Our understanding of coronavirus has evolved so much, including the dominant narrative that the virus is for the older.
Initially, we thought that Covid lasted for a couple of weeks. Then we saw a flurry of anecdotes and research on lingering symptoms in adults, that lasted weeks and sometimes, even months after the infection - also called 'Long Covid'.
There is no official medical definition for long Covid, which is also called post-Covid syndrome or chronic Covid syndrome - that includes an array of stubbornly persistent symptoms.
For adults, this could include fatigue, brain fog, headache, dizziness, palpitations, breathlessness, cough, muscle pain. The list is quite long. Researchers say there may be up to 100 other symptoms.
Now, there is growing evidence that shows that many children develop long Covid too.
Having Covid itself can be traumatic for children. This is even harder. It can be tiring, confusing and big enough to seek medical help too.
Increasing Evidence of Long COVID in Children
Evidence from the first study of long Covid in children in Italy, suggests that more than half of children aged between 6 and 16 years old who had Covid have at least one symptom lasting more than 120 days.
The UK Office for National Statistics's report estimates that 12.9 percent of UK children aged 2 to 11, and 14.5 percent of those aged 12 to 16, still have symptoms five weeks after their first infection.
Lingering symptoms after Covid are not unusual, but it's probably not as common as in adults, doctors told FIT.
"We are seeing a lot of children with long Covid. When I say a lot, it is in proportion, a lot of children," Dr Nameet Jerath, a Pediatrician at Indraprastha Apollo Hospitals in Delhi, said.
Long COVID: How Does It Affect Children?
By now, we know that one of the perplexing traits of Covid is that it affects people differently and there is no logical answer to that. It's the same with long Covid in adults and in children, too.
All the doctors FIT spoke to listed different symptoms of long Covid in children.
However, the incidence of low-grade fever that went on for weeks, was a common symptom they listed and which was seen in maximum number of kids with long Covid.
"80% of the patients had low-grade persistent fever," Dr Dhiren Gupta, Pediatrician at Ganga Ram Hospital in Delhi, said.
The fever won't be too high or have high inflammatory markers to say that it is MISC (Multisystem inflammatory syndrome in children), Dr Rachana Sharma, Pediatrician at BLK Max Hospital in Delhi, added.
According to Dr Sharma, in children who had suffered from mild to moderate Covid, insomnia, rashes, mild cough and diarrhoea were most common.
The otherwise not so worrying, easily treatable rash, has become a problem as children keep coming back with it, she added.
Dr Jerath said mild symptoms, not very severe but concerning enough for the parents to seek medical advice, like low-grade fever, headaches and stomach aches were the most prominent symptoms.
Meanwhile, symptoms like sleep issues, brain fog, breathlessness, fatigue, palpitations, are more common in adults, the doctors said.
"Breathing difficulties are very uncommon in children because most children do not have severe lung involvement with Covid," Dr Jerath said.
Dr Gupta, however, said breathlessness among children has been common.
What About Other Psychological Issues?
Covid long-haulers go through a number of psychological and sleep issues too. But it is difficult to attribute psychological issues to long covid since it could due to a number of factors.
Lockdown and being confined to one's home could affect one's mental health. Insomnia is multifactorial too.
Staying at home, watching television and playing online games for longer hours - all of these affect mental health, Dr Jerath said.
Identifying and Seeking Help
Doctors told FIT that while parents are good observers, it is important that they do not neglect medical help brushing it off as a post-Covid symptom.
"Usually, parents are very observant, and they're very astute in their remarks. Mothers can pick up subtle differences in the behavior or in the demeanor of the child," Dr Jerath said.
"We have to depend on the parental version of events, since children might not be able to explain the symptoms and history."
Meanwhile, Dr Gupta said there have been several cases in which underlying, serious diseases were unmasked.
"Tuberculosis is rampant. Gut-related infections and cytomegalovirus were also unmasked," Dr Gupta said.
So, it's important that patients don't neglect the symptoms and doctors investigate thoroughly, he said.
What Are the Treatment Options?
Long Covid per se does not need any specific treatment apart from just symptomatic management, doctors told FIT.
"You treat the symptoms if they are significant. You don't need strong medicines or steroids for that," Dr Jerath said.
The investigations are basically to rule out if there is anything else going on simultaneously, which needs treatment.
What Support Can the Family Provide?
Good nutrition, balanced diet and simple things we know can prevent the spread of coronavirus. We've all heard these tips, but it's important that we stick to them.
Besides, family can provide mental health support and encourage children to take part in more physical activity, doctors said.
"If the child is not able to perform physically, it is perfectly alright. But still, one needs to keep building on the physical activity of the child," Dr Sharma said.
We've ignored long Covid for far too long.
Due to lack of understanding of the effects of the virus, and doctors overlooking their needs initially, Covid long-haulers had to form their own support groups to sensitize and run their own research projects.
Now, with a better, although not clearer picture emerging of the implications, it's vital that these patients are dealt with compassionately.
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