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Long COVID in children

Checked: 23-08-2023 by Vicky Ryan Next Review: 23-08-2025

Overview

Long COVID in children is an area of ongoing uncertainty and there is currently still no universally agreed definition of Long COVID (1) or Post Covid Syndrome in children. Persistent symptoms in children following COVID-19 infection do occur, but the pattern is different to the pattern of symptoms in adults. In the CLoCk study, 14 % of children aged 11-17 reported persistent symptoms 3 months following infection (2).

Most children who develop COVID-19 will have mild disease and make a full recovery and persistent symptoms are uncommon. For those children with persistent symptoms, the commonest reported at three months following COVID infection were: tiredness, headache, shortness of breath, dizziness and anosmia. There is also evidence of mental health effects and that mental and physical health symptoms are closely related. (1)

The effects of different variants on Long COVID symptoms is currently not known but studies are ongoing.(1)

(1) Long COVID - the physical and mental health of children and non-hospitalised young people 3 months after SARS-CoV-2 infection; a national matched cohort study (The CLoCk) Study. - August 2021

(2) Long covid: One in seven children may still have symptoms 15 weeks after infection, data show - September 2021

Who to Refer

Most children will make a full recovery following COVID infection and if there are persistent symptoms, these will usually be mild. For those children who have significant ongoing symptoms more than 4 weeks following infection, then further investigations or referral may be required.

Prior to referral, a physical examination should be undertaken to exclude other potential causes of symptoms. A more urgent referral should be considered if there are Red Flags (see section below).

For adults aged 18 and over please use the adult pathways.

Advice for Parents/carers

If you are a parent and you think your child has Long COVID, please talk to your GP. You may find further information on long COVID here: https://www.longcovidkids.org/

COVID Recovery - NHS

Once other more concerning medical conditions have been excluded then all patients should be directed to the NHS website page - Long-term effects of COVID-19 (long COVID), which has advice for patients on self care and managing expectations during recovery. (The previous 'Your COVID Recovery' site has been taken down).

Red Flags

Please see the Children and Young People - USC page for further advice on symptoms and signs that may warrant a 2WW referral.

Referral

*****Update - March 2023 - The Regional Paediatric Long COVID Clinic is now closed to new referrals.******

Please therefore consider the following options:

Advice & Guidance - Paediatric (Remedy BNSSG ICB) via eRS (for children under 16 years)
Paediatric referral via eRS - request either general or specific specialty depending on symptoms (for children aged under 16 years*).
Paediatric Specialist Fatigue Service at the Royal United Hospitals Bath - for children with symptoms of chronic fatigue if referral criteria are met. If you refer directly to the Bath ME/CFS Service please ALSO refer to your local paediatric service.
Mental Health support - For children requiring support with their mental health please see the Mental Health Resource page.

*Young people aged 16 and 17 years -General paediatric services are not available in BNSSG for patients aged 16 and 17. In these patients, the referring GP should carry out initial investigations in primary care to rule out other conditions (see adult Long COVID pages) and can then refer to the RUH Paediatric Specialist Fatigue Service.

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.