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experts are learning how seemingly mild cases of COVID-19 have turned into debilitating
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While most people with severe COVID-19 were adults, experts are learning how
seemingly mild cases of COVID-19 have turned into debilitating cases of long-haul
COVID-19.
fatigue
trouble concentrating
shortness of breath
muscle aches
depression
anxiety
Symptoms may appear weeks after the initial infection, even if the initial infection is
mild or asymptomatic. The symptoms may also change over time.
In these cases, many children have seemingly mild cases that then lead to long-haul
COVID-19, which can be debilitating.
Researchers are still working to uncover the cause of long-haul COVID-19 and
identify the most effective treatment approaches.
Molly Burch was 16 years old in March 2020, when she first developed symptoms of
COVID-19.
“She started with a little cough on March 8, and then by March 9, that cough was
getting worse and she had a fever,” Molly’s mother, Ann Wallace, told Healthline.
Over the next 3 weeks, Molly’s symptoms got worse before they got better.
After her initial infection had passed, some of her symptoms lingered on, and months
later, new symptoms appeared.
“I thought she was better, but in August, her symptoms came back with new shortness
of breath,” said Wallace. “I remember because it was her birthday; she was having
trouble breathing, and it was incredibly alarming.”
Molly’s acute illness may have subsided, but the teenager never fully bounced back.
Walking up the stairs now leaves Molly out of breath. A day at school leaves her
exhausted.
Her symptoms are consistent with long-haul COVID-19, in which symptoms last for
weeks or months after someone first contracts the virus that causes COVID-19.
“I feel like in the past week, she’s better than she was the week before,” said Wallace.
“But you never know with long COVID. You can think you’re in the clear and then be
slammed.”
Testing capacity was very limited when Molly became sick in March 2020. Her
doctor presumed she had COVID-19 based on her symptoms, but she didn’t meet the
narrow testing criteria that were in place then in her home state of New Jersey.
“Molly had not been out of the country. She did not have contact with a known case
of COVID. And she had a fever and a cough, but no shortness of breath,” recalled
Wallace.
More than a week after Molly got sick, Wallace also developed symptoms of COVID-
19.
Both of them were finally tested on March 22: Wallace’s results were positive, but
Molly’s were negative.
That doesn’t mean that Molly didn’t have COVID-19. By the time she got tested, she
was weeks into her illness — at a point where the virus is often no longer detectable.
“The place where we got tested said, ‘Molly is presumed positive,’” said Wallace.
“The doctor had initially said, ‘We think it’s COVID,’ and my positive test gave
further credence to that.”
“It’s not that people haven’t offered help. It’s that in the beginning, there was really
no help to offer,” Wallace said.
“And it’s still maddening, the difficulty getting care for people with long COVID,”
she said.
Over the past year, more specialized clinics have opened up across the country to
provide rehabilitation support to people recovering from COVID-19.
“We started noticing children who have had lingering symptoms from COVID, and
there wasn’t a lot of data on it or resources to help some of these kids,” said Dr.
Daniel B. Blatt, a pediatric infectious disease specialist at the clinic. “So we decided
to create our own clinic to not only treat these children but also investigate the
nuances of the syndrome.”
Long-haul COVID-19 causes general symptoms, which means they are similar to
those of other conditions. For example, fatigue and shortness of breath may be caused
by a variety of infections.
“One thing that we’re really good at as infectious disease doctors is teasing out
whether it is long COVID or a different infection that can look like long COVID,”
said Blatt.
“Then we’ll either have the patient come back and follow up in our clinic or we’ll
refer them out to different sub-specialists depending on what their symptoms are,” he
continued.
Molly’s doctor has recently ordered chest X-rays and referred her to a cardiologist.
Offering emotional support
To help children and families cope with long-haul COVID-19, Blatt said that one of
the most important things that a healthcare professional can provide is emotional
support and reassurance.
“Almost everyone we’ve had so far with long COVID gets better with time,” said
Blatt. “It’s scary and frustrating to have lingering symptoms, but the reassurance that
they will get better helps with a lot of the anxiety.”
Emotional support is also a key aspect of the care that Noah Greenspan, DPT, CCS,
EMT-B, provides to patients at the COVID-19 Rehabilitation and Recovery Center at
H&D Physical Therapy in Manhattan, New York. Greenspan is a cardiopulmonary
and complex medical physical therapist and founder of the Pulmonary Wellness
Foundation.
Greenspan has been treating Wallace’s own persistent symptoms following COVID-
19, while also offering her support in managing her daughter’s health needs.
“One thing that Noah has offered is this awareness of how families are impacted, how
I’m impacted by my daughter’s health, and how helping her get better is also helping
me,” Wallace said.
Stepping up as a community
Children with long-haul COVID-19 need support from other community members as
well, including school personnel.
“I think we need school leaders to be mindful of kids who’ve had COVID, so they’re
not pushed too hard,” Wallace said.
Molly’s school has recently adopted a hybrid learning approach, which means she has
in-person classes 2 days a week and online classes the rest of the time. The academic
demands have been hard for her to manage.
“Several weeks in a row, she went in to school on Wednesday and then could not get
out of bed on Thursday,” said Wallace. “You know, the effort of going to school just
knocked her out.”
Even when Molly attends classes online from home, it requires energy that she only
has in short supply.
“We need accommodations, even when kids are learning from home,” said Wallace.
“In a kid’s life, being sick for a year is a huge deal,” said Wallace. “Think of all the
developmental milestones and social milestones that kids go through in the course of a
year.”
Blatt told Healthline that the only way to avoid getting long-haul COVID-19 is to do
what you can to avoid getting COVID-19 in the first place.
“And the best way to not get COVID is to get vaccinated,” he said.
The more adults and older children get vaccinated, the more protection that may
provide to younger children.
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