Consequences beyond acute SARS-CoV-2 infection in children

Abstract

Although most children are spared from developing complications from SARS-CoV-2 infection, some may suffer consequences including Long Covid and multisystem inflammatory syndrome in children (MIS-C). Although the occurrence of these conditions has decreased over time, they can still occur, and recognition of symptoms and prompt diagnosis is imperative for early intervention.

Fig. 1.. A comparison of the timing, clinical characteristics, and outcomes of Long Covid and MIS-C.

(A) Shown are timelines for the development of Long Covid and MIS-C after initial SARS-CoV-2 infection. *The size of the “Moderate-Severe Acute COVID-19” box does not correspond to the proportion of children and adolescents who have moderate-severe acute COVID-19. The majority of children with COVID-19 have mild or no symptoms. (B) Shown are approaches to diagnose, prevent, and treat acute COVID-19, MIS-C, and SARS-CoV-2. **Not all patients with acute COVID-19 are recommended to receive targeted treatment. Treatment for severe acute COVID-19 includes SARS-CoV-2 antiviral therapy, steroids, and anticytokine antibody therapies. Treatment for MIS-C includes IVIG, glucocorticoids, and anticytokine antibody therapies. In both, anticytokine antibody therapies are usually reserved for patients not responding to other interventions. ***Specialist care might include cardiology (especially for MIS-C), neurology, rheumatology, infectious disease, pulmonology, and rehabilitation. ICU, intensive care unit.