The American Academy of Pediatrics (AAP) recently published guidance to provide pediatricians with direction when caring for patients – aging in range from infants to adolescents – following a SARS-CoV-2 infection.
This guidance covers follow-up care to monitor the resolutions of COVID-19 symptoms; administration of COVID-19 vaccines and other routine immunizations; screening for and addressing mental health concerns; advice for participation in group sports and outings; and coordinating care with specialists if needed.
AAP’s guide suggests that all patients who test positive for a SARS-CoV-2 infection – whether symptomatic or not – should have at least one follow-up conversation or visit to their primary care physician.
Depending on the severity of the patient’s infection, an in-person visit may be recommended. For mild or asymptomatic cases, a follow-up visit may be done via telehealth phone call or video.
During the patient’s evaluation, the pediatrician should discuss the following:
- COVID-19 vaccination
- Return to daily living
- Return to sports or physical activity
- Return to camp
- Return to childcare, school (K-12) and higher education
- Multisystem Inflammatory Syndrome in Children (MIS-C)
The AAP also developed interim guidance on COVID-19 testing for children and adolescents who were previously SARS-CoV-2 positive and are advising against serum testing for antibodies.
Outside of the acute illness, the following are some of the ongoing or residual symptoms known to occur following a SARS-CoV-2 infection:
- Anosmia and/or Ageusia
- Cognitive fogginess or fatigue
- Physical fatigue/poor endurance
- Mental health/behavioral health sequelae
Children and adolescents with underlying medical and behavioral conditions who experienced COVID-19 should be monitored using a team-based approach. Their primary care pediatrician should coordinate care with medical, surgical, occupational and behavioral specialists as needed.
Studies have shown that children and adolescents – like adults – may experience “long-haul COVD-19” symptoms months after experiencing an infection. Pediatricians should consider a conservative approach to testing and diagnostics if symptoms persist.