Thread by @DrZoeHyde

Long COVID is real, and we need to protect children from it. In Israel, long COVID clinics for children are busy. The clinic at the Schneider Children’s Medical Center in Petah Tikva has about 150 patients and hundreds more are waiting for treatment. 🧵
haaretz.com/israel-news/th…

Liat Ashkenazi-Hoffnung, a clinic doctor says that in some children long COVID "appears as a direct continuation of severe illness but in very many of the children, there is a severe illness, followed by a lull of several months and only then do the symptoms of long COVID begin."

Many children fully recover, but it can take time.

Ashkenazi-Hoffnung says "we had a boy here who was a competitive swimmer and came down with long COVID and was very anxious and in pain. After half a year he went back to swimming and even broke a personal record."

But some children experience protracted symptoms.

The doctor goes on to say that "a few children ... a year after the illness, haven’t recovered, and they have symptoms that are affecting their day-to-day functioning. There are cases in which it lasts for more than a year."

Interestingly, about 15% of the children at the clinic have no antibodies to SARS-CoV-2, even though they tested positive on a PCR test.

This shows we need to be careful when designing studies to explore how common long COVID is. The control group may not be true controls.

Dr Ashkenazi-Hoffnung thinks that the prevalence of long COVID is underestimated, although she cautions that "not all symptoms have the same significance. The essential question is whether it affects functioning."

She says, "[f]ifteen percent of the children ... trained in various sports for three or four hours a day six days a week, and after the coronavirus they can’t even walk for five minutes. Their parents and sometimes the doctors don’t always connect this to the coronavirus."

"These children aren’t spoiled or depressed – they are dealing with physical damage that is part of long COVID and they want to go back to their activities."

The lack of understanding of long COVID is causing cases in children to be missed or misdiagnosed.

"[D]octors are telling parents it’s psychological, or the child is spoiled, or they should wait and it will pass and they aren’t diagnosing the symptoms," says Ashkenazi-Hoffnung.

It's also causing children to undergo unnecessary tests in some cases.

"For example, a child who was experiencing dizziness came to us after a series of tests and was diagnosed as suffering from vertigo and was sent to an ear, nose and throat doctor."

Symptoms that some people perceive as minor are actually causing significant problems for some children.

"We are seeing children coming in with very significant nutritional deficits because of the loss of the sense of taste or its incomplete return," says Ashkenazi-Hoffnung.

"There are children who smell the smell of burning or for whom the tastes of foods that had been familiar to them have completely changed. This is a common phenomenon, and it leads to very picky eating and weight loss."

But doctors have been able to find treatments that help some children.

"We have found that many of the children, at least a third of them, suffer from shortness of breath and giving them an inhaler, even if they don’t have asthma, helps some of them," says Ashkenazi-Hoffnung.

Dr Liat Ashkenazi-Hoffnung and her colleagues have published a study on some of their patients.

You can read it here: journals.lww.com/pidj/Abstract/…