Conference Coverage

Fatigue, Headache Are Primary Symptoms of Long COVID Among Patients 21 Years of Age or Younger

Anthony Calabro, MA

In a retrospective study involving a large cohort of young patients, researchers identified fatigue and headache as the primary symptoms of long COVID in participants 21 years of age or younger.

Long COVID presents with a wide range of symptoms from dizziness and brain fog to chest and joint pains, which can last from weeks to months. While much of the research on this disorder involves adults with long COVID symptoms, little is known about long COVID in younger individuals and the impact of vaccination on the progression of symptoms over time.

In a retrospective analysis, researchers followed all patients 21 years of age or younger who presented to the COVID Recovery Clinic at Children’s Hospital of Los Angeles from August 2021 to April 2023. In total, researchers identified 107 patients with long COVID, of which 51 (47.7%) were women. The median age of participants diagnosed with long COVID was 14.1 years (interquartile range = 11.1-15.9).

The results of the analysis indicated that the most common symptoms were fatigue (94.4%) and headache (73.6%), followed by exercise intolerance (57%), dizziness (49.5%), brain fog (41.1%), shortness of breath (31.8%), musculoskeletal pain (30.8%), chest pain, and palpitations (29%).

In an interview with Consultant360 on her study, which was presented at ID Week 2023 in Boston, Massachusetts, Dina Kamel, MD, pediatric infectious diseases fellow at Children's Hospital Los Angeles, noted that long COVID in younger individuals is now a well-established health problem.

“I encourage all pediatricians to be aware of this constellation of symptoms and have their patients seen in one of the long COVID centers so that they are able to be closely followed up, and if there is any therapeutic intervention in the future, we will be able to provide it for those patients,” Dr Kamel told Consultant360.

At the time of presentation, 57 patients (53.3%) were vaccinated, and of those patients, 35 (61.4%) received the vaccine after the onset of long COVID symptoms. Of those individuals who received the vaccine after symptom onset, 51.4% reported no change in symptoms after receiving a vaccination. A total of 42.9% reported symptom improvement, and 5.7% had progression of symptoms.

The next step for Dr Kamel and her team is to follow this patient cohort for a longer period with the goal of creating a multidisciplinary model of care for this patient population.

“Longer perspective follow-up is our next step in this research,” Dr Kamel said. “We're following these patients closely every 3 to 6 months, following up on the symptoms and asking them from their perspective, what they think is the best help for their symptoms. And in this case, we were able to help the rest of our patients.”

This study had limitations. For example, Dr Kamel noted that their study needed more detailed epidemiological data, as well as an objective assessment of the quality of life of the patient population. The authors also acknowledged that further investigation is needed.

“In our large cohort of pediatric patients, we identified fatigue and headache as the predominant presenting symptoms,” the authors concluded. “COVID-19 vaccine led to symptomatic improvement in a proportion of patients. Longer prospective follow-up is needed to help better understand the impact of long COVID on children. COVID-19 vaccines should be further investigated in a systematic fashion as a possible therapeutic intervention in children with long COVID.”

Kamel, D. Clinical spectrum of pediatric long COVID and impact of COVID-19 vaccines on the clinical course. Talk presented at: IDWeek 2023. October 11-15, 2023. Accessed October 4, 2023.