What are the specific symptoms of Post-COVID-19 Condition in children?
Post-COVID-19 Condition (PCC), also called Long COVID, can affect children and adolescents even after a mild case of COVID-19. Symptoms are varied and can last for months, sometimes interfering with daily activities. While many children recover within a few months, some experience persistent symptoms that require medical attention. The most common symptoms include fatigue, trouble thinking or concentrating, and breathing problems.
What the research says
A 2024 review in the European Journal of Pediatrics reports that frequent symptoms in children and adolescents include fatigue, exertion intolerance, and anxiety 8. Some children develop postural tachycardia syndrome (PoTS), a condition causing rapid heartbeat upon standing, and a small number meet criteria for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) 8. A systematic review of pediatric PCC notes that symptoms can affect multiple body systems, including the brain, lungs, heart, and gut, and may involve immune system changes and inflammation 4.
Respiratory symptoms are common. A 2023 study of 184 children with PCC and respiratory complaints found that 11% had mild airway obstruction on lung function tests, and 22% had elevated exhaled nitric oxide, a marker of airway inflammation 9. Symptoms like cough and shortness of breath were frequent, but lung volumes and gas exchange were normal in nearly all children 9. Another study of English schoolchildren found that 1.8% of primary school pupils (ages 4-11), 4.5% of secondary school pupils (ages 11-16), and 6.9% of older teens (ages 16-18) met the definition of PCC in March 2022 10. Specific symptoms such as anxiety and difficulty concentrating were reported by many children regardless of prior infection, but loss of smell and taste, cardiovascular symptoms, and some systemic symptoms were more common in those who had tested positive for SARS-CoV-2 10.
A meta-analysis comparing PCC to other post-viral syndromes found that only a subset of outcomes—like fatigue, memory loss/brain fog, and palpitations—were more frequent after SARS-CoV-2 infection, suggesting many symptoms may be similar to those after other respiratory viruses 3. This highlights the importance of careful diagnosis to rule out other causes.
What to ask your doctor
- Could my child's fatigue or trouble concentrating be related to a past COVID-19 infection, even if the illness was mild?
- What tests can help rule out other conditions that might cause similar symptoms, such as asthma, allergies, or anxiety?
- Are there any specialists (like a pediatric pulmonologist, cardiologist, or neurologist) who should be involved in my child's care?
- What strategies can help my child manage post-exertional malaise (worsening of symptoms after activity) and gradually return to school and play?
- How long do these symptoms typically last in children, and when should I seek further evaluation if they persist?
This question is drawn from common patient questions about Pediatrics and answered using cited medical research. We do not provide individualized advice.