Q: My son had COVID-19 a few months ago and seems to have some lingering effects. Should I talk to his pediatrician?
A: Millions of U.S. children and teens have tested positive for SARS-CoV-2, the virus that causes COVID-19. Fortunately, they have been less likely than adults, so far, to become very ill.
However, even if they had few or no symptoms, kids can develop a number of other conditions after the COVID-19 infection. Some are minor and may go away on their own. Others are more serious and may need treatment.
After a COVID-19 diagnosis, talk with your child’s doctor about lingering or new symptoms, and what to do. Your pediatrician also can help guide your child’s safe return to activities, such as sports.
Here are some symptoms and conditions that can affect children after COVID-19 that you should discuss with the pediatrician:
— 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 three months or longer. Children 6 years or older with ongoing symptoms may need lung function tests. Children with exercise-induced breathing problems that don’t go away may also need heart tests to rule out complications such as blood clots or abnormal heart function.
— 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% had signs of myocarditis on heart imaging, regardless of how severe their symptoms were during the infection. Symptoms of myocarditis may include chest pain, shortness of breath, irregular heartbeat, and fatigue. Children and teens who had COVID-19 infection and these symptoms within the last six months need an 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 ages 10 to 19 who have had COVID-19 experience changes to their smell and taste. This can have a negative effect on their eating habits and mood. It can also prevent them from noticing dangerous odors.
These symptoms typically go away in several weeks. If they don’t, your child’s doctor may recommend steps to test or help retrain these senses.
— Developmental issues: Active COVID-19 illness can affect the brain and, in rare cases, lead to stroke or encephalitis (brain swelling). Serious inflammation of the brain can lead to obvious difficulties in a child's daily function, but children who have had mild or moderate COVID-19 infection may still experience subtle changes in attention, speech, schoolwork, movement and mood. Your pediatrician may refer you for follow-up with a neurodevelopmental specialist, a speech language pathologist or physical or occupational therapists.