Practical Recommendations for Long COVID in Children

Post-COVID conditions, also called long COVID, long-haul COVID or post-acute COVID-19, occur where someone does not recover as quickly as expected following COVID-19 infection. In some cases, symptoms can last weeks or months, and a child’s typical functioning may be impacted.

How likely is it that my child will experience “Long-COVID”?

Most children with COVID-19, even those who are hospitalized, recover fully and return to their normal level of functioning within a short amount of time. However, a small group of children experience symptoms that last four weeks or longer. These symptoms can include loss of taste or smell, fatigue, body aches or pain, and brain fog or difficulty focusing. Although research is limited, studies suggest that the rates of Long-COVID in kids may be under 5% of all children who are diagnosed with COVID-19.

What causes “Long-COVID”?

We don’t know why some children recover fully and others have lingering symptoms. We do know that Long-COVID is related to a lot of different factors, including a child’s genetics and pre-existing health, their environment, and their emotional health. The COVID-19 virus creates a stressor in a body. This stress can lead to physical symptoms or in many cases, can make physical symptoms, like pain or fatigue, worse. We also know that when kids don’t feel well, they don’t participate in as many activities, which then can make them feel worse both physically and emotionally.

What should I do if I think my child has Long-COVID?

Talk with your child’s pediatrician about your concerns and know that there are lots of things you can do to help! Almost all people with Long-COVID can and will get better. Set a positive expectation for recovery and reassure your child that they will get better. However, “getting better” can sometimes take work and extra help from those around your child.

Recommendations for School

Once your child is no longer contagious and is allowed to return to school, it is important to get them back into their usual routine. Attending school has many benefits and we know that when children stop activities, it can lead to increased stress and emotional symptoms. Share this information with your child’s school to help them successfully get back into their routine.

• Pacing: encourage your child to take their time and try not to do too much too soon. Talk to the school about scheduling breaks and reducing homework until your child is able to handle a larger workload. Doing a little bit of work in school is better than none at all!
• Support for symptoms: if your child does not feel well during the day, talk to their school about where they can go. A nurse’s office or the guidance counselor’s office can be a good place to visit, recharge, and relax. When your child is feeling better, they can return to the classroom. Resist the urge to pick your child up early unless absolutely necessary. 
• Frequent communication: stay in touch with your child’s school team to make sure they are getting the help they need to stay in school and continue to recover.

Recommendations for Physical Activity 

• Pacing: just like with school, your child can take small steps back into activity and sports. Take one day at a time, and perhaps start with a family walk outside and build from there. Exercise, movement, and sports can improve emotional and physical health, and are key parts of getting back to typical functioning.

Recommendations for General Well-Being and Coping

• Understand that your child may have good days and bad days. If they are having a bad day and don’t want to go to school, validate their feelings and then help support them in attending.
• Sleep can often be disrupted when a child gets sick and has lingering symptoms. Prioritize a bedtime routine and your child getting enough sleep.
• Return to routine as much as possible. By sticking to your typical schedule, daily life can feel a little more predictable and controlled. This will help your child feel safe and focus on school, friends, activities, and other things that are important to them (rather than over-focusing on symptoms).  
• Model a calm, positive attitude to support your child’s recovery. Your child will look to you to determine how to respond and hopefully adopt a similar helpful mindset.