Researchers Study Long-Term Effects of COVID-19 in Young People

While most people who get COVID-19 are better within a few weeks, some people have symptoms that last longer. Sometimes symptoms come back after someone gets better. I, along with other researchers at Nationwide Children’s Hospital, recently published a study of adolescents (ages 10-19) with these long-lasting symptoms. This is called long COVID.

The two most common long-lasting or returning symptoms include tiredness (fatigue) and shortness of breath. Those symptoms are called lasting pulmonary sequelae. Lasting means patients continue to have the symptoms for a long time. Pulmonary relates to the lungs. Sequelae are medical conditions or complications that follow another medical condition. Think of it like a book or movie sequel. First you had COVID-19 (part one). This led to fatigue and breathing problems (the sequel or part two). A single complication is a sequela. Two or more complications are called sequelae.

Treating Young Patients with COVID-19

For the study, which was published in “Pediatric Pulmonology,” we reviewed patients seen between February and December 2021. We studied different measures of lung function and compared changes over time. Even though most patients showed mild infection, nearly all patients who were tested in the clinic had high heart rate (tachycardia), notable fatigue and shortness of breath. Six months later, while some test results improved, some patients still had a varied heart rate, fatigue and shortness of breath.

Study Findings

About one-third of patients responded positively to bronchodilator therapy. A bronchodilator is a medicine that helps to relieve asthma symptoms. Patients in this group usually had a family or personal history of asthma. Another group of patients had vocal cord dysfunction. A third group showed symptoms even though nothing abnormal on testing could be found. These findings suggest that the full panel of lung tests may not be needed for pediatric patients.

We also concluded that bronchodilator therapy may be worth starting sooner with pediatric patients, given that about a third of them respond well. In addition, the results suggest that clinicians should be aware of vocal cord dysfunction as a potential cause of shortness of breath and fatigue in young people with long COVID.

Over three-quarters of the patients seen in the clinic were not vaccinated against COVID-19, and some of them suffered re-infections with the virus. We found that long COVID is debilitating for some of these kids: people think this disease is mild in pediatric populations, but we see kids that can’t go back to school, don’t graduate on time and can’t play their sport anymore.

Overall, we found that better definitions of long COVID in young people are needed, as well as more studies to understand what treatments help with symptoms.