We need to know more about long COVID in kids.

Pediatric researchers at Columbia University's Vagelos College of Physicians and Surgeons are joining colleagues at 25 institutions across the country to understand more about long COVID and mitigate future impact.

The Columbia team expects to receive up to $9.4 million in funding to learn about long COVID in children and young adults as part of NIH’s REsearching COVID to Enhance Recovery (RECOVER) initiative.   

Most people recover quickly from COVID, but up to 40% of patients experience effects for weeks and even months after the infection has passed. In some people, severe symptoms unrelated to the initial infection can emerge. Considering the recent surge in cases, the public health impact could be significant.   

“The main goals of RECOVER are to better understand what are the long-term effects of COVID, to determine what percent of children experience it, and to ultimately help those affected fully recover,” says Melissa Stockwell, MD, MPH, chief of the Division of Child and Adolescent Health at Columbia University Vagelos College of Physicians and Surgeons. Researchers also will identify and better characterize the symptoms of long COVID in children and young adults.

Columbia cardiologists have been seeing children with chest pain, heart palpitations, and orthostasis (drops in blood pressure when standing) following a COVID infection. “Given the many unknowns of the long-term impact of COVID on exercise tolerance,” says Columbia pediatric cardiologist Erika Berman Rosenzweig, MD, “some children are referred to cardiologists to assess return to sports.”

One teenager seen by Columbia immunologist Joshua Milner, MD, had chest pain for weeks after contracting COVID. The teenager then began fainting repeatedly and developed abdominal pain prompting extensive evaluation. She has largely recovered, but is still not back to her former baseline health a year later. “This was a jarring course of events, and she is just one example of what we are seeing,” says Milner.    

As one of 10 pediatric/perinatal teams in the NIH initiative, Columbia will help recruit 20,000 children and young adults, including those with long COVID, those who recovered completely, and those who never had COVID. Parents and caregivers also will be recruited.   

The RECOVER initiative’s national study of tens of thousands of individuals in support of large-scale studies on the long-term effects of COVID-19—involving more than 100 researchers —was launched with a $470 million award from the NIH. 

According to the CDC, children with long COVID have symptoms similar to adults, namely tiredness or fatigue, headache, insomnia, trouble concentrating, muscle and joint pain, and cough. But they may have trouble describing what they are experiencing.  

“RECOVER research can help everyone,” says Stockwell.