Published: 2020-11-18 09:09 | Updated: 2020-11-19 14:24

Case report of potential “long COVID” in children

Two children walking away along a path
Children walking Photo: Gunilla Sonnebring

Recent data suggest that adults may experience long-term symptoms after COVID-19 infection, but if such symptoms also occur in children is still unknown. Children tend to have milder COVID-19 than adults, but in a case-report from Sweden, Professor and pediatrician Jonas F Ludvigsson describes five children with potential “long COVID”. These findings, together with a systematic review of long COVID in children, are published in the journal Acta Paediatrica.

COVID-19 has been linked to an increased risk of death and morbidity, particularly in the elderly population and in people who belong to risk groups. The disease tends to have a milder course in children. Although it is known that a small number of children with COVID-19 develops so called multi-inflammatory syndrome (MIS-c), reports of other complications are rare.

In a systematic review now published in Acta Paediatrica, Jonas F Ludvigsson, pediatrician at Örebro University Hospital and professor at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, reviewed 179 publications that might concern long COVID in children (here defined as symptoms persistent two months after onset of COVID-19), but none of these publications actually concerned long COVID in children.

In an accompanying case report in the same article, Ludvigsson describes five children with clinical COVID-19 who had similar long-term effects to adults.

“The children were between 9 and 15 years old and four were girls. All five children had fatigue, dyspnoea, heart palpitations or chest pain and four had headaches, difficulties concentrating, muscle weakness, dizziness and sore throats”, says Professor Ludvigsson.

All of the children had remaining symptoms 6-8 months after COVID-19 onset. Fatigue was the predominant symptom.

”Half a year after disease onset, some of the children had improved, but none had fully returned to school. More research is needed into the prevalence and prognosis of long COVID in children*, says Professor Ludvigsson. “The healthcare needs to follow-up these children, some of these children have substantial complaints.”

Disclaimer: Dr Ludvigsson coordinates a study on behalf of the Swedish IBD quality register (SWIBREG). That study has received funding from the Janssen Corporation.

Publication

"Case report and systematic review suggest that children may experience similar long-term effects to adults after clinical COVID-19,” Jonas F Ludvigsson, Acta Paediatrica, online Nov. 17, 2020. doi: 10.1111/apa.15667