Long COVID effects in adolescents, young children vary

On August 21, 2024, researchers from the National Institutes of Health's Researching COVID to Enhance Recovery Initiative, also known as the RECOVER Initiative, published an article in JAMA analyzing the different ways long COVID presents in pediatric patients. NIH researchers characterized the symptoms of long COVID in children and adolescents, noting varying symptoms among the various age brackets.

Despite the variations among the two groups, the researchers emphasized that nearly every organ system in children and adolescents was impacted by long COVID.

"Most research characterizing long COVID symptoms is focused on adults, which can lead to the misperception that long COVID in children is rare or that their symptoms are like those of adults," said David Goff, MD, Ph.D., division director for the division of cardiovascular sciences at the NIH's National Heart, Lung, and Blood Institute, in the NIH press release. "Because the symptoms can vary from child to child or present in different patterns, without a proper characterization of symptoms across the life span, it's difficult to know how to optimize care for affected children and adolescents."

Researchers gathered data from 3,860 pediatric patients with a history of SARS-CoV-2 infection between March 2022 and December 2023 across 60 sites nationwide, comparing the symptoms to 1,516 children and adolescents who did not have a history of infection.

Based on a comprehensive survey completed by caregivers, analyzing 75 prolonged COVID symptoms, overall health, physical health, and quality of life, the researchers identified 18 common prolonged symptoms in younger, school-age children (ages 6 -11).

Roughly 57% of school-age children who had COVID experienced headaches. Additionally, 44% had memory or focus difficulties, 44% had trouble sleeping, and 43% experienced stomach pains. Other common symptoms included body, muscle, or joint pain, daytime tiredness or sleepiness, low energy, and feelings of anxiety.

Comparatively, researchers identified 17 common long COVID symptoms in adolescents (ages 12-17). The most common symptom -- daytime tiredness, sleepiness, or low energy -- impacted 80% of this population. Additionally, body, muscle, or joint pain affected 60% of adolescents, while headaches were reported by 55%. Memory and focusing difficulties were identified in 47% of adolescents. Other common symptoms included anxiety and difficulty sleeping.

"The symptoms that make up the research index are not the only symptoms a child may have, and they're not the most severe, but they are most predictive in determining who may have long COVID," said Rachel Gross, MD, associate professor in the departments of pediatrics and population health at New York University Grossman School of Medicine and lead author on the study.

Although future research might need to explore long-term COVID-19 symptoms in children five and younger, this data underscores the importance of pediatric COVID-19 vaccinations.

In 2023, the United States CDC updated its pediatric immunization schedule, adding COVID-19 vaccines to the recommended vaccinations for children six months and older. Although the politicization of vaccination might be driving a declining focus on pediatric vaccinations among Republicans and Republican-leaning independents, vaccination remains a critical tool for preventing COVID and long COVID.

In fact, the FDA recently authorized updated mRNA COVID-19 vaccines that address currently circulating variants.

"Vaccination continues to be the cornerstone of COVID-19 prevention," said Peter Marks, MD, Ph.D., director of the FDA's Center for Biologics Evaluation and Research, in the FDA press release. "These updated vaccines meet the agency's rigorous, scientific standards for safety, effectiveness, and manufacturing quality. Given waning immunity of the population from previous exposure to the virus and from prior vaccination, we strongly encourage those who are eligible to consider receiving an updated COVID-19 vaccine to provide better protection against currently circulating variants."

Veronica Salib has covered news related to the pharmaceutical and life sciences industry since 2022.