Kids Can Have Long COVID, too—and It May Not Look the Same as It Does in Adults

Long COVID has been much discussed here and elsewhere—even more so since new acute cases of COVID-19 have slowed—so it’s likely you have a general sense of what to look for in prospective cases. That’s unless the patient is a child, anyway; new information just published in JAMA Pediatrics reveals that, while uncommon in kids, postacute sequelae of SARS-CoV-2 infection (PASC) manifests differently in younger patients than it does in adults. The cohort study, reflecting the care of 659,286 children at nine U.S, children’s hospitals, sought to identify the most common symptoms, health conditions, and medications associated with PASC in children. Changes in smell and taste, not including loss of smell, were the most common symptoms (adjusted hazard ratio of 1.96), followed by loss of smell (aHR 1.85), hair loss (1.58), chest pain (1.52) and abnormal liver enzymes (1.5). The most common systemic features were myocarditis (aHR 3.10), acute respiratory distress syndrome (2.96), myositis (2.59), mental health treatment (1.62), and disorders of teeth and gingiva (1.48). Cough-and-cold preparations were the most common medication features, followed by nasal decongestants for systemic use, corticosteroids with antiseptics, opioids, and decongestants. In terms of patient characteristics,  children who had been admitted to the intensive care unit during their illness, who are younger than 5 years of age, and those with comorbid complex chronic conditions are most likely to experience PASC, according to the study.