Postacute/Long COVID in Pediatrics: Development of a Multidisciplinary Rehabilitation Clinic and Preliminary Case Series

Am J Phys Med Rehabil. 2021 Dec 1;100(12):1140-1147. doi: 10.1097/PHM.0000000000001896.

Abstract

The long-term sequelae after SARS-CoV-2 infections in children is unknown. Guidance is needed on helpful models of care for an emerging subset of pediatric patients with postacute/long COVID who continue to experience persistent symptoms after initial COVID-19 diagnosis. Here, we describe a pediatric multidisciplinary post-COVID-19 rehabilitation clinic model as well as a case series of the initial cohort of patients who presented to this clinic. A consecutive sample of nine patients (pediatric patients <21 yrs of age) who presented to our clinic are included. The most common presenting symptoms were fatigue (8 of 9 patients), headaches (6 of 9), difficulty with schoolwork (6 of 8), "brain fog" (4 of 9), and dizziness/lightheadedness (4 of 9). Most patients had decreased scores on self-reported quality-of-life measures compared with healthy controls. In the patients who participated in neuropsychological testing, a subset demonstrated difficulties with sustained auditory attention and divided attention; however, most of these patients had preexisting attention and/or mood concerns. There were also some who self-reported elevated depression and anxiety symptoms. Pediatric patients with postacute/long COVID may present with a variety of physical, cognitive, and mood symptoms. We present a model of care to address these symptoms through a multidisciplinary rehabilitation approach.

MeSH terms

  • Adolescent
  • Anxiety / rehabilitation
  • Anxiety / virology
  • COVID-19 / complications*
  • COVID-19 / diagnosis
  • COVID-19 / psychology
  • COVID-19 / rehabilitation*
  • Child
  • Fatigue / rehabilitation
  • Fatigue / virology
  • Female
  • Headache / rehabilitation
  • Headache / virology
  • Humans
  • Male
  • Neuropsychological Tests
  • Patient Care Team*
  • Pediatrics / methods*
  • Post-Acute COVID-19 Syndrome
  • Quality of Life
  • SARS-CoV-2
  • Subacute Care / methods*