Children who contract COVID-19 usually recover quickly and don’t need special support after returning to school. However, some people who become infected with the disease experience persistent symptoms and post-viral complications. These complications can include tiredness, shortness of breath, brain fog, changes in taste and smell, and headache. This post-viral syndrome is known as long-range COVID-19, more commonly referred to as “long COVID” in the medical community.

Children who have been sick with COVID for a long time need support in school. Some symptoms – such as fatigue, brain fog, and memory impairment – are similar to those after a concussion. However, because these symptoms are difficult to identify or track, teachers can find it difficult to know how to help.

We are researchers studying how schools deal with concussions and the prevalence of long-term COVID and the psychological consequences associated with it. We believe that strategies schools use to support students with concussions can also help those with persistent COVID-19 symptoms.

Children and long COVID

Not all physical symptoms that occur after a COVID-19 illness indicate a long-term COVID. If symptoms persist for more than a few weeks, a thorough medical evaluation by a pediatrician with knowledge of long-term COVID is recommended. Post-COVID pediatric clinics are an excellent way to find such doctors. However, at this time, these clinics are not widely used in the United States.

Post-COVID complications have been reported commonly in adults. However, research on prolonged COVID in children is scarce as estimates of persistent symptoms vary widely. The wide-ranging estimates likely reflect differences in the way study participants were recruited, how long they participated in the study after developing acute COVID-19, the symptoms assessed by the researchers, and other methodological differences.

School accommodation

Students who continue to have symptoms after testing negative and are allowed to return to school should inform the school of any ongoing problems. Even if the child is not officially diagnosed with COVID for a long time, a gradual return to school and activities as well as academic and ecological accommodation can support the children during their recovery.

We recommend that parents, teachers, and doctors work together to aid the child’s recovery. This is called collaborative care. It is helpful if a school specialist – such as a school nurse, a counselor or a psychologist – acts as the central communicator. This includes sharing accommodation with teachers, talking to doctors (with a signed clearance), and communicating progress to the family.

Together, these collaborative care teams can set up temporary accommodation for the student concerned, such as:

  1. Enable a flexible attendance schedule with rest breaks to minimize fatigue.

  2. Reduce physical activity and minimize exposure to over-stimulating environments to avoid fatigue and headaches.

  3. Change the workload. This may include, for example, removing high-effort and minor work projects, providing alternative assignments, and allowing the student to drop out of class without penalty. Base grades on adapted work so that the child is not punished for memory problems.

  4. Give extra time to complete assignments and tests so a child with brain fog can process information.

  5. Develop an emotional support plan for the student to help prevent anxiety and depression. This may include finding an adult in school to talk to if the child feels overwhelmed or providing a support group for students to discuss their experiences and recovery.

  6. Encourage the student to explore alternative after-school activities that are not physically and cognitively taxing.

We recommend that schools move forward adjustments for a student with long-term COVID and gradually decrease these as the student recovers. Symptoms, recovery rate, and trajectory vary for each student. Therefore, a gradual and supervised return to activity is important to ensure that symptoms do not worsen as students become more active. If symptoms worsen, accommodations should be resumed.

A developing disease

We still have a lot to learn about the long-term effects of COVID-19 and the prognosis for those with long-term COVID illnesses. These guidelines are based on what is known at this point in time and should be viewed as preliminary.

With COVID rates and treatments evolving, it is important for parents, educators, and healthcare professionals to keep talking about persistent symptoms and effective treatments.

Susan Davies, Professor of School Psychology, University of Dayton; and Julie Walsh-Messinger, Associate Professor of Psychology, University of Dayton

This article was republished by The Conversation under a Creative Commons license. Read the original article.


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