Long COVID in Kids: Signs, Symptoms, and Treatment

Kids don’t get serious illness from a COVID-19 infection as often as adults. But kids can still have complications from COVID. Some people who develop COVID infection can experience long-term effects, or long COVID. Anyone who has had a COVID infection is at risk for this condition — and that includes toddlers, children, and teenagers. Here, we go over the signs of long COVID in kids, as well as treatment options.

What is long COVID?

Long COVID happens when you have new or worsening COVID symptoms that occur 3 months or more after originally having COVID, per the definition from the National Institutes of Health (NIH). The timeline of these symptoms is important because COVID usually only lasts a few days or weeks in kids. The definition of long COVID is the same for kids as it is for adults.

How common is long COVID in kids?

Researchers are still learning how often long COVID affects kids. Among children who have had COVID infection, estimates suggest that 10% to 20% may experience long COVID. 

But reports vary quite a bit. That’s likely because COVID can cause many different types of symptoms. Plus, it’s difficult to accurately track long COVID because some kids never showed symptoms of COVID in the first place.

Long COVID is less common in children and adolescents than it is in adults. This is partly because COVID infection itself is less common in young people. But, even among people who’ve had a COVID infection, the risk of long COVID is higher in older age groups.

What are the symptoms of long COVID in kids?

Just as symptoms of COVID infection can vary widely, so can symptoms of long COVID. Experts believe it affects multiple areas of the body. There are over 200 recognized symptoms of long COVID. Here are a few common areas long COVID can affect. 

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Lungs

Respiratory issues are the most common symptoms of a typical, short-term, acute COVID infection. They’re also some of the most common long-lasting symptoms.

Respiratory symptoms that can be part of long COVID include:

• Chest pain

• Cough

• Exercise-induced shortness of breath

Heart

COVID infection can affect the heart in different ways, although the issue is usually myocarditis. Myocarditis is inflammation of the heart muscle. It can occur as part of the initial illness or with long COVID.

Symptoms of myocarditis can include:

• Chest pain

• Shortness of breath

• Arrhythmias

• Fatigue

In more severe cases, myocarditis can lead to:

• Heart failure

• Heart attack

• Stroke

• Sudden cardiac arrest

Nervous system 

Children with long COVID can also experience neurologic problems. They may have cognitive delays that affect academics, behavior, or speech and language. This could be due to nervous system injury from COVID-related inflammation. 

“Brain fog” is a common complaint after COVID infection in adults. It can also affect children and adolescents. Brain fog is a generic term that describes symptoms of:

• Unclear thinking

• Problems paying attention

• Trouble with concentration or memory

In one study, about 1 in 10 kids with long COVID experienced brain fog.

Loss of smell and taste is another neurologic problem that can occur with long COVID. Up to 1 in 4 children may experience changes in smell or taste when they have COVID infection. Though these changes can last for months in adults, they typically improve over a few weeks for children.

Mental health

Researchers have found many mental health effects of long COVID. Psychological symptoms include:

• Mood changes

• Trouble sleeping

• Anxiety

• Depression

• Thoughts of suicide

Mental health symptoms are common after COVID infection and it’s important to pay attention to them. Anyone with signs of depression or anxiety should get help and support from a healthcare provider.

Other symptoms

One of the most challenging features of long COVID is the long list of possible symptoms. In a recent study of children ages 6 to 11 years old with long COVID, the most common symptoms included:

• Trouble with memory or focusing

• Back or neck pain

• Stomach pain

• Headache

• Fears

• Refusal to go to school

• Skin rashes

• Trouble sleeping

• Nausea or vomiting

• Lightheadedness or dizziness

Among teenagers ages 12 to 17 years old, the most common symptoms tied to long COVID were:

• Change or loss of smell or taste

• Bone, muscle, or joint pain

• Back or neck pain

• Low energy

• Feeling tired all day or after walking

• Trouble with memory or focusing

• Lightheadedness or dizziness

• Headache

These symptoms can occur even when there aren’t other signs of COVID affecting the lungs, heart, or mental health.

What are the long-term health effects of COVID in children?

Compared to adults, kids with short-term COVID infection often have no symptoms. When they do get sick, their symptoms can be quite mild. And life-threatening complications from COVID are rare in kids. That means COVID infection carries a relatively low risk in the short term. 

But, sometimes, infection in children brings long-term effects. In addition to long COVID, children can be at risk for multisystem inflammatory syndrome (MIS-C).

What is multisystem inflammatory syndrome (MIS-C) in children after COVID?

Multisystem inflammatory syndrome (MIS-C) in children is a rare but serious complication of COVID infection that occurs 2 to 4 weeks after an active infection. Widespread inflammation can cause multiple organ systems to fail, which can lead to death.

Healthcare professionals diagnose MIS-C based on the history of a child’s illness and a clinical exam. Diagnostic testing for MIS-C may include:

• Vital signs

• Blood work

• Chest X-ray

• Electrocardiogram (EKG)

Signs of MIS-C include fever that won’t go away, abnormal lab test results, and evidence of organ dysfunction or shock.

There’s no specific treatment for MIS-C. So, your care team will focus on managing systems to help your child feel as comfortable as possible. They may recommend steroids to help with inflammation. Steroid treatment and medications that modify the immune system may help with the effects of inflammation. 

It’s best to identify and treat MIS-C early. Contact a healthcare professional right away if your child has recently recovered from COVID and develops a new fever along with any of the following:

• Red or bloodshot eyes

• Skin rash

• Swollen lips or tongue

• Swollen hands or feet

• Severe pain in the belly, vomiting, or diarrhea

• Problems with blood clotting

• Confusion or inability to stay awake

How do doctors diagnose long COVID in kids?

No specific lab test can diagnose long COVID. There’s also no definitive way to say whether symptoms are from long COVID or something else. 

Long COVID can cause a wide range of symptoms that change over time. So, it’s important to work closely with your healthcare team to watch ongoing symptoms and explore any new ones that develop.

What is the treatment for long COVID in kids?

There’s no treatment that cures long COVID. Instead, treatment aims to help with managing specific symptoms and supporting kids while they recover. 

Depending on the type and severity of symptoms, management may require a team approach. This may include things like:

• Additional medications

• Mental health support

• School support

• Physical therapy

• Rehabilitation services

• Specialty care 

How long does it take children to recover from long COVID?

Each child with long COVID has a different recovery time, depending on their symptoms. There’s also a wide range in terms of when symptoms of long COVID start and how long they last. 

For some people, long COVID can last from weeks to months. Others may have long COVID symptoms more than 1 year after a COVID infection. And some people don’t even develop symptoms of long COVID for months after an initial COVID infection. Research to learn more about long COVID and its effects is ongoing.

Why trust our experts?

Written by:

Louisa Salisbury, MD

Louisa Salisbury, MD, is a licensed, board-certified general pediatrician. She received a bachelor’s degree in human development from the University of California, San Diego, and obtained her medical degree from the University of Vermont Robert Larner College of Medicine.

Edited by:

Alex Eastman, PhD, RN

Alex Eastman, PhD, RN, is a California-based registered nurse and staff medical editor at GoodRx, where he focuses on clinical updates and Latino health.

Reviewed by:

Kerry R. McGee, MD, FAAP

Kerry McGee, MD, FAAP, has over a decade of experience caring for babies, children, and teenagers as a primary care pediatrician. She has a special interest in adolescent health, particularly in adolescent mental health.

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