Long COVID symptoms in children can vary by age

Symptoms associated with Long COVID in children differ based on the child's age, according to a nationwide, multi-site study. The research will be presented at the Pediatric Academic Societies (PAS) 2024 Meeting, held May 2–6 in Toronto.

Experts say that the study findings allow clinicians to recognize and manage Long COVID in children more accurately based on common symptoms. The study characterized pediatric Long COVID symptoms and how they differ based on a child's age.

The study identifies symptoms in different age groups including young children, such as infants, toddlers, and preschool-age children (birth to five years); school-age children (6 to 11 years); adolescents (12 to 17 years); and young adults (18 to 25 years). Researchers compared prolonged symptoms in participants with and without a history of a COVID-19 infection to identify symptoms mostly highly linked with Long COVID.

According to the findings, school-age children, adolescents, and young adults with a history of a COVID-19 infection had many prolonged symptoms in common, including low energy; tiring after walking; headaches; body, muscle, and joint pains; lightheadedness or dizziness; trouble concentrating or focusing; and gastrointestinal symptoms, like nausea and vomiting.

Some symptoms varied by age with school-age children having more prolonged phobias or fears of specific things and school refusal, and adolescents having more fears of crowds or enclosed spaces and panic attacks compared to similarly aged children without a COVID-19 infection history.

Research showed that change in smell or taste was more commonly described by adolescents and young adults, and chest pain and palpitations were more common in young adults, but not in the younger age groups.

The study found that young children between birth and 5 years old with a prior COVID-19 infection were more likely to have general symptoms, including poor appetite, trouble sleeping, and fussiness, and prolonged respiratory symptoms like stuffy nose and cough, compared to young children without a known prior COVID-19 infection.

"These findings underscore the importance of characterizing Long COVID in children while researchers are still discovering the long-term effects of COVID-19 infection in this age group," said Rachel Gross, MD, MS, associate professor of pediatrics and population health at New York University Grossman School of Medicine and presenting author.

"This research is important because clinicians can appropriately diagnose and treat Long COVID when they better understand how different age groups are affected by the condition."

Researchers surveyed 7,229 caregivers and children enrolled in the National Institutes of Health's Researching COVID to Enhance Recovery (RECOVER)-Pediatrics study, 75% of whom had reported having had a COVID-19 infection.