Children also have long Covid, and it can appear unexpectedly



CNN

November 10th is a day that Kim Ford remembers too well. It was the day last year when her 9-year-old son, Jack, was scheduled to receive his Covid-19 vaccine at the school clinic. They were excited that he would finally have some protection, but on November 9th he had the sniffles.

“It simply came to our notice then [November 10] and he felt even worse, I told him, “You know what, we’re going to test you before you go in, because I don’t want you to get the Covid vaccine if you really have Covid,” Michigan’s mother said.

Jack tested positive for Covid-19 that day and has been living with the symptoms ever since.

This has prevented him from staying in school all day. You need to limit how much you play baseball with other kids in the neighborhood. Even playing Fortnite for too long can make you feel sick the next day.

He is one of millions of children potentially with long Covid.

“My stomach hurts. It’s a little hard to breathe. You have a stuffy nose. It’s just an absurd amount of things you can feel,” Jack Ford said. “Sometimes it’s very annoying. It’s not like a cold, you know, it feels like Covid.

“People may think you’re pretending, but you’re not pretending. You feel like you have Covid,” he added.

It is unclear how many children go on to develop long Covid, because there is not enough research on this age group, some experts say.

Nearly 13 million children have tested positive for Covid-19 since the start of the pandemic, according to the American Academy of Pediatrics. Studies suggest that between 2% and 10% of these children will develop a long Covid, but the number may be higher. Many parents may not know that their child has had Covid for a long time, or that the child’s pediatrician has not recognized it as such.

In adults, some research puts the number at around 30% of cases.

“I personally think it’s a very undiagnosed problem,” said Dr. Sara Kristen Sexson Tejtel, who helps run a long Covid pediatric clinic at Texas Children’s Hospital in Houston.

Many doctors treating children at long Covid clinics across the country say they have long waits for appointments. Some are reserved until September.

There is no specific test for long Covid. It is unclear which children will have it, as it can happen even when a child has a mild case of Covid-19.

“It simply came to our notice then which we have not fully appreciated. Some arrive with heart failure after asymptomatic Covid infections, “said Dr. Jeffrey Kahn, head of the Pediatric Infectious Diseases Division at UT Southwestern Medical Center in Dallas.” What strikes me is that it usually occurs. about four weeks after the infection, and the infection can be really asymptomatic, which is really amazing. ”

Even when children with long Covid are tested for diseases that can cause these symptoms, nothing may appear.

“They tested me and it seemed like nothing was happening to me, but they went out of their way to find something,” Jack Ford said.

His lung function test and ECG returned to normal. “The Covid clinic said this is very common in children with long Covid. Sometimes all the tests go back to normal,” Kim Ford said.

Dr. Amy Edwards, who runs Covid’s Long Pediatric Clinic at UH Rainbow Babies & Children’s Hospital in Cleveland, agreed that a lot is happening.

“We also tested them and their gastrointestinal tracts are normal. I’m doing a big immune study and their immune system looks normal. Everything ‘looks normal,’ but kids don’t function normally,” Edwards said. “I tell families, ‘They have to remember, there are limits to what medical science understands and can prove.’ Sometimes we’re not smart enough to know where to look.”

Adult problems tend to be more obvious, Edwards said, because they are more likely to do so they have an organic dysfunction that is shown in the tests.

Doctors are still trying to understand why Covid happens this way in children. They are also finding out what symptoms define long Covid in children. Some studies in adults show a range of 200 symptoms, but there is no universal clinical case definition.

At the Sexson Tejte Clinic in Texas, children often fall into certain categories. Some have fatigue, brain fog and severe headaches, “to the point that some kids can’t go to school, grades are failing, that kind of trouble,” he said.

Another group has heart problems such as heart palpitations, chest pains and dizziness, especially when they return to normal activities.

Another group has stomach problems. Many of these children also have a change in their sense of taste and smell.

Sexson Tejte said it’s not entirely different from the symptoms adults have, “but it’s not the mixture of the involvement of different organ systems with adults.”

One of Jack Ford’s symptoms affects the amount of energy he has for typical activities.

“Covid’s long-term patients have post-exertion discomfort, which is Jack’s biggest problem,” Kim Ford said. “So if you overdo it, and you don’t even have to overdo it physically. You might be very upset about something the day before, or you might be really mentally engaged in something like watching TV or playing video games sitting in his chair, he will knock it out. ”

Energy has become such a problem that Jack can’t go to school for an entire day. His parents started it again with one or two hours a day and have gradually increased it to about 5 and a half hours a day.

“We’ve been trying to increase it to six, but so far it hasn’t worked,” Kim Ford said. “He woke up pretty miserable the next day.”

Edwards, who runs the long-running Covid Clinic in Cleveland, says he needs to talk to parents to carefully balance the amount of energy their children spend. Most healthy people can get by if they are tired, but those with long Covid can’t. “It’s like they have a bucket of energy, and it has to be used carefully for school, to play, to watch TV. Everything they do needs energy, and once the bucket is empty, that’s it, “Edwards said.

Some of his teenage patients are exhausted just facing the typical school drama.

“Long-haul carriers have to think about every aspect of their day and when they can spend that energy. They have to have that balance. Otherwise, they run out.”

Many also have anxiety. Something may stem from the illness itself or the doubt they have heard from doctors or adults when they say they are not feeling well.

Experts across the country say they have listened to patients whose complaints are ignored, even after a radical change in their health. They have been told that they are being dramatic or seeking attention, or that the symptoms are in their head.

“I don’t want to be too critical, but there are some doctors who directly rule it out,” said Dr. Alexandra Yonts, director of Children’s National’s post-Covid clinic in Washington. “Then the kids just fight. They go from place to place.”

Yonts believes that there needs to be better recognition among doctors that Covid can be a real problem for a long time.

“I have two children in wheelchairs after having Covid who have never been in a wheelchair before. There is a child with crutches. I have a child who lost the use of his hands,” said Edward . “These kids have to be believed.”

There is no specific treatment for long Covid, but most of these clinics are multidisciplinary.

At the Edwards Clinic, which opened last year, experts can address lung problems, digestive problems, physical rehabilitation, sleep problems, mental health issues and more. There is a staff nutritionist as well as a licensed acupuncturist and pediatrician licensed in Chinese Medicinal Herbs.

In addition to preparing a child’s schedule so that he can determine where to spend his energy and when to take breaks, Edwards Clinic teaches children to meditate. They do massages and mind-body exercises.

“Children need a lot of help. They improve significantly, they really do, if we are aggressive and receive intensive support and comprehensive therapy, ”Edwards said.

But not all children can enter a clinic.

“I’ve talked to so many people working on pediatric recovery in Covid, and they all say the same thing: ‘We care about children who don’t get help, who don’t have parents who can defend them. or browse the medical system. ‘ It keeps me awake at night, “Edwards said.

Much of what their clinic does is encourage children to get enough sleep and eat healthy foods, but not all families can afford healthy eating.

“It simply came to my notice then. And now they have children with long-distance Covid, “Edwards said.” Just wait for more people to realize the problem and try to help. ”

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