When it comes to covid, children have been largely spared. They can be infected and spread the virus, but they are unlikely to become seriously ill or die. Yet, just like adults, they can exhibit symptoms that persist well beyond the initial infection. This condition, officially known as the post-acute sequelae of SARS-CoV-2 infection (PASC), is often referred to as “long” covid.
It needs to be taken seriously, says Alok Patel, a pediatrician at Stanford’s Lucile Packard Children’s Hospital. “Even though although the covid itself – the acute infection – was less severe in children, the long covid is very debilitating, isolating and frightening for families.”
Why are we talking about this now?
Vaccination changes the demographics of the pandemic. As more adults get vaccinated, children and young adults represent a growing proportion of cases. The absolute number of cases in children is still lower than it was at the height of the pandemic, but infection rates in children have not declined as quickly as in adults.
It makes sense. With the virus still circulating, “it will hit the most vulnerable people, who are the people who have not been vaccinated”, Sean O’Leary, vice chairman of the AAP committee on infectious diseases, told NPR. Children under 12 are not yet eligible for the vaccination, and the youngest who can get the vaccine have one of the lowest vaccination rates in the United States. “There has been a lot of attention on these post-covid symptoms in adults,” Patel explains. But “we haven’t had the kind of robust data that we really need in the pediatric population.” This is slowly starting to change.
How common is long covid in children?
That’s the problem — we just don’t know. “There is just a dearth of good published and peer-reviewed medical literature on this topic,” says Alicia Johnston, infectious disease specialist and head of Boston Children’s Hospital’s new post-covid clinic. And the handful of studies that exist show very different rates.
For example, Italian researchers interviewed caregivers of 109 infected children and found that 42% of children had at least one symptom two months after their diagnosis. Four months later, the number fell to 27%.