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Preventing long COVID in children a cause for vaccination

Posted on: May 11, 2022

Written by: Shawna Cadieux

When 8-year-old Olivia Gooch tested positive for COVID-19 in early January 2022, her parents expected the illness would be mild, as it often is in children. However, after 10 days Olivia's condition still included a severe dry cough, shortness of breath, fatigue and a low-grade fever.Olivia Gooch.jpg

“I practically lived with her in a steam shower," says her mom, Teneane, who is also a registered nurse. “She'd say “Mom, I feel so sicky, so horrible."

Olivia's intense cough continued for 6 weeks, during which time her mom brought her into Nanaimo Regional General Hospital's emergency department to be evaluated. She received chest x-rays, full bloodwork and an electrocardiogram to check her heart function, in addition to a steroid inhaler to help with her breathing.

“Olivia's cough was scary. I slept with her every night with my hand on her back as I was concerned her poor lungs would give out," says Teneane. “Seeing her so sick really pulled on our heartstrings."

After six weeks, Olivia's cough began to subside. The little girl had been away from school during her illness and her parents were hoping she'd be able to return to classes. However, she also started to complain about excruciating pain in her lower legs and feet.

“By this time Olivia was being seen by a pediatrician who told us that there have been cases of joint inflammation after COVID," says Teneane. “Every day it got worse, to the point where she was crawling on the floor, unable to walk."

Oliva wasn't able to bear weight on her right foot, resorting to the use of crutches for three weeks.

“I didn't know what to do. I even took her back to emergency for x-rays to rule out something more sinister like a stress fracture in her foot because the pain was so bad," says Teneane. “Doctors were extremely caring and they kept telling us to give it time, but I felt so helpless."

By the end of February, Olivia was being seen by a pediatrician at the pediatric outpatient clinic in Nanaimo and finally began weight bearing with the help of a cane. Her cough slowly improved as well. Her parents took their daughter to the swimming pool to increase her activity, and consulted with a physiotherapist and kinesiologist who worked with Olivia to improve her mobility. She was also referred to Dr. Marie-Claude Gregoire, a Victoria-based pediatrician with a keen interest in treating long COVID in children.

Dr. Gregoire is one of several pediatricians consulting with the new Post-COVID Recovery Clinic located at the Royal Jubilee Hospital (RJH), one of five clinics in British Columbia currently aimed at supporting people who are still experiencing symptoms three months or longer after a COVID-19 infection. 

When a child diagnosed with long COVID is referred to the RJH clinic, they are connected with Dr. Gregoire or other pediatricians who collaborate with clinic physicians and staff during the care journey. In addition to her work with children, Dr. Gregoire is a medical director with Island Health who helped to establish South Island COVID-19 high risk assessment clinics during the early days of the pandemic.

“During the first couple of waves we mostly saw adults affected. However, when Omicron emerged huge numbers of children were infected with COVID, many who weren't fully vaccinated yet," says Dr. Gregoire. “Previous to Omicron, long COVID in kids was less common, however now we are seeing it more frequently due to the large number of children affected in the fifth wave."

The Public Health Agency of Canada lists the most common post-COVID symptoms in children as fatigue or tiredness, headaches, weight loss, muscle pain, sleep disturbances, stuffy or runny nose, and difficulty thinking or concentrating. Some patients, including Oliva Gooch, report that mental or physical over exertion may make the condition worse.

Although there is no treatment for long COVID, pediatric patients referred to Dr. Gregoire will receive the same type of care as is provided to adults at the post-COVID clinic – coaching on self-management of symptoms in order to achieve a similar quality of life to what they had prior to COVID, as well as physiotherapy and occupational therapy.

“It can be hard for parents of children with long COVID to hear that there is no magic treatment, but with these supportive therapies we do see improvements over time," says Dr. Gregoire. “We know it is frustrating, but it will get better."

Much is still being learned about long COVID, both in adults and in children. A recent study that received significant media attention claims that 1 in 4 children who contract COVID will develop long COVID, however Dr. Gregoire says it is important to realize that the study's findings are extremely preliminary and have not undergone the peer review process, which identifies errors. 

For example, while long COVID is defined by the WHO and BCCDC as symptoms persisting three months or longer after infection, the study groups children who are experiencing symptoms one month post infection with those who are still sick after 12 weeks.

“We still have so much to learn about COVID including its effect on developing brains, but what we do know for certain is that vaccination is the best way to prevent severe disease," says Dr. Gregoire.

Teneane Gooch agrees wholeheartedly.

“It is so hard to see your child that sick. Never in a million years did I ever expect this to happen to Olivia," she says. “If by sharing our story I can prevent one child, one family, from going through what we have, then it will be worth it."

Today, Olivia is feeling much better, though she still walks with a very slight limp. Her mom says she has good and bad days, but things are steadily improving.

“I thank my lucky stars all the time that she is feeling better," says Teneane. “She still has some joint pain and the experience has been extremely traumatic, but we keep encouraging her and telling her that she can get through this. Over Spring Break she was even able to enjoy biking and skiing! She is such a trooper."

For more information about COVID-19 vaccinations, please visit https://www2.gov.bc.ca/gov/content/covid-19/vaccine/register

For more information about the Post-COVID Interdisciplinary Clinical Care Network (including symptom information sheets and educational videos) which includes Post-COVID Recovery Clinics, please visit phsa.ca/postCOVID