Children hospitalised with Covid-19 can have lingering issues

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More than a quarter of children hospitalized with COVID-19 in the early stages of the pandemic had health problems two to four months later.

Research published today in the journal Pediatrics reports that 27 percent of children hospitalized with COVID-19 had either activity impairment, persistent symptoms, or both conditions two to four months after being treated for the disease.

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“Almost three quarters were back to baseline, which is reassuring. But, unfortunately, more than one in four were not,” Dr. Adrienne Randolph, lead investigator of the study and a senior associate in critical care medicine at Boston Children’s Hospital, said in a press release.

“Although this is much better than many reports in hospitalized older adults, it is still very worrisome. The risks of severe illness and lingering complications are higher than the risk of complications from the vaccine, which are very rare,” she added.

The research was conducted between May 2020 and May 2021, before vaccines were available for children.

The most common lingering symptoms were fatigue or weakness, shortness of breath, cough, headache, muscle and body aches, and fever.

Dr. Dean Blumberg, chief of Pediatric Infectious Diseases at the University of California Davis Children’s Hospital says the study is a good reminder that while the rates of hospitalization and ICU admission may be lower in children than in adults, COVID-19 can still have a significant long-term impact on them.

“They still are significantly affected by this. This can change their lifestyles. It can change the ability for them to participate in normal childhood activities. I think it’s a wake-up call for some parents at least about how important it is to protect their children against COVID to make sure that they are vaccinated and that they do avoid situations that are high risk for infection,” Blumberg told Healthline.

The children and adolescents in the study also reported activity impairment after two to four months.

This included not being able to walk or exercise as much as they previously could, sleeping more than usual, feeling distracted or unfocused, and having difficulties completing schoolwork.

It’s something that Dr. Jaime Friedman, a pediatrician in San Diego, has seen in her patients.

“I have seen children with decreased endurance and trouble returning to sports following COVID. Thankfully, in the children I have seen this was temporary,” she told Healthline.

“It’s very worrying because so many believe COVID doesn’t affect children. We know that’s not the case. With schools starting I’m worried about increased infections. It’s not ‘just a cold’ for everyone,” Friedman added.
Protecting children

Data from the U.S. Centers for Disease Control and Prevention shows that more than 1 million people in the United States have died due to COVID-19.

Of these, only 1,201 were children and adolescents.

However, experts say COVID-19 still needs to be taken seriously in children as the long-term impact of lingering symptoms or impairment can be significant.

“If long COVID results in impairment in learning then that can affect a child’s future. It can affect their future careers, their financial success, it can affect them in so many ways,” Blumberg said.

“There is increasing evidence that infection with COVID can result in the development of more chronic diseases such as diabetes, and so it can affect their physical health as well,” he added. “There’s a lot of different effects that can happen in children and the real tragedy of it is there’s no good solutions. There’s been very few studies of what to do with patients with long COVID and to develop any kind of effective therapies.”

While the study examined children who were admitted to the hospital, experts say even children who aren’t hospitalized can still experience health problems following a COVID-19 infection.

“Some children also have persistent symptoms or activity impairment after COVID-19 even if they did not require hospitalization,” Dr. Julianne Burns, a pediatric infectious diseases physician at Stanford Medicine Children’s Health in California, told Healthline.

“Pediatricians have seen many kids whose lives are affected after a COVID-19 illness. Persistent symptoms, especially fatigue, may prevent older kids from attending school and participating in sports and other activities they previously enjoyed. Even younger children may experience symptoms that affect their daily life, like needing to nap more often,” she added.

The experts who spoke with Healthline say the best thing parents can do to protect their children is to try and avoid COVID-19 in the first place by taking sensible precautions.

“Parents can ensure that their children are up to date on COVID-19 vaccination (including boosters, if eligible) which has been shown to reduce the risk of severe illness. This is important even if children have already had COVID-19,” Burns said.

“Parents can also take sensible protections to try to reduce the risk of getting COVID-19, such as wearing a mask in crowded settings, and especially indoors,” she added.

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