THE DOCTOR IS IN
OP / ED BY DR. ADIL MANZOOR
When someone gets COVID, they can expect to feel better within two weeks. Of course, other factors come into play here, like pre-existing health conditions, age, gender, vaccination status, and even race. But, on average, the infected person can go on with their lives as usual after two weeks. Full recovery from COVID infection can take as much as 12 weeks.
However, some people infected with COVID can experience long-term effects from their COVID infection, which is known as long COVID or post-COVID conditions (PCC). This condition has been well observed in adults, and reports show that children can also have long COVID. This article will examine how hospitalization and multiple symptoms can affect long COVID in children.
For long, health experts did not understand how to diagnose or even define long COVID. This is primarily because it is difficult to determine whether the observed symptoms result from the COVID infection or other health conditions. Notwithstanding, in October 2021, the WHO proposed a definition for long COVID, stating that it generally occurs three months from the onset of COVID, with symptoms that last at least two months and cannot be explained by an alternative definition.
This definition has been modified over time, but the principle remains the same – symptoms that persist or develop after COVID infection. People who experience long COVID often report the following symptoms: fatigue, weakness, fever, coughing, difficulty breathing, chest pain, brain fog, headache, change in smell or taste, depression, diarrhea, and muscle pain. The list is not exhaustive, and other symptoms may accompany long COVID.
Although long COVID is more likely in adults, studies have shown that children and adolescents can develop the condition too. One study showed that one in four children and adolescents have long COVID. The most frequent long-COVID symptoms among children are mood changes, fatigue, sleep disorders, headache, and respiratory symptoms. The study reached a consensus that it was imperative to conduct more trials to understand the pathophysiology of the condition and implement necessary protective measures.
Since then, there have been quite a few studies into long COVID in children. However, one has caught the public eye. In the 3-month study that examined 1,884 children, 5.8 percent of patients, including 9.8 percent of hospitalized children and 4.6 percent of discharged children, reported long COVID symptoms. This implies that long COVID is more likely in children requiring hospitalization for their infection than in those treated in an emergency room and discharged.
The result of the study is consistent with the long COVID research in adults, also showing that people with more severe COVID illness are more likely to develop long COVID symptoms. Aside from long COVID, severe COVID illness can also affect multiple organs, which can increase the risk of new health conditions, like diabetes and heart conditions.
The study also showed that 4.7 percent of hospitalized children and adolescents with no more than three initial COVID symptoms eventually had long COVID. For those with four to six initial symptoms, that figure is 7.4 percent. However, the figure catapults to 23 percent among children with over seven COVID symptoms. Therefore, the more COVID symptoms children and adolescents have initially, the greater the risk of developing long COVID.
While the study did not focus on the vaccination status of the participants, the CDC states that people who did not get the COVID vaccine might be at more risk for developing post-COVID conditions.
This study underlines the concerns of many health experts: recovering from COVID does not mean the end of COVID. In fact, there will likely be no end to COVID in the literal sense. However, we are responsible for preventing the spread and severity of the condition however we can. Since it has been highlighted that hospitalizations increase the risk of long COVID, and it has also been proven that vaccination reduces the risk of hospitalization, logic informs us that vaccination can help prevent long COVID.
Further, the vaccine has been approved for virtually all children and adolescent age groups, meaning you have a responsibility to get your children vaccinated for their safety. Please do. Stay safe.
This article was written by Dr. Adil Manzoor DO, a Board Certified Internist & Board Eligible Pediatrician, who works as a Hospitalist, and Emergency Room Physician. He is also the current President of Garden State Street Medicine, a non-profit organization whose sole purpose is to provide free preventive and acute urgent care services for the homeless. He is also the co-founder of his own unique medical practice Mobile Medicine NJ.
References
- https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2794484?utm_campaign=articlePDF&utm_medium=articlePDFlink&utm_source=articlePDF&utm_content=jamanetworkopen.2022.23253
- https://www.nature.com/articles/s41598-022-13495-5#:~:text=The%20prevalence%20of%20long%2DCOVID%20in%20children%20and%20adolescents%20was,and%20respiratory%20symptoms%20(7.62%25).
- https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html
- https://erj.ersjournals.com/content/early/2021/06/10/13993003.01341-2021
