Long covid causes very different symptoms in children versus teenagers

Symptoms of long-term COVID-19 appear to differ significantly in young children and adolescents. A better understanding of how the condition presents could aid diagnosis.

So far, most long-term COVID-19 research has focused on adults. This is partly due to “a misconception that children cannot get long-term COVID-19,” Rachel Gross At New York University.

So far, Gross and her colleagues have tracked 751 children aged 6 to 11 and 3,109 children aged 12 to 17 who, according to their caregivers, had previously been infected with the SARS-CoV-2 virus.

The researchers defined long COVID as at least one symptom lasting more than a month, starting or worsening during the COVID-19 pandemic, and existing at the time of the study.

In younger children, these symptoms mainly include sleeping problems, difficulty concentrating, and abdominal problems such as pain, nausea, vomiting, and constipation.

Among nearly 150 children of the same age who had not been infected, these symptoms were uncommon and their blood samples showed no antibodies to the virus.

In contrast, the teens had long-term COVID symptoms that often included pain, fatigue and loss of smell or taste, compared with 1,300 who did not.

Gross said it’s unclear why different age groups experience different symptoms, but it could be due to differences in their hormones and immune systems. Or, teens may be better at expressing their symptoms than younger children, Danilo Buonsenso At the Gemelli University Hospital in Rome, Italy. For example, a teenager might complain of fatigue, while a caregiver might only notice that a younger child has symptoms that last for a long time when he or she is vomiting.

Based on that data, the researchers developed a scoring system to rank how closely a young person’s symptoms correlate with whether they might have long COVID. Currently, diagnosis depends on doctors ruling out other conditions and understanding the different forms long COVID can take. “Doctors like to have a score or more objective criteria, and these tools would certainly be helpful in helping clinicians at least identify that a kid might have long COVID,” Buonsentho said.