causes and refer to specialists for medication, therapies, or psychological support.
“Rehabilitation in children should be geared towards participation in school and extra-curricular activities, social engagement that are important to a child’s typical development. So guidance for long COVID in adults cannot be automatically used for pediatric patients,” Morrow said.
Morrow said in any long COVID case, it’s crucial to move at the specific patient’s pace instead of a set timetable.
Medical professionals are instructed to be cautious in recommending activities and return to play or sports.
“They’re doing better, then they try to do more, they’re running around, and then they just have a crash, worsen symptoms again, and can’t do anything. It’s just kind of this vicious cycle,” Morrow explained.
The key is spotting symptoms early and bringing kids to the doctor so they can immediately start learning how to conserve energy and stop symptoms from getting worse.
Caregivers should head to the doctor if the child’s symptoms don’t improve or if they develop new symptoms within one month of their initial COVID infection.
The new guidance also offers education for doctors about treatment options and additional testing that can be done in resource-limited areas where there isn’t a specialist or long-COVID clinic.