More than a year and a half into the COVID-19 pandemic—and in the midst of a national surge in cases—we’re still trying to figure out the virus’s impact on children. While it seems they’re less directly affected in adults, it’s widely accepted that they can have (and spread) the disease while being largely asymptomatic, but also that they’re susceptible to multisystem inflammatory syndrome in children (MIS-C). And what about “long haulers” among children? Parents are even more perplexed than clinicians as to what should be considered “safe” when kids want to play with their friends or get ready for fall sports. Some school districts are requiring negative tests before allowing young athletes to get on the field, while others are simply mandating medical clearance from those who tested positive for COVID-19. According to an article just published on the  JAMA Pediatrics Patient Page, those “clearance” exams should include checking for fever, chest pain, palpitations, dizziness, swelling of the hands or feet, fatigue, and difficulty breathing (and, presumably, a fresh COVID-19 test). Even children who pass the evaluation should be advised to return to their sport of choice gradually due to the risk of long-term effects of the virus. And if they’re 12 and older, the article advises, “get them vaccinated so they are not at risk of infection or long-term COVID-19 problems.”

Dad Wants to Know if It’s ‘Safe’ for His Child to Start Soccer. Would You Know What to Say?
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