COVID Long-Hauler Syndrome in a Nigerian Child - A Case Report

Main Article Content

Iso Precious Oloyede Chinenye Nnoli Itoro Anietimfon Akpan


Introduction: Post-covid long-hauler syndrome has been observed in up to half of the children who had symptomatic Covid with symptoms lasting beyond 120 days.

Case report: PEC, is an 11year old female who presented with a history of unproductive Cough 5/7, Fever 5/7 and breathing difficulty. Physical examination revealed an acutely ill, dyspneic and tachypneic child, with a respiratory rate of 42 cycles/min. She had vesicular breath sounds and few basal crepitations. Her SPO2 was 75% in room air. The Chest Xray showed widespread nodular opacities. Her manteoux test was 3mm. A chest CT-scan showed diffuse in-homogenous densities with fibrocystic changes seen involving both lungs with associated areas of ground glass opacification in the upper lung bilaterally. Her COVID-19 PCR test was positive.  A diagnosis of COVID-19 disease was made. She was admitted into the paediatrics ward and treated with antibiotics and intranasal oxygen. Her SPO2 remained between 85-88% on oxygen and 75-79% in room air.  She became stable on the 6th day of admission and parents left against medical advice.

Four months post diagnosis the child presented with cough and breathlessness. A repeat chest x-ray showed massive lung infiltrates, multiple patchy opacities and hyperinflated lung fields. Her ESR was 30mm in the first hour. A lung function test was suggestive of severe restrictive/obstructive abnormality.  The 2- dimensional echocardiography was normal. A diagnosis of Post-covid 19 interstitial lung disease was made and she was placed low dose prednisolone 2mg/kg for six weeks. Her response to treatment will be assessed in subsequent follow-up.

Conclusion: Post COVID long-hauler syndrome is present in children who survive COVID-19. A high index of suspicion is required to diagnose and offer the correct treatment.

Article Details

How to Cite
OLOYEDE, Iso Precious; NNOLI, Chinenye; AKPAN, Itoro Anietimfon. COVID Long-Hauler Syndrome in a Nigerian Child - A Case Report. Medical Research Archives, [S.l.], v. 10, n. 5, june 2022. ISSN 2375-1924. Available at: <>. Date accessed: 25 june 2022. doi:
Case Reports


1. Thomson H. Children with long covid. New Sci. 2021 Feb 27;249(3323):10–11.
2. Raveendran AV, Jayadevan R, Sashidharan S. Long COVID: An overview. Diabetes Metab Syndr. 2021;15(3):869–75.
3. Hicks R. Research Definition for “Long COVID” in Children and Young People Agreed- Medscape- Feb 08, 2022 [Internet]. [cited 2022 Feb 13]. Available from:
4. Raveendran AV. Long COVID-19: Challenges in the diagnosis and proposed diagnostic criteria. Diabetes Metab Syndr. 2021;15(1):145–6.
5. Soriano JB, Murthy S, Marshall JC, Relan P, Diaz JV; WHO Clinical Case Definition Working Group on Post-COVID-19 condition. A clinical case definition of post COVID-19 condition by a Delphi consensus. Lancet Infect Dis. 2022 APr; 22(4): e102-e107. doi:10.1016/S1473-3099 (21)00703-9.
6. Wild JM, Porter JC, Molyneaux PL, George PM, Stewart I, Allen RJ, et al. Understanding the burden of interstitial lung disease post-COVID-19: the UK Interstitial Lung Disease-Long COVID Study (UKILD-Long COVID). BMJ Open Respir Res. 2021;8(1):e001049.
7. Buonsenso D, Munblit D, De Rose C, Sinatti D, Ricchiuto A, Carfi A, et al. Preliminary Evidence on Long COVID in children. Acta Paediatr. 2021 Jul; 110(7):2208-11. doi:10.1111/apa.15870. Epub 2021 Apr 18. PMID:33835507; PMCID: PMC8251440. [Accessed 2022 Apr 14].
8. Say D, Crawford N, McNab S, Wurzel D, Steer A, Tosif S. Post-acute COVID-19 outcomes in children with mild and asymptomatic disease. Lancet Child Adolesc Health. 2021;6:e22–3.
9. Sterky E, Olsson-Åkefeldt S, Hertting O, Herlenius E, Alfven T, Ryd Rinder M, et al. Persistent symptoms in Swedish children after hospitalisation due to COVID-19. Acta Paediatr. 2021;110(9):2578–80.
10. Kabi A, Mohanty A, Mohanty A, Kumar S. Post COVID-19 Syndrome: A Literature Review. J Adv Med Med Res. 2021 Feb 4;32:289–95.
11. Ludvigsson JF. Case report and systematic review suggest that children may experience similar long-term effects to adults after clinical COVID-19. Acta Paediatr. 2021;110(3):914–21.
12. Nogueira López J, Grasa C, Calvo C, García López-Hortelano M. Long-term symptoms of COVID-19 in children. Acta Paediatr. 2021;110(7):2282–3.
13. Ramakrishnan RK, Kashour T, Hamid Q, Alwani R, Tieyjeh IM. Unravelling the mystery surrounding Post-Acute Sequelae of COVID-19. Front. Immunol., 2021; 12;686029. doi:10.3389/fimmu.2021.686029
14. Doležalová K, Tuková J, Pohunek P. The respiratory consequences of COVID-19 lasted for a median of 4 months in a cohort of children aged 2–18 years of age. Acta Paediatr 2022; 00: 1-6. doi:10.1111/apa.16297. [accessed 2022 Apr 15]
15. Singh A, Kumar O, Bansal P, Margekar S, Aggarwal R, Ghotekar L, et al. Post-COVID Interstitial Lung Disease - The Looming Epidemic. J Assoc Physicians India. 2021 Jul 1;69 (7): 11-12. PMID:34431265.
16. Wu M, Sharma PG, Rajderkar DA. Childhood interstitial lung disease: A case-based review of the imaging findings. Ann Thorac Med. 2021;16(1):64–72.
17. Wells AU, Devaraj A, Desai SR. Interstitial Lung Disease after COVID-19 Infection: A Catalog of Uncertainties. Radiology. 2021 Apr 1;299(1):E216–8.
18. Bush A, Cunningham S, Blic J de, Barbato A, Clement A, Epaud R, et al. European protocols for the diagnosis and initial treatment of interstitial lung disease in children. Thorax. 2015 Nov 1;70(11):1078–84.