Effective Strategies for Managing Pediatric Long COVID Symptoms

Key Findings on Long COVID in Pediatric Populations

Recent studies have indicated that children are not immune to the long-term effects of COVID-19. An observational, prospective, longitudinal, multicenter study conducted in Italy revealed that 68.6% of children reported at least one post-COVID symptom, with 16.2% experiencing long COVID (Esposito et al., 2025). The most common symptoms included respiratory issues (43.4%), neurological and cognitive dysfunction (27.7%), gastrointestinal issues (22.1%), fatigue (21.6%), and sleep disturbances (18.8%).

Age and gender differences were significant, with older children and females more prone to cardiovascular and neurological issues, suggesting a need for tailored interventions based on demographic factors. The study highlights that while the occurrence of long COVID in children is less frequent than in adults, the persistence of symptoms can lead to significant challenges in their daily lives (Esposito et al., 2025).

Symptoms and Treatment Approaches for Pediatric Long COVID

Children with long COVID may manifest a range of symptoms that require varying management strategies. Effective symptom management for pediatric long COVID should encompass a multidisciplinary approach that includes medical, psychological, and educational support.

1. Medical Management:

   • Respiratory Therapy: For children experiencing respiratory symptoms, pulmonary rehabilitation may be beneficial. This includes breathing exercises, pulmonary hygiene, and possibly bronchodilators if indicated.
   • Cognitive Rehabilitation: For those with neurological and cognitive symptoms, cognitive rehabilitation strategies can aid recovery. This may include structured cognitive exercises and gradual return to academic activities under supervision.

2. Psychological Support:

   • Counseling Services: Children may experience anxiety and depression due to the ongoing health challenges. Access to counseling services can provide emotional support and coping strategies.
   • Support Groups: Connecting with peers who are experiencing similar challenges can foster a sense of community and support.

3. Educational Support:

   • Individualized Education Plans (IEPs): Schools should be encouraged to develop IEPs tailored to the needs of children with long COVID. This may include accommodations such as extended deadlines, reduced workloads, and additional tutoring.
   • Home Schooling Options: In cases where symptoms are severe, temporary home-schooling arrangements may be necessary to ensure continued education without exacerbating health issues.

4. Nutritional Support:

   • Balanced Diet: Ensuring a balanced diet rich in vitamins and minerals can support the immune system and aid recovery. Families should be educated on the importance of nutrition in managing long COVID symptoms.

5. Physical Activity:

   • Gradual Return to Activity: Encouraging light physical activity, as tolerated, can help improve overall well-being and reduce fatigue. A structured exercise program may be beneficial.

Implications of Pediatric Long COVID on Health and Education

The implications of pediatric long COVID extend beyond immediate health concerns. The long-term persistence of symptoms can hinder children’s educational progress and social development. Schools may face challenges in accommodating the needs of affected students, which can lead to increased absenteeism and academic underachievement.

Furthermore, the psychological impact of long COVID on children can result in increased rates of anxiety, depression, and social isolation. It is imperative that educational institutions collaborate with healthcare providers to develop comprehensive support systems that address both academic and emotional needs.

Table 2: Impact of Long COVID on Educational Outcomes

Future Research Directions for Long COVID in Children

Despite the growing body of research on long COVID in pediatric populations, significant gaps remain. Future research should focus on the following areas:

1. Longitudinal Studies: Long-term studies are needed to understand the full spectrum of long COVID symptoms and their impact on children’s health and development over time.

2. Intervention Studies: Evaluating the effectiveness of various treatment modalities, including psychological interventions, physical rehabilitation, and dietary management, will help establish best practices for managing pediatric long COVID.

3. Vaccine Impact Studies: Research is needed to assess the impact of COVID-19 vaccinations on the incidence and severity of long COVID symptoms among children.

4. Diverse Populations: Future studies should include diverse populations to better understand how socioeconomic, cultural, and geographic factors influence the prevalence and management of long COVID in children.

5. Biomarker Research: Identifying biomarkers associated with long COVID can facilitate early diagnosis and targeted interventions, improving outcomes for affected children.

Frequently Asked Questions (FAQ)

What are the common symptoms of pediatric long COVID? Common symptoms include respiratory issues, fatigue, neurological and cognitive dysfunction, gastrointestinal problems, and sleep disturbances.

How can parents support their children experiencing long COVID? Parents can support their children by ensuring access to medical care, psychological support, educational accommodations, and promoting a balanced diet and physical activity.

Is long COVID common in children? While long COVID is less common in children than in adults, studies indicate that a significant percentage of children do experience persistent symptoms following COVID-19 infection.

What should schools do to support students with long COVID? Schools should develop Individualized Education Plans (IEPs), provide counseling services, and create supportive environments for students recovering from long COVID.

What are the future research directions for pediatric long COVID? Future research should focus on longitudinal studies, intervention effectiveness, vaccine impacts, diverse populations, and identifying biomarkers for better management of pediatric long COVID.

References

1. Esposito, S., Puntoni, M., Deolmi, M., Ramundo, G., Maglietta, G., Poeta, M., Zampogna, S., Colomba, C., Suppiej, A., Cardinale, F., Bosis, S., Castagnola, E., Midulla, F., Giaquinto, C., Giordano, P., Biasucci, G., Fainardi, V., Nunziata, F., Grandinetti, R., Condemi, A., Raiola, G., Guarino, A., Caminiti, C. (2025). Long COVID in pediatric age: an observational, prospective, longitudinal, multicenter study in Italy. Frontiers in Immunology. https://doi.org/10.3389/fimmu.2025.1466201

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3. Ali, S. H., Fallon, N., Giesbrecht, T., Stancak, A., Roberts, C. A. (2025). Affective touch reduces histamine evoked itch experience. PLOS ONE. https://doi.org/10.1371/journal.pone.0319006

4. Ziv, S., Malik, L., Vardi, Y., Edwards, J. (2025). Red flags to suspect inborn errors of immunity in patients with autoimmune diseases. Biomedica. https://doi.org/10.7705/biomedica.7561

5. Crowley, J. P., Kelsen, J. R., Fang, J. F., Malik, L., Ziv, S. (2024). Allergic and immunologic evaluation of children with celiac disease. Frontiers in Pediatrics. https://doi.org/10.3389/fped.2025.1568174