Parents may be reassured by studies of long-term impact of Covid on children
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Our understanding of long Covid is still developing as the virus itself is so new, and our knowledge about long Covid in children is even more limited.
However, a new British study indicates the risks for children are significantly lower than for adults. This follows a smaller study in Australia with similar results.
In Ireland, two leading paediatricians said these findings echo their experiences so far, with one describing the studies as “reassuring” for parents.
Another said she is more worried about the “severe mental health impact” some children experience from the pandemic generally, something she is already seeing in Limerick.
Long Covid generally means symptoms lingering after the initial infection for eight to 12 weeks — or significantly longer for some people. The HSE estimates this may affect as many as one in ten ill adults.
However, until now there has been very little data on long Covid in children.
This new study uses data uploaded to a mobile app launched by Zoe Limited and King’s College London. Researchers identified 75,529 children with PCR test results from over 250,000 uploads by parents or guardians.
Working with 1,734 children affected between September and January, they found just one in 50 (1.8%) had symptoms lasting more than eight weeks.
Fewer than one in 20 (4.4%) experienced symptoms for four weeks or more. Illnesses lasted on average for five days for children under 11, and for about seven days for over-12s.
So while parents watching over a sick child must feel every day as an eternity, this indicates the virus is less virulent for children even after infections.
Dr Ronan Leahy, consultant in paediatric immunology and infectious diseases with Children’s Health Ireland said: “From my own personal experience, I haven’t seen very much long Covid.”
He said: “I think we have received a couple of referrals but, by and large, the numbers seem to be small. By and large, the children seem to be recovering pretty well.”
There has not been “ a huge disease burden” among younger children so far, he noted.
“It is good news: Bad as the virus is, at least children are not getting particularly sick. We didn’t know this 16 months ago when it all started — we were all very anxious,” he said.
However, he said some parents of children with vague symptoms may opt for GP care instead of hospitals.
The Zoe study also found children who did not have Covid-19 experienced “persistent and burdensome illness".
Dr Leahy said: “I don’t think you can necessarily definitively attribute fatigue to SARS-CoV-2.
This wider negative impact of the pandemic is of huge concern to professor of paediatrics at the University of Limerick, Clodagh O’Gorman.
“Paediatricians throughout Ireland are seeing a legacy of Covid-19-related mental health issues in children” she said.
“These could be children who have had Covid-19 or have not had Covid-19 but who have been touched by the experience of living with Covid-19 in their lives."
She and her colleagues are treating “devastating mental health effects which our system is not resourced to adequately deal with".
Prof O’Gorman, a paediatrician at University Hospital Limerick, said she has not seen a large number of children with long Covid so far.
She said: “It remains to be seen how much Covid-19 we will see in children during this current wave of the pandemic and how much long Covid we will identify in children after this current wave of the pandemic.”
Despite the depth of the King’s College study, some UK scientists have claimed it is not clear whether a child recovered or the parent tired of uploading data. Those using the app were described in the study as “over-representative of women, those of White background, and those with above-average socioeconomic status".
Perhaps reassuringly however for parents, a study at the Royal Children’s Hospital in Melbourne, Australia, also echoes the Irish doctors’ experiences.
The study of less than 200 children, published in in April, found they experienced post-viral coughing for three to eight weeks, and fatigue from six to eight weeks.
Dr Leahy said this could impact how parents think about vaccinations.
Vaccinating over-12s potentially protects children from long Covid, as well as reducing their anxiety around returning to school, he said.
He added: “It may also potentially protect them from the hyper-inflammatory symptom [PIMS TS]. We don’t know that for sure but there is certainly a case to argue that.”
However, he said: “The younger you get, the balance of risk versus benefit is much less clear.”
He pointed to the different choices being made around the world to protect children as an example of the uncertainties.
“It is early days, everybody is still learning,” Dr Leahy said.