What parents need to know about post-COVID-19 condition in children


The persistence of symptoms for a long time after severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) infection is now familiar as post‑COVID syndrome (PCS).

To the best of our knowledge, the risk of long‑term clinical outcomes in children after SARS‑CoV‑2 infection is still unclear.

Unlike in adults, current evidence suggests a lower prevalence of persistent symptoms in children. However, since several studies are characterized by great heterogeneity, it is difficult to accurately estimate the exact incidence of PCS in children.

The presence and course of recovery depend on risk factors that are more common in adults than children.

Proposed pathophysiological mechanisms in PCS in children include age‑dependent immune responses, angiotensin‑converting enzyme 2 expression, blood‑brain barrier development or social issues affecting children behavior, such as school closure and social isolation.

Multisystem inflammatory syndrome in children (MIS-C) and COVID-19:

Multisystem inflammatory syndrome in children (MIS-C) is a serious condition that appears to be linked to coronavirus disease 2019 (COVID-19). Most children who become infected with the COVID-19 virus have only a mild illness. But in children who go on to develop MIS-C, some organs and tissues — such as the heart, lungs, blood vessels, kidneys, digestive system, brain, skin or eyes — become severely inflamed. Signs and symptoms depend on which areas of the body are affected.


Signs and symptoms of multisystem inflammatory syndrome in children (MIS-C) include those below, though not all children have the same symptoms.

  • Fever that lasts 24 hours or longer
  • Vomiting
  • Diarrhea
  • Pain in the stomach
  • Skin rash
  • Feeling unusually tired
  • Fast heartbeat
  • Rapid breathing
  • Red eyes
  • Redness or swelling of the lips and tongue
  • Redness or swelling of the hands or feet
  • Headache, dizziness or lightheadedness
  • Enlarged lymph nodes

Emergency warning signs of MIS-C

  • Severe stomach pain
  • Difficulty breathing
  • Pale, gray or blue-colored skin, lips or nail beds — depending on skin tone
  • New confusion
  • Inability to wake up or stay awake

When to see a doctor

If your child has any of the emergency warning signs listed above — or is severely sick with other signs and symptoms — get care immediately. Take your child to the nearest emergency department or call 911 or your local emergency number.

If your child isn’t severely ill but shows other signs or symptoms of MIS-C, contact your child’s doctor right away for advice. Doctors may want to do tests — such as blood tests, or imaging tests of the chest, heart or abdomen — to check for areas of inflammation and other signs of MIS-C.