Long COVID in children.

QUESTION: Several physicians in our family medicine clinic noted a recent increase in the number of children with nonspecific symptoms after having had COVID-19. Based on the assumption that these children may have long COVID syndrome, what is the recommended treatment? ANSWER: Lockdowns and isolation during the COVID-19 pandemic have affected the physical and mental health of children and adolescents. A recognized complication of COVID-19 is a post-COVID-19 syndrome (long COVID) that was initially reported in adults with an estimated prevalence of 10%. More recent reports on long COVID in children suggest a prevalence of 8% to 10%, but small cohorts, a range of symptoms, and challenges in defining the syndrome make accurately estimating the prevalence difficult. Furthermore, providers may find it challenging to differentiate between neuropsychiatric symptoms that are consequences of COVID-19 infection versus those that are a result of stress, anxiety, or changes in behaviour owing to restrictions associated with the pandemic. Until more evidence is available, management includes obtaining a detailed history, performing a comprehensive physical examination, and aiming to relieve symptoms while following up every 2 to 4 months.