Stony Brook Children's Hospital has seen fewer than 20 long...

Stony Brook Children's Hospital has seen fewer than 20 long COVID cases in children, said Dr. Sharon Nachman, chief of the division of pediatric infectious disease for the system.  Credit: Newsday/John Paraskevas

A large-scale study of still-rare cases of long COVID in children identified symptoms of the condition — including among the most common: inflammation of the heart, according to results published in the Journal of the American Medical Association.
Other symptoms include changes in smell and taste, loss of smell, hair loss, chest pain, skin rashes, fatigue and malaise, fever and chills, and diarrhea.

The study, “Clinical Features and Burden of Postacute Sequelae of SARS-CoV-2 Infection in Children and Adolescents,” or PASC,  and published Aug. 22, looked at 659,286 individuals and found long COVID ”uncommon,” but concerning when it does present.

“Myocarditis was the most commonly diagnosed PASC-associated condition. Acute illness severity, young age, and comorbid complex chronic disease increased the risk of PASC,” the study authors said.

The study concluded that "the burden of PASC appeared to be low and systemic features were predominant and varied" and that further research was needed.

What to know

A large-scale study of still-rare cases of long COVID among children found inflammation of the heart to be the most common symptom.

Other symptoms include changes in smell and taste, loss of smell, hair loss, chest pain, skin rashes, fatigue and malaise, fever and chills, and diarrhea.

The study looked at 659,286 children and found long COVID ”uncommon,” but concerning when it does present.

The research was funded by the National Institutes of Health.

Stony Brook Children's Hospital has seen fewer than 20 long COVID cases in children, said Dr. Sharon Nachman, chief of the division of pediatric infectious disease for the system. Nachman said she couldn't quantify the number of children treated in the system for COVID-19 but it’s in the tens of thousands since the start of the pandemic two-and-half years ago.

“Long COVID, I think, is much less common in children compared to adults,” she said. "The problem is, we don’t have enough time to say, ‘we’re not going to see it.’ An adult who comes to us with COVID — and then has long COVID symptoms — often has many years of living. Therefore, they have some comorbidities, either they have high blood pressure, cardiac disease, they have arthritis, they have diabetes, and then they have their long-haul symptoms on top of that.”

“Children, for the most part, come to us native to other illnesses," Nachman said, "so it’s hard to say, will their symptoms of long-haul COVID kick in when they’re a teenager, or then young adult? Because we don’t have enough years of follow-up to say, ’it’s not going to happen.’ ”

When a pediatric patient presents with potential long COVID, the child is checked to see whether that is indeed the diagnosis or something else, said Dr. Lorry Rubin, director of pediatric infectious diseases at Northwell Health’s Cohen Children’s Medical Center in New Hyde Park.

“I take a history under a physical and go over the specifics of the symptoms, and do my best to see if it’s reasonable to attribute those symptoms to COVID or perhaps if they had similar symptoms even before the COVID episode,” he said.

Pulmonary symptoms? Cardiac symptoms? Neurological? Psychiatric? A child can also then be referred to a specialist.

Rubin said the working definition of long COVID is four or more weeks after the acute infection, “but I don’t have any way to follow that patient and then prove that it’s long COVID … the only way I can prove it’s not long COVID is if I come up with an alternative diagnosis.”

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