Post Covid-19 Syndrome in Children
Definition:
Signs and symptoms that develop during or following an infection consistent with COVID-19 which continue for more than 12 weeks and are not explained by an alternative diagnosis.
Symptoms may include generalised pain, fatigue, breathlessness, headache and palpitations. Most post Covid 19 syndrome presentations are similar to Post-Viral Fatigue and ME/CFS.
Symptoms present 12 weeks after a covid episode are common but enduring significant disruption to daily life is much less frequent. Suspect Post COVID Syndrome where there is an otherwise unexplained significant change in amongst other symptoms i.e. energy/fatigue and school/cognitive performance.
In the majority of cases, GPs will be able to manage the child’s condition with simple interventions e.g. responsive flexibility in activity levels, sleep hygiene, liaising with school.
Useful statistics on the emerging picture of Post COVID 19 syndrome in Children and support for families can be found at https://www.longcovidkids.org/
Referral:
Children with complex symptoms, who are experiencing persisting or worsening of their symptoms after 12 weeks post COVID-19 and are not explained by an alternative diagnosis should be referred through the RMS to General Paediatrics.
Following assessment in secondary care, the General Paediatrician may either refer to the Chronic Fatigue Service [LINK] or they may refer the child into the virtual MDT which is being hosted by Bristol Children’s Hospital for further Advice and Guidance regarding the management and treatment options for the child.
Investigations (to include in referral):
- Urinalysis for protein, blood and glucose
- Bloods: FBC, CRP, U&E, LFT, Bone Profile, HbA1c, Ferritin, TFT, Coeliac screen and CK.
Contributors:
Dr Robert Gardner - PCS assessment service clinical lead.
Dr Richard Tozer – South West Regional lead for Paediatric post COVID services
Mel Terry, Service Manager RCHT
Sarah Rattigan, Head of nursing, Women and Children’s Care Group, RCHT.
Tom Fontaine, Consultant Paediatrician, RCHT
Dr S Burns RMS GP Lead Paediatrics