Post-COVID Syndrome
Most of us think of viruses like we think of the common cold or a gastrointestinal bug: a brief inconvenience that gets better in a few days. But sometimes even common viruses inflict significant and in some cases permanent damage to the bodies and lives of infected people.
Take enterovirus, for instance, which typically causes mild sniffles and perhaps a cough in most people. However, in rare cases, one strain of enterovirus (EV-D68) can also attack the nervous system and cause acute flaccid paralysis (AFM) in children, potentially leading to permanent muscle weakness and lifelong disability.
30 or 40 years after suffering an infection with poliovirus — a devastating pathogen nearly eradicated by global immunizations programs but recently enjoying a comeback — significant muscle weakness and disability can return as post-polio syndrome.
Sometimes a virus stays dormant in the body after the initial symptoms resolve, only to come to life years and even decades later to wreak further havoc. Shingles is a great example of the chickenpox virus (varicella-zoster, also known as human herpesvirus 3) laying low for decades after a childhood infection before inflicting great pain and suffering as we get older. (Two vaccines — one given to children (Varivax), the other to adults (Shingrix) — are highly effective in preventing shingles.)
Subacute sclerosing panencephalitis (SSPE) is a rare but fatal complication of infection with the measles virus (rubeola) that injures the brain years later. (Childhood vaccinations with the MMR vaccine prevent this tragic outcome.)
Our shared experience with coronavirus (SARS-CoV-2) tells us that getting sick with COVID-19 might not be the end of the story, even after many of the initial symptoms get better. Andrew Gregory worries the prolonged suffering resulting from long-COVID is “devastating the lives and livelihoods of tens of millions of people.”
Covid has killed almost 6.5 million people and infected more than 600 million. The WHO estimates that 10% to 20% of survivors have been left with mid- and long-term symptoms such as fatigue, breathlessness and cognitive dysfunction. Women are more likely to suffer from the condition.
With the absence of evidence about how best to treat it, long Covid is turning people’s lives upside down, and many face “often lengthy” and “frustrating” waits for support or guidance, [WHO director general] Tedros said. The large numbers of those cruelly affected by the long tail of Covid are also having a dangerous impact on health systems and economies still reeling from waves of infections.
Frances Stead Sellers finds reasons to be alarmed about long-COVID in the results of a recent study:
Dr. Benjamin Mazer is also worried about long-COVID but thinks medium COVID is more dangerous:
I am still afraid of catching COVID. As a young, healthy, bivalently boosted physician, I no longer worry that I’ll end up strapped to a ventilator, but it does seem plausible that even a mild case of the disease could shorten my life, or leave me with chronic fatigue, breathing trouble, and brain fog. Roughly one in 10 Americans appears to share my concern, including plenty of doctors. “We know many devastating symptoms can persist for months,” the physician Ezekiel Emanuel wrote this past May in The Washington Post. “Like everyone, I want this pandemic nightmare to be over. But I also desperately fear living a debilitated life of mental muddle or torpor.”
Even the most familiar maladies of “long COVID”—severe fatigue, cognitive difficulties, and breathing trouble—tend to be at their worst during the medium post-infection phase. An early analysis of symptom-tracking data from the U.K., the U.S., and Sweden found that the proportion of those experiencing COVID’s aftereffects decreased by 83 percent four to 12 weeks after illness started.
The American Academy of Pediatrics refers to symptoms persisting after the acute phase of COVID-19 as post-COVID syndrome. Complaints and conditions that can affect children and teenagers in the weeks and months after acute symptoms subside include:
• Breathing problems. Because COVID-19 most often affects the lungs, lingering respiratory symptoms are not uncommon. These may include chest pain, cough, and more trouble breathing during exercise. Some of these symptoms can last for 3 months or longer.
• Cardiac issues. Myocarditis, an inflammation of the heart muscle, can develop after COVID-19 (and in extremely rare cases, receiving mRNA vaccines). One study of adult patients who recently recovered from COVID-19 suggested that 60% of them had myocarditis, regardless of how severe their COVID symptoms were during the infection. Symptoms of myocarditis may include chest pain, shortness of breath, irregular heartbeat and fatigue. Children and teens who had moderate or severe symptoms within the last 6 months need a thorough exam, including heart tests, before returning to school or sports activities.
• Smell and taste. As many as 1 out of 4 children and teens age 10 to 19 years of age who had COVID experience changes to their sense of smell and taste. This can have a negative effect on their eating habits and mood.
• Developmental issues. Acute COVID-19 illness can affect the nervous system and, in rare cases, lead to stroke or encephalitis (brain swelling). Children who’ve had COVID-19 may experience subtle changes in attention, speech, school work, movement and mood.
• Mental fatigue. “Brain fog”—unclear or “fuzzy” thinking, concentration, or memory—is a frequent complaint among adults who’ve had COVID-19. Children and teens may have similar symptoms. Your child may seem more forgetful or have trouble paying attention. They may be slower at reading and need more repetition and breaks while learning.
• Physical fatigue. After SARS-CoV-2 infection, children and teens may tire more easily and have less physical endurance, even if they had no heart or lung symptoms from the virus.
• Headaches. Headache is a common symptom during and following SARS-CoV-2 infection.
• Mental and behavioral health. Having had COVID-19 can affect a child’s mental health. For children with existing mental/behavioral illness, events surrounding COVID-19 (hospitalization, isolation, absence from school activities) may also make symptoms worse.
• Multisystem inflammatory syndrome in children (MIS-C) is a rare complication that typically happens 2 to 6 weeks after SARS-CoV-2 infection. Vaccination with two doses of the Pfizer-BioNTech is reported to prevent MIS-C in kids 12 to 18 years old. In addition, all of the critically ill MIS-C patients who required life support in a recent study were unvaccinated. If your child has symptoms such as fever without an obvious cause after having COVID-19, talk with your pediatrician.
• Symptoms of diabetes, including frequent urination, increased thirst, increased hunger, weight loss, tiredness or fatigue, stomach pain and nausea or vomiting, have been reported in some children and teens who had COVID-19.
• Long-haul COVID-19 is a general term that covers physical and mental health symptoms some patients experience 4 or more weeks after SARS-CoV-2 infection.
Read more about post-COVID conditions in children and teenagers and how to recognize and relieve some of the symptoms here. One hopes this information will help parents who have so far been reluctant to get their infants and children immunized and protected against this brutal pandemic virus to give their pediatricians a call and schedule the safe and highly effective vaccines as soon as possible (along with a seasonal flu vaccine, of course, and preferably before the holidays).
source http://www.thepediablog.com/2022/10/18/post-covid-syndrome/
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