Unpredictability of long Covid in children means frontline staff are dealing with a 'new beast', warns Cork paediatrician

Dr Niamh Lynch, a consultant in paediatrics at the Bon Secours Hospital in Cork, tells Sarah Horgan that there is no way to predict how children could be affected by a fourth wave of Covid-19
Unpredictability of long Covid in children means frontline staff are dealing with a 'new beast', warns Cork paediatrician

Dr Niamh Lynch, a consultant in paediatrics at the Bon Secours Hospital, in Cork City, is warning parents to be on high alert for long Covid-19 symptoms in their children, following a significant number of cases.

A CORK paediatrician has described how frontline workers are dealing with “a new beast” as more children fall victim to the debilitating effects of long Covid-19.

Dr Niamh Lynch, a consultant in paediatrics at the Bon Secours Hospital, in Cork City, is warning parents to be on high alert for long Covid-19 symptoms in their children, following a significant number of cases.

Dr Lynch said: “I am only seeing a tiny snapshot of the overall general picture. The people who are seeing these children the most are GPs.

“Only a portion of children go on to see a paediatrician. My GP colleagues tell me that the numbers of children they are seeing with lingering symptoms are quite high.”

She said that long Covid-19 is not the only threat to a child’s health.

“I have seen children with Covid, long Covid, and the late effects of paediatric multi-system inflammatory syndrome (PIMS-TS).

“Children with the latter were the sickest of all three. PIMS-TS is not long Covid, but, rather, a delayed reaction to the illness that can affect the heart of children. It’s a very severe illness.”

“If a child gets PIMs we need input from Crumlin. It’s the only way to manage these children because it can be so severe sometimes that we have to transfer them to hospital.

“This is a very serious condition. Long Covid is obviously very unpleasant as well but PIMS-TS is an emergency situation.”

Dr Lynch said that some parents don’t initially make the connection between a previous Covid diagnosis and their child’s symptoms.

“This is totally understandable. There may have been another person in the house that was sick but the child seemed to come through the initial infection quite well. For a lot of families, it’s hard to remember back given that this was such a dark time.

“Many lost family members and it’s only when they sit down to think about it that they realise their child hasn’t been quite right.”

She said there is no way of telling how children might be affected in the event of a fourth wave.

“The elephant in the room is that there is a fourth wave that seems to be building at the moment. Everything I’m telling you now about the original Covid and alpha variant is limited because we don’t know what’s going to unfold with this new Delta variant.

“There are a lot of questions. Is it going to be more contagious among children or affect them more severely? Right now we don’t know any of that. We are operating blind and that’s why it’s so important that everything is done to make schools as safe as possible. Children have suffered a lot by not being able to go to school but by the same token, they have to be safe in order to reopen.

'NEW BEAST'

“Whatever I am saying to you now is only what we know about the old Covid. This is an entirely new beast. “

She stressed that this is was not something families could have predicted.

“We are gathering data all the time. It seems to be more prevalent in older children. How sick you are with Covid doesn’t predict whether you will get long Covid or not. Many children with long Covid only had a mild infection initially.

“An awful lot of children who have come to see me had Covid in the wave in January.

“Most of them have made a full recovery and it’s mentioned incidentally. However, it’s something for parents to be aware of because so many children had the infection over Christmas.

Dr Niamh Lynch, paediatrician, BonSecours, Cork: "Many lost family members and it was only when they sit down to think about it they realise their child hasn’t been quite right."
Dr Niamh Lynch, paediatrician, BonSecours, Cork: "Many lost family members and it was only when they sit down to think about it they realise their child hasn’t been quite right."

“Soon afterwards, parents were looking at their children and thinking that they are still not quite right. Considering long Covid as a possibility is something for parents to bear in mind, especially if they were diagnosed with Covid or had somebody in the same house who was diagnosed.”

The consultant said that further data is required to understand the illness.

“With teenagers, it’s a bit more prevalent. The children that I’m seeing are all slightly older. It can be very debilitating for children because of the very persistent feelings of fatigue, breathlessness, headaches and palpitations. Thankfully, the children that I’m seeing have been improving.

“I am seeing this as the months go by but we are going to need large amounts of data to know what the timeframe will be. Obviously, this is a very new disease.

“In this country, children didn’t really get affected by it until Christmas time when the numbers were very high. We just have to collect data and establish what the course will be for children in Ireland.

“From the data that we have, there doesn’t seem to be anything that predisposes a child to long Covid. For the most part, children who had long Covid have been previously healthy.

“Certainly, children with underlying conditions are more susceptible to Covid conditions but there doesn’t seem to be a clear pattern for children who are going to go on to develop long Covid.”

She emphasised that certain children suffering from the illness may never have received a formal Covid-19 diagnosis.

“In the third wave, there were so many people with Covid that not everybody who was a close contact was tested. Some of the children might not have shown signs of infection but as time has gone on and they remained fatigued and had brain fog, in retrospect, it was obvious that they had Covid.

“When we do the blood tests we see that they have been exposed to it. At the time of the third wave not all household contacts were getting swabbed so parents didn’t have confirmation at that time that their child had Covid.

SYMPTOMS

“When a child has confirmed Covid or suspected Covid and they are not coming back to their usual energy levels parents need to speak to their GP. If their concentration isn’t as good as it normally would be and they are complaining of ongoing headaches, lethargy and feeling out of breath these are all long Covid symptoms.”

Dr Lynch is calling on the Department of Education to support schools in protecting children.

“I’m hoping that the secondary school cohort will be the next to be vaccinated. Trials have been done in that age group and it does seem to be effective in preventing infection and transmission in that age group.

“It’s very important that the Department of Education facilitates schools, but not just for vaccinations.

“It has taken a long time to get all the adults vaccinated. Even if we started vaccinating children-with the best will in the world-we wouldn’t have them all vaccinated by the time they go back to school.

“It’s really important that mitigation efforts are put in place in schools in terms of adequate ventilation, air purification and adequate social distancing.

“Schools need to be supported during the Delta wave because if they aren’t supported in becoming safe then they won’t be able to run.”

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