What science got wrong about kids and COVID – Deseret News

There is growing evidence that although children have a lower rate of severe acute illness from COVID-19, lingering effects after even seemingly mild cases affect millions of children and adolescents. According to a recent JAMA study, between 1 in 5 and 1 in 10 pediatric infections — including asymptomatic cases and those that are severe — are followed by long-term COVID symptoms.

That’s up to 6 million children in the United States. And research suggests the risk increases with repeated infections. During this time, symptoms can last three years or more.

Longer-term effects, which may appear just weeks or months after contracting COVID-19, “impact all organ systems,” according to a study of adolescents recently published in JAMA.

In research published this month, children with COVID-19 were found to have a significantly higher risk of developing type 2 diabetes within six months of COVID, compared to their peers with other respiratory diseases – a finding published in JAMA Network Open.

Symptoms must last at least three months to be considered long COVID. They can be physical, cognitive and mental, said Dr. Kirti Sivakoti, an assistant professor of pediatrics at University of Utah Health and associate director of Primary Hospital’s Evidence-Based Pediatric Unexplained Autonomic Symptoms Program. for Intermountain Children, at the Deseret News. She said the “multitude of symptoms” can include dizziness, headaches, brain fog, extreme fatigue and various types of pain.

There are many similarities between long COVID and postural orthostatic tachycardia syndrome, she added. This condition, often referred to simply as POTS, is an autonomic nervous system problem that causes an abnormally rapid increase in heart rate when sitting or standing. This can lead to dizziness, fainting, palpitations, fatigue, headaches, nausea, trouble sleeping, and other problems.

In children, long COVID often manifests as truancy and academic failure at previously high levels among young people, she said.

What makes some young people susceptible and others not remains a mystery, but Sivakoti said evidence suggests that external, behavioral, environmental and genetic factors contribute.

False sense of security

An essay by Blake Murdoch in Scientific American recently explained some of the misunderstanding and underestimation of COVID-19’s impact on children, noting that he had “some help from scientists.” In 2023, the American Medical Association’s pediatric journal published a study — which has since been retracted — reporting that the rate of long COVID symptoms in children was “surprisingly low,” at just 0.4%. The results were widely publicized as good news and helped rationalize the status quo, where children are repeatedly exposed to SARS-COV-2 in under-ventilated schools and parents believe they will not suffer any harm. serious harm.

Murdoch is a health policy expert, bioethicist, lawyer and science communicator at the Health Law Institute at the University of Alberta. He is particularly interested in “disconnects between scientific evidence, ethical principles, and policy.”

The belief that COVID-19 has little effect on children means people may not be taking adequate precautions to reduce the risk of exposure. And often, it takes longer to make a diagnosis, even after other causes of the symptoms have been ruled out. This can lead to significant loss of function. Early diagnosis and treatment are key to preventing long-term decline and improving quality of life, Sivakoti said.

Studies add to list of health problems

A growing body of research links COVID-19 infection in children to ongoing health problems.

A study published in JAMA by researchers at Rutgers University and the National Institutes of Health found that prolonged COVID symptoms in children are “tangible, pervasive, widespread, and clinically distinct within specific age groups,” as a Rutgers press release notes.

“We have compelling evidence that COVID-19 is not just a mild, mild illness for children,” said Lawrence C. Kleinman, professor of pediatrics and population health expert at Robert Wood Johnson Medical School in Rutgers and third co-author of the study. . “There are children who are clearly disabled by long COVID for long periods of time.”

This study involved 140 researchers in the United States and nearly 5,400 children and adolescents. Of these, around 86% had been infected with COVID-19. The study focused on 74 known symptoms in nine areas: eyes, ears, nose and throat, heart and lungs, gastrointestinal, dermatologic, musculoskeletal, neurological, behavioral and psychological, and general, according to Rutgers.

Forty-five percent of infected children ages 6 to 11 reported experiencing one or more prolonged symptoms after overcoming active infection. The same is true for 39% of adolescents aged 12 to 17 who have been infected with COVID – both figures significantly higher than among children who have not been infected. The study said that among adolescents, the most common symptoms were loss of taste and smell, followed by lack of energy, muscle pain and fatigue. In the younger group, memory and concentration were the main problems, followed by stomach pain, headaches and back or neck pain.

Questions have been asked about how researchers know the symptoms are a lingering effect of COVID, and not other conditions. A recent study in the journal eClinicalMedicine went to great lengths to rule out other causes through detailed medical evaluations and “carefully ruling out other potential causes of symptoms such as low blood sugar, anemia, and other infections,” to be sure the symptoms could be attributed to COVID. , as reported by Medical and Life Science News.

Among other issues, the study found that COVID infection increased the risk of developing autoimmune diseases, including Hashimoto’s thyroiditis and celiac disease.

In the study linking COVID-19 to a higher risk of developing diabetes, records of 600,000 children aged 10 to 19 were used – half with a history of COVID infection in 2020, 2021 or 2022 and the other half with other respiratory infections, including influenza. . Lead author and Case Western Reserve University School of Medicine epidemiologist Pauline Terebuh told the Post it was a “huge spike.” If a child is diagnosed with diabetes, they will have a lifetime of carrying this chronic disease.

What drives this link requires further investigation, the researchers said. The Post noted that there is “debate among scientists about the extent to which type 2 diabetes might be an autoimmune disease.”

The study does not suggest that all children infected with COVID will develop diabetes. And Sivakoti said doctors haven’t seen COVID-related diabetes at the Intermountain Primary clinic, “but we’ve seen a lot of long COVID.” She notes a lot of overlap in symptoms treated across different clinical groups, including POTS, dysautonomia and chronic pain.

Managing long-tail symptoms

“Honestly, there is so much overlap between these three that we almost lumped them into one. With long COVID in particular, it’s sort of this range, this multitude of symptoms, whether they’re physical, cognitive, mental, that have lasted long after COVID. Chronicity is an important factor here,” Sivakoti said.

The fatigue that young people experience is not the kind where you work 16 hours a day, go home exhausted, sleep 10 hours and then feel fine. “This is the type of fatigue that rest does not cure and these patients are extremely tired even going to school. So there is a huge rate of truancy, missing schools, missed academic potential, which leads to huge costs for families,” she said.

Some patients experience abdominal pain, joint pain and respiratory symptoms. “I would say it can affect anything and everything,” she said, adding that the journey to diagnosis can be long and then back to functioning and quality of life. It’s important to get a diagnosis and start treating symptoms, because it doesn’t take long for function to decline significantly, Sivakoti said.

Studies show that vaccination not only lowers the risk of getting COVID but also of having long-term symptoms, she said.

Fortunately, prolonged COVID symptoms lessen over time, Sivakoti said. But often, children have already lost ground in education and development. She is a proponent of prevention so that long COVID never impacts them at all.