Over the months, the prolonged forms of Covid-19 have multiplied and are now part of the daily practice of healthcare professionals. But, the prolonged forms of the disease do not only affect adults. The long Covid can also be declared in children and adolescents. The High Authority for Health (HAS) has just published a sheet for health professionals to help them identify and care for these children. Explanations.
Child and adolescent long Covid
Children, and to a lesser extent adolescents, have long been considered relatively spared from severe forms of Covid-19. What regarding prolonged forms of SARS-CoV-2 infection? According to available studies, the proportion of children and adolescents affected by a long Covid would vary from 2 to 5%. Long Covid in children is associated with a long list of possible symptoms:
- Headaches ;
- Sleep disturbances;
- Weight loss;
- Concentration problems;
- Diffuse joint pain;
- A cough chronic;
- Abdominal pain;
- From dizziness;
- Fatigue and exercise intolerance;
- Chest pain.
These symptoms, often associated, can alter the daily life of the child and in particular his schooling. The identification and care of the child or adolescent with long Covid is a key issue. Hence the interest of the sheet published by the HAS.
Diagnose as early as possible…
Early diagnosis of a prolonged form of long Covid is an essential prerequisite for better care of the child or adolescent.. For this, the health professional must take into account:
- The history and duration of symptoms;
- The context of occurrence;
- Clinical examination;
- Differential diagnoses (other possible causes of observed symptoms).
Once the long Covid has been diagnosed, an additional assessment is recommended by the HAS to detect a possible complication of the infection (injury to the myocardium or pericardium, PIMS (pediatric multi-system inflammatory syndrome), etc.) or to highlight a potential other pathology (autoimmune disease, inflammatory disease, thyroid pathology, diabetes …). This assessment occurs for children or adolescents whose symptoms persist beyond one month following infection with SARS-CoV-2.
… to better take care of the child or adolescent
Given the wide range of possible symptoms, which vary in number, intensity and duration, HAS recommends global, multidisciplinary and personalized care, to be instituted as soon as the diagnosis is made. This support meets five objectives:
- Define personalized objectives adapted to the situation of each child, both medically, but also at school, family or social;
- Reassure the child and his relatives by accompanying and supporting them at each stage;
- Adapt the child’s activities to his state of health, with a view to a gradual return to normal life;
- Limit as much as possible the consequences on the daily life of the child;
- Prescribe the most suitable drug or non-drug treatments for each child.
This care, which can last several months, must be continuously adapted to the needs of the child, the evolution of his symptoms and his abilities. If the long Covid concerns a severe form of the disease, follow-up in a hospital setting may be necessary at least initially. This sheet, which will be updated as knowledge regarding Covid-19 is acquired, is an important tool for health professionals dealing with children and adolescents who are victims of long Covid.
Estelle B., Doctor of Pharmacy
Sources
– COVID-19 rapid responses Prolonged symptoms following child and adolescent Covid-19 rapid response method. has-sante.fr. Accessed March 24, 2022.
