Introduction Many patients infected with SARS-CoV-2 experience long-lasting effects. An estimated 3.7-58% of paediatric patients with COVID-19 will develop PASC. PASC often involves neurological, behavioural, and psychiatric symptoms. PASC affects at least 500,000 American children, yet the full spectrum of neuropsychiatric symptoms among children with PASC is largely undocumented.

Methods This descriptive study outlines the demographics, symptoms, family histories, functional impacts, and treatment approaches to PASC in a paediatric tertiary care hospital. All patients were initially seen in an infectious disease clinic as part of a multi-disciplinary PASC program, where 40% overall were referred to neuroimmunology. All patients included in this study were those who were then seen in neuroimmunology. Using a standardized history form, data were gathered as part of routine neuroimmunology clinic visits.

Results Between April 2021 and October 2023, the neuroimmunology clinic saw 115 patients (mean age = 15.3 years, range = 6.3-21.4 years.) Common PASC symptoms included fatigue (93.4%), headaches (86.1%), sleep problems (78.3%), and memory (74.8%) and attention problems (80.9%). Frequent psychiatric symptoms included new acute onset depression (25.2%) and anxiety (47.8%) Functional impact was significant; 14.8% took extended leaves of absence from school. A family history of autoimmunity was present in 75.7%. Treatment approach emphasized rehabilitation, school supports and accommodations, and symptomatic management with lifestyle modifications.

Conclusion PASC can cause substantial functional limitations. Paediatric PASC patients experience significant neurological impacts, thus the most common subspecialty referral was neurology. PASC treatment requires a coordinated team approach to manage numerous symptoms and their impacts.

Margaret Wilson-Murphy
Boston Children's Hospital
United States

Sara Del Vecchio
Boston Children's Hospital
United States

Alicia Johnston
Boston Children's Hospital
United States

Catherine Lachenauer
Boston Children's Hospital
United States

Maitreyi Mazumdar
Boston Children's Hospital
United States