Long COVID living in children

Overview

Long COVID (also called post-COVID-19 syndrome) is when symptoms from a COVID-19 infection last for weeks or months after the initial illness. In children, it can affect their energy, focus, and daily activities. It is not the same as the original infection, and it can happen even after a mild case.

Long COVID is not as common in children as in adults, but it does happen. Studies suggest that around 1 in 100 children who had COVID-19 may have symptoms lasting more than 12 weeks.

Children who had COVID-19, even if the initial infection was mild, can develop long COVID. It can affect children of any age, from toddlers to teenagers, and it is slightly more common in older children and in those who had more severe initial symptoms.

Symptoms

Common symptoms

• Extreme tiredness (fatigue)
• Headaches
• Trouble concentrating or 'brain fog'
• Shortness of breath or feeling out of breath easily
• Chest tightness or pain
• Cough that won't go away
• Loss of taste or smell that lasts
• Dizziness or feeling lightheaded
• Trouble sleeping
• Feeling anxious or low

Symptoms in children

• Persistent tiredness that doesn't get better with rest
• Problems with memory or focusing in school
• Headaches that come and go
• Stomach aches or feeling sick
• Sore muscles or joints
• Mood changes like irritability or sadness
• Feeling tired after physical or mental activity (post-exertional malaise)

Symptoms in older adults

• Long COVID in older adults often includes more severe fatigue, breathing problems, and joint pain.
• Older adults may also have higher risk of blood clots and other complications.
• Recovery may take longer in older adults compared to younger people.

Causes

Main causes

• Long COVID is caused by the body's response to the virus that causes COVID-19, not by the virus itself still being active.
• It may involve ongoing inflammation, immune system changes, or damage to organs like the lungs or heart.

Risk factors

• Having a more severe initial COVID-19 illness (though it can happen after mild cases)
• Being older (adolescents more than younger children)
• Having other health conditions like asthma or obesity
• Being female (slightly higher risk in girls than boys)

When to see a doctor

See a doctor urgently if:

• If your child has any of the emergency symptoms listed above, call your local emergency number immediately.
• If your child has new or worsening shortness of breath, chest pain, or confusion, seek urgent medical help.

Book a routine appointment if:

• Contact your child's doctor if symptoms like tiredness, headaches, or trouble concentrating last for more than 4 weeks after a COVID-19 infection.
• Make an appointment if your child is missing a lot of school or cannot do usual activities because of ongoing symptoms.
• Talk to the doctor if your child's symptoms are getting worse or not improving over time.

Diagnosis

There is no single test for long COVID. Doctors diagnose it by listening to your child's symptoms, doing a physical exam, and ruling out other health problems. Your child may have had COVID-19 before, but sometimes the infection was not tested. The diagnosis is based on symptoms that start during or after a COVID-19 infection and last for more than 4 weeks.

Tests that may be done

• Your doctor may do a blood test to check for inflammation or other issues.
• They might check oxygen levels with a pulse oximeter (a small clip on the finger).
• If your child has chest symptoms, a chest X-ray or breathing tests may be done.
• Sometimes an ECG (heart tracing) is done if there are heart-related symptoms like chest pain or palpitations.

What to expect at your appointment

The doctor will ask about your child's symptoms, activity levels, and how they affect daily life. They may ask about school attendance, mood, and sleep. Be prepared to describe when symptoms started and what makes them better or worse. Your child may be referred to a specialist clinic for long COVID if symptoms are severe or not improving.

Treatment

There is no one medicine that cures long COVID. Treatment focuses on managing symptoms and helping your child gradually return to normal activities. It often involves a team of healthcare professionals, including your family doctor, physiotherapists, occupational therapists, and psychologists.

Self-care at home

• Encourage rest when tired, but also gentle activity like short walks when feeling okay – listen to your body.
• Break tasks into small, manageable chunks – for example, do homework for 10 minutes then rest.
• Keep a diary of symptoms to see patterns and what helps.
• Stay hydrated and eat regular, balanced meals.
• Get good sleep: keep a regular bedtime, avoid screens before bed, and make the bedroom calm.

Medical treatments

Treatment is tailored to the person. For headaches, simple pain relief (like paracetamol or ibuprofen) may be used – always ask your doctor or pharmacist for correct dosing. For breathing problems, breathing exercises or physiotherapy might be recommended. If your child has a lot of fatigue, a graded exercise program supervised by a specialist can help – this means slowly increasing activity over time. For mood changes, talking therapies like counselling may be helpful. Do not give any new medicine without consulting a healthcare provider.

When is surgery considered?

Surgery is not a treatment for long COVID itself. However, if long COVID leads to complications (like blood clots or heart inflammation), surgery might be needed for those specific problems. This is very rare in children.

Living with this condition

Long COVID can make normal activities harder. Your child may need more breaks throughout the day. They might not be able to do everything they used to do at once. It helps to plan the week with built-in rest time. Let your child know it is okay to stop if they feel tired or unwell.

Lifestyle tips

• Encourage a balanced routine with rest, light activity, and fun things to do.
• Set realistic goals – for example, walking for 5 minutes today instead of 30.
• Help your child stay connected with friends through calls or video chats if they cannot be together in person.
• Limit screen time, especially before bed, to improve sleep.

Diet and exercise

Eat a healthy, varied diet with plenty of fruits, vegetables, whole grains, and protein. Avoid too much sugar or caffeinated drinks. For exercise, gentle activities like walking, stretching, or yoga can help, but only if your child feels able. Do not push them – it is important to avoid 'overdoing it' because that can set recovery back. A physiotherapist can design a safe, gradual exercise plan.

Mental health and emotional wellbeing

Living with long COVID can be frustrating and upsetting for children. They may feel left out, sad, or worried about missing school and activities. It is normal to have these feelings. Encourage your child to talk about how they feel. If they seem very anxious or down, a GP or school counsellor can help. Reassure them that they are not alone and that things can get better.

Prevention

The best way to prevent long COVID is to avoid getting COVID-19 in the first place. However, even with precautions, it can still happen. Reducing the risk of severe illness may lower the chance of long COVID.

Vaccines

COVID-19 vaccines reduce the risk of severe illness and may also lower the chance of developing long COVID if a child does get infected. Speak to your doctor about vaccination for your child according to your local guidelines.

Screening programmes

There is no routine screening test for long COVID. If your child has had COVID-19 and develops new or ongoing symptoms, talk to your doctor. Early support can help manage symptoms and speed recovery.

Complications

If left untreated

• Persistent fatigue that affects school attendance and physical activity
• Trouble concentrating that makes learning difficult
• Mood changes like anxiety or depression that may get worse without support
• Physical deconditioning (weakness) due to not moving enough

Long-term outlook

The outlook for children with long COVID is generally positive. Most children get better over time, often within 6 to 12 months. Some may have symptoms that last longer, but with the right support and care, many return to their normal activities. Researchers are learning more every day, and new treatments are being developed. You and your child are not alone – healthcare teams are here to help.

Find support

International organisations

• World Health Organization (WHO) – Long COVID information
• Long COVID Kids – International support group

Local organisations

• Your local GP or paediatrician · Global
• Long COVID clinic at your local hospital (ask your doctor for a referral) · Global

Helplines

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