Coronavirus Chronicles — By Any Other Name, Just As Awful

masked face of young girl

The numbers are not considered statistically impressive (yet), but the children and youth who are affected by the coronavirus may be in for a much rougher time than anyone currently expects. In addition to now having an official name (post-acute sequelae SARS-CoV-2 infection) and an acronym (PASC), long-haul COVID is also known as post-acute COVID, or chronic COVID. Neither term is reassuring.

Post-acute just means “not in the hospital hooked up to machines.” One narrow usage of “chronic” refers to an illness lasting more than three months. In other health contexts it means of lengthy duration, persistently recurring, or forever. Another expression being used is “long-term,” and nobody knows what long means in this context.

Humankind has been learning about COVID-19 for only a couple of years, so its overall toxicity is an unknown quantity. One valid possibility, at least until we know a lot more, is that Long COVID could last for, like, 50 years. At this moment in time, its potential to ruin a person’s entire life has not been fully assessed.

Minimizing the danger to children from COVID-19

There is something terribly dismissive and uncaring about a bunch of adults going around saying “Oh, it’s not so bad for kids,” because we don’t know any such thing. Sure, the number of kids who have lost limbs to COVID is objectively quite small. But it is pretty significant to the kids involved. There is a certain callousness involved in discounting children’s pain, similar to telling a kid with a compound fracture to “walk it off.”

Here is another thing. Nobody knows the number of adults who have been infected by child carriers of the virus, which is a sensible reason for trying to limit the number of children who catch it. The grownups likely to be infected by children are the very grownups most needed by those children — their parents and other caregivers; their teachers; their mentors.

Some researchers have discovered what appears to be evidence that the virus can lurk in the body, undetectable by testing, for as many weeks or months as it pleases.

The light of distant stars

Then, it can pull a slick maneuver called recrudescence, and come roaring back in full potency. Or it launches a series of surprise attacks on different systems and organs. This could prove to be a huge obstacle for the young person who has a sport to train for, or a batch of college applications to prepare.

The Long COVID’s bag of tricks holds another twist. When adults suspect they have it, they can hark back to a positive test or at least to an increasingly well-documented pile of symptoms. But children, says writer Dyani Lewis, “rarely experience severe initial symptoms of COVID-19.” So when a child turns up with a motley list of improbable problems, there might be no apparent relation to the length or severity of their COVID infection. The fact that they ever had a case of the virus might not even have been initially recognized.

In order for Long COVID to be treated, it first has to be identified, and this can be a difficult step for many reasons. The non-acknowledgment of an initial case of COVID-19 is only one, and that itself can stem from various causes, like the unavailability of test kits or the lack of institutions and personnel able to administer them. Much as we hate to face this, in some jurisdictions, record-keeping and reporting are not as accurate as we might wish.

Within a family, there might be one main, very sick patient, who absorbs all the attention and concern, making it less likely that a child’s long-lasting symptoms will be noticed. There might be a parent who believes the child is malingering. It all makes for a very complicated situation.

Your responses and feedback are welcome!

Source: “Long COVID and kids: scientists race to find answers,”, 07/14/21
Image by Nenad Stojkovic/CC BY 2.0

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
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Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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