Tackling the long tail of Covid
Derren Hayes
Tuesday, June 29, 2021
Paediatric long Covid hubs are to co-ordinate therapeutic support to help children recover from the disease.
There are growing concerns about the long-term impact that contracting Covid-19 can have on children, with some campaigners warning that tens of thousands of young people could be left with additional education and health support needs.
As understanding among clinicians about the virus has grown, there is increasing recognition that, like adults, children can experience enduring symptoms too, with these ranging from minor rashes through to cognitive impairment.
In response, the government announced last month (June) plans to create a network of 15 specialist paediatric long Covid hubs based in hospitals in England’s major cities to co-ordinate support for children and young people (see list below). These hubs will also engage with education, mental wellbeing and public health services to ensure support is linked to children’s wider needs.
The announcement comes as cases of the more infectious Delta variant of Covid-19 increase in the UK, with latest Office for National Statistics (ONS) data showing the proportion of primary-age school children and older teenagers testing positive is rising fast.
The ONS data also shows 7.4 per cent of children aged two to 11 and 8.2 per cent of those aged 12-16 report continued symptoms. However, Dr Liz Whittaker, consultant in paediatric infectious diseases and immunology at Imperial College London, which is involved in the London hub, says other studies have shown lower rates.
“It is a new condition and we don’t know how many young people are affected,” she says. “It depends on who and what you ask, and when and how you ask it.”
However, Sammie McFarland, founder of support group Long Covid Kids thinks the proportion of children affected by long Covid could be higher than the ONS estimates because of undiagnosed cases due to lack of awareness.
Italian research into long Covid in children found more than half of children aged between six and 16 who got the virus had at least one symptom lasting more than 120 days. McFarland estimates that up to 240,000 children may need support with long Covid.
“The mean age for children with long Covid is 10,” says McFarland. “No child is immune to Covid and every child is at risk of long Covid. We need an awareness campaign about what the effects are of Covid on children.”
Dr Whittaker, who is a member of the Covid expert advisory group at the Royal College of Paediatrics and Child Health, explains that in addition to developing effective interventions an important role for the hubs will be to work with paediatricians and GPs to gather data on prevalence.
Symptoms and impact
Long Covid Kids has compiled a list of the most common symptoms children report, including chronic fatigue, gastrointestinal problems and severe headaches.
However, McFarland says children also report mental health problems including intrusive thoughts, overly sexualised behaviour and obsessive compulsive disorder.
Dr Whittaker also highlights the anxiety it induces in sufferers due to the debilitating nature of some of the symptoms, some of which needs psychological support to manage.
“It is normal to experience anxiety,” she says. “As well as pharmacological treatment and rehabilitation, psychological support is also needed.”
Long Covid Kids is in contact with 3,000 children affected by the condition, some with mild symptoms, but others whose lives have been turned upside down. McFarland says some of the children supported by the network have suffered severe developmental regression resulting in being unable to go to school or undertake everyday activities.
“A lot of these children have been in bed for months, some are in wheelchairs, others have verbal ticks,” says McFarland. “It’s really going to affect their education and I expect many will be in need of support from special educational needs and disability services.”
Types of support
Dr Whittaker says the new long Covid hubs will focus support on children with severe symptoms who are struggling to engage with education.
While hubs may have different approaches, she expects GPs to identify children who present with long Covid-like symptoms and, if severe, refer them for an urgent review by a hub paediatrician, who can then arrange for early access to therapeutic services.
So far, the number of children referred for specialist support is low, says Dr Whittaker, adding that it is unclear whether this is due to a lack of need or it going unrecognised by health and care practitioners. As such, she says an awareness programme is needed.
Long Covid hubs for adults have been successful in helping people recover, which is good news for children, says Dr Whittaker.
“Adults with long Covid, who have more severe disease, clearly show recovery, which is reassuring,” she says. “Studies show children also respond well to support, so it is important they get access to that.”
PAEDIATRIC LONG COVID HUB SITES
- Newcastle
- South Tees
- Sheffield
- Leeds
- Hull
- Liverpool
- Manchester
- Birmingham
- Leicester
- Cambridge
- Bristol
- Oxford
- Portsmouth
- Southampton
- London
Source: NHS England
Further reading