South Middlesex Times

In the most comprehensive national study since the onset of the COVID-19 pandemic, a team of researchers, including a Rutgers-organized consortium of pediatric sites, has concluded that long COVID symptoms in children are tangible, pervasive, wide-ranging, and clinically distinct within specific age groups.

Results of the study, funded by the National Institutes of Health (NIH), are published in the Journal of the American Medical Association.

“We have convincing evidence that COVID-19 is not just a mild, benign illness for children,” said Lawrence C. Kleinman, a professor of pediatrics and population health expert at Rutgers Robert Wood Johnson Medical School (RWJMS) and the study’s third co-author. “There are children who are clearly disabled by long COVID for long periods of time.”

In the early stages of the pandemic, a myth arose suggesting that because children often developed only mild cases of COVID-19, their risks were not serious. However, this conjecture dissipated amid data demonstrating that some children infected with COVID-19 will get very sick and others will suffer an array of health complications long after initial exposure.

Broadly defined, long COVID includes symptoms such as aches, fatigue, memory loss, and stomach pain that develop more than a month after a COVID-19 infection. Worldwide, an estimated 65 million people live with long COVID. Until recently, most research into COVID-19’s lingering effects focused on adults.

To quantify long COVID’s impact on children and determine whether symptoms experienced by young patients differ by age group and from adults, Kleinman and more than 140 researchers throughout the United States analyzed data from NIH’s Researching COVID to Enhance Recovery (RECOVER) Initiative.

As part of RECOVER, caregivers for 5,367 children (898 school-aged children and 4,469 adolescents) completed online surveys about their children's health. Roughly 86 percent had previously been infected with COVID-19 while 14 percent had not. The survey assessed 74 known and potential long COVID-19 symptoms across nine domains: eyes; ears; nose; throat; heart; lungs; gastrointestinal; dermatologic; musculoskeletal; neurologic; behavioral and psychological; menstrual; and general.

By analyzing responses, researchers found that 45 percent of school-age children (ages 6 to 11) who had been infected reported at least one prolonged symptom after initial recovery versus 33 percent of uninfected children. Thirty-nine percent of adolescents (ages 12 to 17) who had been infected reported one prolonged symptom compared with 27 percent of uninfected adolescents. These differences implicate the virus as a likely causal factor rather than just having lived through the pandemic.

Long COVID symptoms in children also were clustered in patterns distinct from adults and each other. For instance, loss of smell and taste was most common among adolescents followed by low energy levels and muscle aches. For school-age children, memory issues topped the list followed by stomach pain and headaches.

Children experienced prolonged symptoms after infection “in almost every organ system,” wrote the authors.

By contrast, adults report experiencing post-exertional malaise, brain fog along with gastrointestinal and heart symptoms more frequently than those who did not have COVID-19.

Recruitment for RECOVER is facilitated partially by an RWJMS collaboration involving ten national pediatric organizations. The Rutgers Collaborative Long-term study of Outcomes of COVID-19 in Kids (CLOCK), which Kleinman heads as lead investigator received an NIH grant exceeding $30 million in its launch year in 2021. To date CLOCK has recruited over 2 thousand participants for pediatric RECOVER studies

While further research is necessary to understand long-COVID's impact on young patients fully Kleinman emphasizes there is no doubt it affects them significantly

“Children do get long-COVID it's not rare," he said "Some severely affected they’re not faking or making it up"

“This new chronic illness brings unknowns we must be prepared to address for generations”