What are symptoms of long-haul COVID?

The most common symptoms of long-haul COVID include:

• Fatigue and poor physical endurance
• Difficulty thinking or concentrating, also known as “brain fog”
• Cough
• Trouble breathing
• Joint or muscle pain
• Chest or stomach pain
• Mood changes
• Headache
• Fever
• Heart palpitations
• Loss of or changes in smell or taste
• Lightheadedness when standing up

There are a variety of chronic symptoms your child can experience after having COVID-19. The specific symptoms your child has could depend on how severe their COVID infection was. For instance, if your child was in the intensive care unit (ICU) on a ventilator, they might have fatigue and weak muscles, as well as a fast heart rate and brain fog. These are common effects in people who have spent time in the ICU.

How is long-haul COVID diagnosed?
There’s no specific test to diagnose long-haul COVID, so it’s diagnosed based on symptoms. Your pediatrician may run other tests or refer you to a pediatric sub-specialist, especially if symptoms continue more than 3 months. They will want to be certain there’s nothing else causing your child’s symptoms.

How long does it last?
That’s still unknown. More studies are needed to understand what’s going on.

What causes it?
Researchers are still trying to figure out what causes some people to experience long-haul COVID. It will probably take some years before we know much.

How is it treated?
Treatment depends on what symptoms your child is having. Your pediatrician will treat individual symptoms, such as headaches, lightheadedness, or problems sleeping.

What about multisystem inflammatory syndrome in children (MIS-C)?
You may have heard of multisystem inflammatory syndrome in children (MIS-C), a serious condition that may be related to COVID-19. However, doctors don’t know for sure yet what causes MIS-C. They just know that many kids who have had it either had COVID-19 or were around someone else who did. Keep in mind that MIS-C is rare.

When to seek help
If your child has been infected with SARS-CoV-2, stay in touch with your pediatrician to monitor for any lingering symptoms. Many medical centers in the United States are creating post-COVID care clinics so they can treat long-haul COVID more effectively. Your pediatrician can help you find a subspecialist or clinic if your child needs one.

Remember
COVID-19 vaccines are the best way to protect your family against COVID-19 and post-COVID conditions, including long-haul COVID. Vaccines are currently available for anyone 5 years of age and older. Clinical trials are underway for children as young as 6 months old.

More information
Post-COVID Conditions in Children and Teens
Postural Orthostatic Tachycardia Syndrome (POTS)
RECOVER – Researching COVID to Enhance Recovery (NIH)
Survivor Corps (national listing of Long COVID centers)

About Dr. Rowe
Peter Rowe, MD, FAAP, is a Professor of Pediatrics at the Johns Hopkins University School of Medicine and serves as the Director of the Chronic Fatigue Clinic at Johns Hopkins Children’s Center. He is a member of the American Academy of Pediatrics Maryland Chapter.