Along Covid, what care of children and adolescents?

Over the months, the prolonged forms of Covid-19 have multiplied and are now part of the daily practice of health professionals. But the prolonged forms of the disease affect not only adults. The long Covid can also be declared in children and adolescents. The High Authority for Health (HAS) has just released a leaflet for health professionals to help them identify and care for these children. Explanations.

Child and teenager along Covid

Children, and to a lesser extent teenagers, have long been considered relatively spared from severe Covid-19. What about prolonged forms of SARS-CoV-2 infection? According to the available studies, the share of children and adolescents affected by a long Covid would vary from 2 to 5%. Long Covid in children is associated with a long list of possible symptoms:

  • headache;
  • Sleep disorders;
  • Weight loss;
  • Problems with concentration;
  • Diffuse joint pain
  • A chronic cough;
  • Abdominal pain;
  • Dizziness;
  • Fatigue and exercise intolerance
  • Chest pain.

These symptoms, often associated, can alter the child’s daily life and in particular his schooling. Identifying and caring for the child or adolescent with Covid has long been a key issue. Hence the interest of the sheet published by the HAS.

Diagnosed as soon as possible …

Early diagnosis of a prolonged form of long Covid is an essential prerequisite for better child or adolescent care.. For this, the healthcare professional must take into account:

  • The history and duration of symptoms;
  • The context of the occurrence;
  • Clinical examination;
  • Differential diagnoses (other possible causes of the observed symptoms).

Once the long Covid is diagnosed, the HAS recommends further evaluation to detect a possible complication of the infection (myocardial or pericardial injury, PIMS (pediatric multisystem inflammatory syndrome), etc.) or to highlight a potential other pathology ( autoimmune disease, inflammatory disease, thyroid disease, diabetes, etc.). This evaluation occurs for children or adolescents whose symptoms persist beyond one month after SARS-CoV-2 infection.

… to take better care of the child or adolescent

Given the wide range of possible symptoms, which vary in number, intensity and duration, HAS recommends comprehensive, multidisciplinary and personalized assistance, to be instituted as soon as the diagnosis is made. This support fulfills five objectives:

  • Define personalized goals adapted to the situation of each child, both from a medical point of view, but also from a scholastic, family or social point of view;
  • Reassure the child and his relatives by accompanying and supporting them at every stage;
  • Adapt the child’s activities to his state of health, with a view to a gradual return to normal life;
  • Limit the consequences on the child’s daily life as much as possible;
  • Prescribe the pharmacological or non-pharmacological treatments most suitable for each child.

This treatment, which can last several months, must be continuously adapted to the needs of the child, the evolution of his symptoms and his abilities. If the long Covid concerns a severe form of the disease, a follow-up in a hospital setting may be necessary at least initially. This fact sheet, which will be updated as knowledge about Covid-19 is gained, is an important tool for health care workers who care for children and adolescents who have long been victims of Covid.

Estelle B., Doctor of Pharmacy

Sources

– Covid-19: identify and manage prolonged symptoms in children and adolescents. has-sante.fr. Accessed March 24, 2022.
– COVID-19 Rapid Response Symptoms Prolonged as a result of the COVID-19 rapid response method of children and adolescents. has-sante.fr. Accessed March 24, 2022.

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