Frequently Asked Questions about COVID-19 — August 24, 2022

“Shared expectations lead to predictability.”

583. Long Covid in children remains a threat while more research is needed.

         QIs long Covid a risk that students may face interrupting their school experiences?

         A:  While the public uses “long Covid” for shorthand, the scientific name is “post-acute sequelae of Covid,” or PASC. Researchers believe this is not a single disease but several distinct illnesses affecting many organ systems.  Scientists still do not know how the virus triggers such a wide spectrum of symptoms that can persist months after the initial infection.  Also not understood is why some of these symptoms show up in some patients but not in others, or what exactly the risk factors are for developing them.  But the most common long-term effects in children appear to be neurological.

In a recent study, one in ten children who have been hospitalized develops post-acute sequelae of Covid (PASC), or long Covid.  The study conducted by Lurie Children’s Hospital in Chicago, the University of California Davis School of Medicine, and the University of Calgary found nearly 10% of hospitalized children reported symptoms of PASC in the months after first contracting Covid.  PASC is defined as having symptoms that persist or return three months after initial infection, according to the World Health Organization.  The symptoms may have an impact on a person’s everyday function, although they may come and go, according to the study, which was recently published in the Journal of the American Medical Association.  As part of the eight-country study, researchers examined 1,884 children who initially presented to the emergency department and were followed up 90-days later. Long Covid (PASC) was found in nearly 10% of those who were hospitalized and also 5% of children discharged from the emergency department. Risk factors for the post-Covid condition included an initial hospitalization of 48 or more hours, four or more symptoms at the initial emergency department visit, and being at least 14 years of age or older. The most reported persistent symptoms were fatigue or weakness, cough, difficulty breathing or shortness of breath, according to researchers.

The most effective way for children to avoid contracting Covid-19 and reduce the possibility of PASC becoming a chronic condition that requires management for months or longer is to obtain vaccinations, and as appropriate and when available, receive booster shots that have been re-engineered to focus on the Omicron subvariant B.A.5.

Opinion 6:   Are CT and CDC back-to-school procedures sufficiently adequate?

According to research done on Covid-19 tests administered at Johns Hopkins Hospital, “Researchers estimated that those tested using a rapid at-home antigen test when the average patient began displaying symptoms of the virus, the false-negative rate was 38 percent.  The test performed best eight days after infection (on average, three days after symptom onset), but even then, had a false-negative rate of 20 percent.”  Many authorities have stated that the antigen tests may require a heavy viral load to report a positive test.  The assumption is that a negative test may indicate an infected person’s viral load is below that when a person could be passing it on to others.  But current research has not yet tested that assumption.

On August 16, the First Lady, Jill Biden, experienced symptoms of a cold coming on.  She took a rapid, antigen Covid test and it came back negative.  Because she is the First Lady, she routinely takes a more accurate PCR test that is processed in a laboratory. And the results later came back positive.  She began isolation and following CDC guidelines based on that PCR test.

The most recent CDC guidelines for parents to evaluate their children’s need to stay home if they might have Covid-19 were reported in FAQ 582 last week.  The new process is called “Test-Mask-Go.”  If a child has symptoms of a cold, such as infrequent coughing, congestion of a runny nose, doesn’t have a temperature over 100°F, and feels well enough to go to classes, he or she can go to school wearing a mask and participate in all activities with the other children.

If any parent feels the possibility that these steps are not adequate to prevent Covid-19 infection of others, they might consider sending their healthy children to school every day wearing a mask.  And be certain their child is vaccinated and if eligible, receives the soon-to-be-available booster shot.