Pediatric Long COVID: A Challenge for Healthcare Professionals
///

The lasting impacts of Long COVID: A pediatric healthcare challenge

DePaul University study reveals youth Long COVID's symptoms, impacts, and parallels with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

Youth who have not recovered from COVID-19 have been referred to as having Long COVID. Unfortunately, we know considerably less about Long COVID among youth than adults.  Reports are emerging that after COVID-19, some children have developed Kawasaki disease, and there are other reports of  COVID-19 causing lung scarring, blood clots, renal failure, and neurological complications. Still, the long-term effects of COVID-19 are unclear, but some survivors will likely continue to experience severe fatigue and other symptoms. 

This study, published in Fatigue: Biomedicine, Health & Behavior, attempted to determine whether COVID-19 symptoms increase, stay the same, or reduce over time for youth with Long COVID.  It also explored myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), as most youth with ME/CFS also had a viral infection at onset.  It might know what occurs with Long COVID by inspecting what has occurred with ME/CFS over time. The sample included 19 parents with a child with Long COVID recruited using social media and a similar group with ME/CFS.

Research findings of pediatric Long COVID

The research found that significant pediatric Long COVID symptoms include difficulty falling asleep, dead/heavy feeling after exercise, difficulty remembering things, difficulty finding the right word, trouble with math or numbers, rashes, allergies, muscle twitches, tinnitus, absent-mindedness, chest pain, joint pain, and loss of hair.

In addition, from the first few weeks of being infected with COVID-19 to about 6 months later, there were significant symptom decreases in immune (i.e. sore throat, fever), neuroendocrine (i.e. high temperature), pain (i.e. eye pain, stomach pain), and classic COVID-19 symptoms such as dry cough, loss of taste/smell, and nose congestion. Those symptoms that were the most frequent and severe during the first few weeks after infection (e.g., fatigue, unrefreshing sleep and post-exertional malaise) remained high over time.

Several investigators have proposed that post-COVID-19 syndrome is similar to that of ME/CFS. It is notable that participants with COVID-19 in the current study demonstrated a pattern similar to other viral outbreaks precipitating the onset of ME/CFS, and these patients later developed symptom profiles mirroring those of ME/CFS (e.g., PEM, unrefreshing sleep, fatigue, etc.). 

The lasting impacts of Long COVID: A pediatric healthcare challenge
Credit. Midjourney

COVID-19 has long-term effects on youth 

Since launching this investigation, the research group at DePaul University has been contacted by other families with youth who are affected with Long COVID. In conversations with them, many parents mentioned the sudden decline in formerly well-functioning youth was extremely upsetting and disruptive to their children both academically and socially.

Parents reported considerable difficulties finding knowledgeable healthcare professionals who could help them deal with the prolonged and disruptive symptoms their children experienced. It is clear COVID-19 can have long-term impacts on functioning for youth, based on findings from this study and conversations with families within the community. Future research should aim to include larger, more diverse sample sizes to fully realize the effects of Long COVID on the greater community.

Needs for the future

The study will also lay the groundwork for future pediatric prevention and intervention trials, based on the risk factors identified for the development of COVID-19.  For example, better sleep hygiene and adequate water intake could be counselled at the onset of COVID-19 to assist in recovery.

For those at risk for developing COVID-19, there is a need for controlled trials of antivirals, anxiolytics, medications to improve sleep (e.g., melatonin), specific forms of drugs to provide circulatory support or autonomic modulation, which might prevent some of its complications.

The research team also certainly needs to know more about risks that compromise immune function among young adults that could be predisposing factors such as obesity, diabetes, emphysema, cardiovascular disease, high blood pressure, smoking tobacco and marijuana vaping of any sort, and drug use.

🔬🧫🧪🔍🤓👩‍🔬🦠🔭📚

Journal reference

Jason, L. A., Johnson, M., & Torres, C. (2023). Pediatric Post-Acute Sequelae of SARS-CoV-2 infection. Fatigue: Biomedicine, Health & Behavior, 1-11. https://doi.org/10.1080/0309877X.2022.2088269

Leonard A. Jason is currently a Professor of Psychology at DePaul University and the Director of the Center for Community Research. Jason is a former president of the Division of Community Psychology of the American Psychological Association. He has edited or written 30 books, and he has published over 900 articles and 100 book chapters. He has served on the editorial boards of ten psychological journals. Jason has also served on review committees of the National Institutes of Health, and he has received over £47,700,000 in federal research grants.

Chelsea Torres, MA, is a doctoral candidate in DePaul University's Clinical-Community MA/PhD program. Her primary interests involve pediatric populations, myalgic encephalomyelitis/chronic fatigue syndrome, and the examination of health disparities in chronic illness. She received her Master of Arts from DePaul University and her Bachelor of Arts from Florida Gulf Coast University.