According to the latest data from the American Academy of Pediatrics, nearly 13 million American children have tested positive since the beginning of the epidemic, and 2% to 10% of them have experienced long-term sequelae, while the actual proportion may be higher.

| Sohu Health

author | Zhou Yichuan

editor | Yuan Yue

New coronavirus pneumonia can bring a series of sequelae to adults, and its impact on children cannot be ignored. According to the latest data from the American Academy of Pediatrics, nearly 13 million American children have tested positive since the beginning of the epidemic, and 2% to 10% of them have experienced long-term sequelae, while the actual proportion may be higher. The website

CNN reports the case of a 9-year-old boy, Jack Ford. According to his mother, Jack had been vaccinated and became ill on November 10 last year, and has been plagued by long-term symptoms since then. He couldn't finish a full day's study, couldn't play baseball with his friends, and even playing video games for long periods of time would make him dizzy and nauseous. Jack himself often feels symptoms of stomach pain and difficulty breathing, which are obviously different from those of a cold. However, because no problem could be found, others thought this was an excuse for him not to go to school, but in fact it was new crown that made him very uncomfortable.

Some studies claim that the risk of sequelae for adults after infection is about 30%, but the number of relevant studies on children is too small. According to data from the American Academy of Pediatrics, nearly 13 million people have been diagnosed positive so far, accounting for 19% of the total population, and 17,000 out of every 100,000 children have been infected. 2% to 10% of these children may suffer from sequelae. In fact, many parents do not understand their children's symptoms, and pediatricians do not fully understand them. The real number may be much larger than this.

Dr. Jeffrey Kahn, chief of the Division of Pediatric Infectious Diseases at UT Southwestern Medical Center in Dallas, said even children with mild infections can develop sequelae, and even some asymptomatic infections develop heart failure four weeks after onset. The Sexson Tejte Clinic of Texas divides such children into several categories, the most common of which are fatigue, brain fog, severe headaches, etc. They can't even go to school and fail their grades; some have heart problems, such as Heart palpitations and chest pain, which are more obvious when returning to normal life; some are stomach problems, and children's sense of taste and smell change.

In December 2021, the "Journal of Pediatric Infectious Diseases" conducted a survey of sequelae from 19,000 child patients and found that the most common symptoms were headache, fatigue, sleep disorders , lack of concentration, abdominal pain, etc. Allergic diseases . Children who are hospitalized longer have a higher risk and longer duration of sequelae.

The most obvious symptoms in Jack are fatigue and physical discomfort after exercise. He cannot fully devote his energy to one thing. Even watching TV or playing games will make him feel dizzy. Initially he could only attend classes for one to two hours, but now it can reach 5.5 hours, but after increasing to 6 hours, waking up the next day will be very painful. Although the symptoms were obvious, the problem could not be identified. After doctors tested Jack's related symptoms, they found that his lung function and electrocardiogram were normal.

Unknown causes of illness often occur in children with COVID-19 sequelae. Dr. Amy Edwards of UH Rainbow Babies and Children's Hospital in Cleveland conducted systemic examinations on some children and found that the gastrointestinal tract function was normal and the immune system was normal, but the actual symptoms did not resolve. She said that adults can receive symptomatic treatment for organ dysfunction, but children cannot find it; many families may go to multiple clinics, and the answer is that they are receiving attention, or it is just psychological symptoms. Some children even develop anxiety, which may stem from the disease or from doctors and parents' suspicion of their uncomfortable symptoms. Therefore, we can only think that our current understanding of the new coronavirus is far from enough, and we do not know how to prevent and solve the sequelae of the new coronavirus.

Edwards said that there is no specific treatment for the sequelae of COVID-19 in children, but it can be treated through multidisciplinary combination. Edward's clinic can comprehensively address lung and digestive symptoms, physical rehabilitation, mental health and sleep problems. The clinic is also equipped with nutritionists , acupuncturists and pediatricians with Chinese herbal medicine licenses. They can make timetables and tell parents and children how to allocate energy and rest appropriately. They can also give children massage and mind-body therapy and tell them how to meditate.

Taking Jack's severe fatigue as an example, parents need to balance the energy consumption of such children.Healthy children can get over it after taking a rest, but patients with COVID-19 cannot. Their energy is limited, and some of it will be consumed by going to school, playing, and watching TV. They must maintain a limit on energy consumption. Once they are used up, they will be exhausted. Overall, with active treatment, intensive all-round support and treatment, significant improvement can occur.

Of course, only a small minority of children are able to receive these treatments. Edwards said he has spoken with many experts in pediatric rehabilitation and they know a lot of patients who are not being cared for or who are unable to see a doctor. What I do is more about getting them enough sleep and healthy food, but not all families can afford it. These families are already in difficulty and have children with long-term illnesses. We hope that more people will be aware of the dangers of childhood sequelae and provide help to this group of people.

On the other hand, it is also stated that although children are at low risk of developing acute symptoms after infection, they should also be vaccinated with new crown vaccine to protect them from sequelae. Therefore, the risk of COVID-19 sequelae should be factored into discussions about the risks and benefits of vaccination in this age group.

Reference:

1.CNN

Children get long Covid, too, and it can show up in unexpected ways

https://edition.cnn.com/2022/05/06/health/children-long-covid-wellness/index.html

2. journals.lww

How Common is Long COVID in Children and Adolescents?

https://journals.lww.com/pidj/fulltext/2021/12000/how_common_is_long_covid_in_children_and.20.aspx