Noting that long Covid manifests itself in children similar to adults, experts on Sunday said there is no need to panic but stressed on early treatment.
Children infected with the SARS-CoV-2 virus can experience symptoms of long Covid lasting at least two months, according to a study published in The Lancet Child & Adolescent Health journal recently.
The largest study to date of long Covid symptoms in children up to 14 years used national level sampling of kids in Denmark and matched positive cases with a control group having no prior history of the infection.
According to Dr. Col. Vijay Dutta, senior consultant in Internal Medicine, Indian Spinal Injuries Centre, long Covid problems in children is a well-known issue.
“We are encountering long Covid syndrome in children similar to adults. They can have multiple presentations, like in the adult population we have involvement of the respiratory system, patients are experiencing recurrent pneumonia, the immunity is lower, so they are experiencing GI infections, such as chronic diarrhoea and weight loss,” he said.
“Due to lowered immunity, they have symptoms like any rheumatological disorder overlap syndromes and other symptoms which are commonly seen in the immunocompromised pediatric age group. They are now being commonly encountered in children who have suffered from Covid. Long Covid is now a well-recognised problem across the world,” Dutta added.
Dr Krishan Chugh, Director and Head of the Paediatrics Department, Fortis Memorial Research Institute, said there was no need to panic.
Citing the Lancet study, he said in all three groups of children — less than three years, four to 11 years, and 12-14 years — those who tested positive in RT-PCR had higher chances of having at least one symptom at the second and third month compared to the children that remained indoors.
“However, in majority of the children, these symptoms were mild. Interestingly, the quality of life related to emotional and social functioning was better in those who had Covid compared to controls in the older children age group,” he said.
The most commonly reported symptoms among children in the 0-3 year category were mood swings, rashes and stomach aches, the study said.
Among four to 11 years old, the most commonly reported symptoms were trouble remembering or concentrating and rashes besides mood swings.
Among 12-14 years old, fatigue, mood swings, and trouble remembering or concentrating were the main symptoms, it noted.
Most of the symptoms the infected children exhibited were the same that could occur in those forced to stay indoors without any contact outside, such as mood swings, Chugh said.
The study included children infected during the Alpha and the Delta waves (first and the second waves) and not the present Omicron wave, which in all ways is milder, he added.
“So, while we have to recognise the children who have long Covid symptoms early and treat them, I think there is no cause for undue alarm. Children have braved Covid better than adults in every way. A meta analysis of several other studies in children on the same subject published in ‘Nature’ on June 23 shows a lower incidence of long Covid than quoted in the Lancet study,” Chugh said.
Dr Meena J, a senior consultant in paediatrics and neonatology at Dwarka’s Aakash Healthcare, however, differed with her counterparts and said it is difficult to identify cases of long Covid in children.
“Long Covid syndrome or post-Covid syndrome refers to symptoms seen in children for at least two months post the Covid infection and this cannot be explained by another disease or ailment, though this problem is very well identified in adults. But it is very difficult to diagnose long Covid syndrome in children because there are a lot of factors which can affect and there are diseases which can present in a similar way and also the symptoms can vary,” she opined.
She said the symptoms can vary from mild anorexia or loss of appetite or weakness to severe problems like joint pain, irritability and loss of appetite, and these have been seen in several children post Covid.
A larger study is needed to assess the impact of the virus on children, she added.
“However, it is too early to say the symptoms are attributed to Covid infection. We need to study a larger population and a population-based studies need to be done to differentiate similar symptoms from children who were never infected with Covid. So, it is too early to say the symptoms are only due to Covid and not a manifestation of any other disease,” she said.