Adults suffering from long COVID often face persistent fatigue, post-exertional crashes, brain fog, shortness of breath, coughing, and loss of smell or taste. However, new research shows that long COVID symptoms can vary significantly in children, and even among different age groups.
According to a study published on Aug. 21 in JAMA, children experience different symptoms than adults, with variations occurring across different age brackets. “Most of what we know about long COVID comes from studies of adults,” said Dr. Rachel Gross, associate professor of pediatrics at the NYU Grossman School of Medicine and co-lead author of the study. The research is part of the U.S. National Institutes of Health’s RECOVER initiative. “This is one of the largest and first studies to try to characterize prolonged symptoms in children and understand how they differ across age groups.”
To gather data, the researchers surveyed caregivers of over 5,000 U.S. children, both those who had previously contracted COVID-19 and those who had not. The team identified which symptoms were most strongly linked to previous infections, indicating long COVID.
Among children aged 6 to 11, the study found 10 key symptoms associated with long COVID, including memory and focus problems, back or neck pain, stomach pain, headaches, phobias, refusal to go to school, itchy skin or rashes, sleep difficulties, nausea or vomiting, and dizziness.
In adolescents aged 12 to 17, eight symptoms were identified, including loss of smell or taste, muscle or joint pain, daytime sleepiness, fatigue after walking, back or neck pain, memory problems, headaches, and dizziness.
While these findings are not yet enough to definitively diagnose long COVID in children, they provide a starting point for estimating its prevalence. The researchers estimated that around 20% of previously infected younger children and 14% of adolescents may meet the threshold for long COVID, with those infected before the Omicron variant being more susceptible. These estimates are higher than previous studies, including a 2022 report from the U.S. Centers for Disease Control and Prevention, which estimated long COVID in just 1% of children.
Dr. Gross emphasized the importance of recognizing the different ways long COVID can manifest in children. “There’s a misperception that long COVID in children will look like it does in adults,” she said. The study suggests that while some symptoms, such as fatigue and cognitive issues, are shared across age groups, others—like phobias and rashes—are more common in children and may be overlooked by clinicians focusing on adult symptoms.
Currently, there are no approved tests or treatments specifically for long COVID, even when correctly diagnosed in children. Nevertheless, the findings highlight the need for parents and doctors to reconsider the risks COVID-19 poses to children. Though children are less likely to experience severe illness or death from COVID-19, long-term complications remain possible, regardless of age.
