Long Covid Symptoms in Children 

In the past three years, at least 15 million children are estimated to have been infected by SARS-CoV-2, the virus that causes Covid-19 (5). Studies suggest that anywhere between 5%-60% of these children have experienced long-term symptoms (5). Patients afflicted by Long Covid commonly experience symptoms such as fatigue, brain fog, and shortness of breath for weeks or months after the initial infection. While Long Covid has been more commonly seen in adults, children experience a similar risk level for Long Covid (3). Long Covid symptoms can present differently in children, however, because children are still growing and may express their symptoms differently from adults. 

Long Covid symptoms can show up differently in children because children are still growing and developing—they are not just “mini adults,” as NIH researcher Dr. Jessica Snowden puts it (5). For example, when a child gets Covid, the virus is more likely to take root in the gut rather than the lungs (1). As a result, children may display more gastrointestinal symptoms such as nausea, vomiting, and diarrhea, compared to adults, who are more likely to show respiratory symptoms (1). 

Additionally, noninfectious remnants of the SARS-CoV-2 virus may remain in children’s bodies for longer after the initial infection. In some studies, these inactive forms of the virus have been found in children’s stool samples three-to-four months after the infection (1). Researchers hypothesize that children’s immune systems may be triggering continuous inflammation in response to these remnant particles for patients who experience Long Covid. 

Children are also less adept at expressing their symptoms verbally and may display symptoms and discomfort indirectly through their behavior. For example, a child may avoid eating because food doesn’t taste good, whereas an adult could verbally confirm that they have lost their sense of smell (5). Similarly, children might cease to play or be less active than usual, while adults can verbally express that they are short of breath or experiencing chest pain (5). 

Although Long Covid is more commonly seen in adults, the lack of high-quality data on pediatric Long Covid suggests that there are many more cases of children with Long Covid than is known. Because only a small percentage of children with Long Covid seek medical attention and infants and toddlers are not always at the age where they can verbally express their symptoms, tracking pediatric Long Covid has been difficult (1). As a result, it is often overlooked by practitioners. Furthermore, varying names and definitions for Long Covid has made studying the phenomenon a challenge (2). Further high-quality studies are necessary to understand Long Covid symptoms in children and the best methodologies for managing long-term post-viral care for children (4). 

References 

1. Katella, Kathy. “What Happens When Kids Get Long COVID?” Yale Medicine, 2 Nov 2021, https://www.yalemedicine.org/news/long-covid-in-kids 

2. Lopez-Leon, Sandra et al. “Long-COVID in children and adolescents: a systematic review and meta-analyses.” Scientific Reports, vol. 12, no. 9950, 23 June 2022. doi: 10.1038/s41598-022-13495-5 

3. Soucheray, Stephanie. “Kids at similar risk for long COVID as adults, study suggests.” University of Minnesota, Center for Infectious Disease Research and Policy, 10 Nov 2022, https://www.cidrap.umn.edu/covid-19/kids-similar-risk-long-covid-adults-study-suggests 

4. Pellegrino, Roberta et al. “Prevalence and clinical presentation of long COVID in children: a systematic review.” European Journal of Pediatrics, vol. 181, no. 12, pp. 3995-4009, 15 Sep 2022. doi: 10.1007/s00431-022-04600-x 

5. “What Long COVID Looks Like in Children and Young Adults.” National Institutes of Health,  22 May 2023, https://covid19.nih.gov/news-and-stories/what-long-covid-looks-like-children-young-adults  

6. Zimmermann, Petra, et al. “Long covid in children and adolescents.” BMJ, 2022, vol. 376. doi: 10.1136/bmj.o143