A shroud of uncertainty covers almost every aspect of the Covid-19 pandemic. There are no reassuring absolutes, basically anything can happen. The most common scenario is a totally asymptomatic youngster who suffers no short or long-term consequences of having been infected. It is also possible to have a very mild acute course, but subsequently develop life-threatening inflammation of the vital organs. This exceedingly rare condition is called MISC (multisystem inflammatory syndrome of children) or PIMS (pediatric multisystem inflammatory syndrome). Still others may have trouble with a protracted recovery phase, with lingering and occasionally debilitating symptoms for weeks to months. Long Covid or post-Covid syndrome is an issue in about one in ten children. Another common concern is how quickly to allow children to resume full activities, with special emphasis on competitive athletes.
With such a remarkably wide range of disease courses and outcomes, it is no wonder parents are uneasy about caring for children with coronavirus. The grand majority of pediatric patients have been diagnosed, monitored and treated by parents at home. Although telemedicine advice can be very helpful, much of the burden of the medical decision-making has been on the parents’ shoulders. Few have actually had the reassurance of a physical exam by a doctor.
The pediatricians at RMC recognize the unmet needs of families with children who have had coronavirus. The RMC Covid Aftercare Clinic was established to evaluate the well-being of children and adolescents and give guidance regarding their care.
The assessment begins with a thorough discussion of the child’s health before, during, and after Covid. The physical examination is comprehensive, and includes a test of oxygen saturation, exercise tolerance, lung function, and stability of the autonomic nervous system. Based upon the aforementioned, some children should have further testing of the blood, subspecialist consultation, and imaging studies. However, most children will not need further examinations. Every case is unique; therefore, each child will receive an individualized plan, not a one-size-fits-all package.
The consultation includes discussion and written educational materials on:
- Long Covid
- Multisystem inflammatory syndrome in children
- Return to sports and physical activities advice
The pediatricians at RMC look forward to reassuring the lion’s share of parents that the child has not suffered any untoward ramifications of Covid disease. And we are eager to help formulate a plan for the few who need further medical evaluation.
This service is intended for adolescents and children with a probable or proven case of Covid that started 3 or more weeks ago. Those who needed inpatient treatment for Covid should request guidance for follow-up from their hospital care team.