Bazak Sharon, University of Minnesota Masonic Children's Hospital, Minneapolis, MN, United States; Allison M. Galkowski, M Health Physicians, Saint Paul, MN, United States
Assistant Professor University of Minnesota Masonic Children's Hospital Minneapolis, Minnesota, United States
Background: For many with Covid-19, including children full recovery is elusive even weeks and months following infection and many experience a constellation of lingering health problems. Long Covid is now recognized as a chronic condition but the clinical pediatric illness is not yet fully understood. It is imperative to describe Long Covid in the pediatric population in order to better diagnose and manage this disease that has the potential to create a public health crisis that will linger for years after the COVID-19 pandemic.
Objective: To describe the demographic and clinical presentation of children with Long Covid syndrome.
Design/Methods: The University of Minnesota Pediatric Covid Clinic has been receiving referrals since April 2020. The clinic is participating in a national registry (PIDTRAN-6_Covid-19), facilitating IRB approved collection of anonymized clinical data from children diagnosed with Long Covid syndrome (Figure 1).
Results: We have identified 39 children (female 24, male 15) who were diagnosed with Long Covid at the University of Minnesota Covid clinic. The majority were previously healthy (32) and average age was 15 years (4-18yr). Acute symptomatic infection preceded the diagnosis in 33 children (mild-28, moderate-4, pneumonia-1) and 6 children could not recall any symptoms in association with their initial infection [Figure 2]. Common symptoms reported by the patients included: fatigue (29), dizziness and/or lightheadedness and/or palpitation (13), abnormal taste/smell (13), headache (12), difficulty concentrating/focusing [brain fog] (11), myalgia/arthralgia (10), dyspnea (8), abdominal pain (7), and sleep disturbance (4) [Figure 3].Conclusion(s): Long Covid can occur in children and is the most common reason for referral to a specialized care clinic. Only minority of children did not have symptomatic acute disease, which may reflect a selection bias, based on those referred to the clinic. It is likely that many more who did not have symptomatic acute infection are not aware that their symptoms are due to SARS-CoV-2 infection and do not seek further consultation. Most patients who are teenagers and more commonly female than male, suffer from fatigue and experience constellation of symptoms that are reminiscence of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and positional orthostatic tachycardia syndrome (POTS). This suggests a post-viral autoimmunity injury as the likely pathophysiology for Long Covid syndrome. Further, population based studied are needed to better understand the true extent and prevalence of this debilitating disease. Figure 1: WHO case definition for post COVID-19 Figure 2: Demographic of Pediatric Long Covid (Nf39)
