Main Article Content
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.
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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: https://www.medscape.com/viewarticle/968062
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.