Long-COVID in Adults, Children and Teens

Post-viral syndrome (PVS) has come to the attention of doctors and the public more than ever before due ‘long-COVID’ even though, post viral illness is nothing new.

Recognition of post viral syndrome (PVS) started in the 1980’s when many doctors including myself were seeing a ‘mystery’ illness that didn’t fit a specific diagnosis based on testing. At that time, it was called post-polio syndrome and names later changed to include myalgic encephalomyelitis (ME), chronic fatigue syndrome (CFS) and fibromyalgia-type illnesses (FM).

PVS can be caused by many different viral infections including Epstein-Barr virus, cytomegalovirus, human herpesvirus, enteroviruses, and the more recently recognized, SARS-Cov-2 virus. It still remains unclear today, 34 years later, as to the origins and why viral symptoms can linger longer in the body. Basically, little or no progress has been made within the Western medical community.

Common Symptoms of Long-COVID

Long-COVID was defined by the WHO as the presence of symptoms that generally occur three months from the onset of COVID-19, with symptoms lasting at least two months and cannot be explained by an alternative diagnosis.

The most common symptoms and percentage of prevalence associated in children and adolescents were:

• mood symptoms (e.g., sadness, tension, anger, depression, and anxiety) – 16.50%
• fatigue – 9.66%
• sleep disorders (e.g., insomnia, hypersomnia, and poor sleep quality – 8.42%
• headache – 7.84%
• respiratory symptoms – 7.62%
• nasal congestion – 7.53%
• cognitive symptoms (less concentration, learning difficulties, confusion) – 6.27%
• loss of appetite – 6.07%
• exercise intolerance – 5.73%
• altered smell – 5.60%

The most common symptoms that we know of in adults include:

• fatigue
• memory problems, difficulty thinking or concentrating
• sleep disturbances
• shortness of breath
• anxiety and depression
• general pain and discomfort
• muscle spasms
• posttraumatic stress disorder (PTSD)

The SARS-CoV2 virus that causes COVID-19 also attacks the thyroid, kidneys, vascular system, lungs, brain, gut, and the adrenal glands. Interestingly, chronic inflammation in the olfactory system (sinus cavities) is correlated with behavioral changes and mood disorders like depression and anxiety.

Long-COVID has heightened the awareness within the medical profession because it is more in the news lately, resulting in more doctors considering it as a diagnosis post COVID-19 infection.

But alas, many do not know where to start when it comes to treatments.

Considering the number of people who have had COVID-19, long haul symptoms could become a huge burden for many people and the medical system over the next few years as more people develop post viral symptoms similar to CFS, ME and FM.

Currently It is estimated that over 23 million American adults are potentially living with long-COVID, while about 7 million are experiencing disabling symptoms. Conservative estimates in Canada report 300,000 and this is based on the World Health Organization’s estimate that at least 10 per cent of those infected with COVID-19 will experience long haul symptoms. Canada has no definition of what long-COVID entails, making it more difficult to properly assess the actual number of people.

What is not commonly known is that the prevalence of long-COVID in children and teens was reported as 25.24% and for those that were hospitalized, 29.19%.

Long-COVID can occur even in people who had mild or no symptoms of COVID-19 which is usually the case with kids. The symptoms they had during the acute infection may not go away, once the infection is gone or can start after a person is feeling better and may come-on weeks later.

Children are much more ill-equipped to deal with traumatic situations due to immature brain and emotional development. Both prolonged loneliness and social isolation have been associated with future mental health problems up to nine years later, strongly suggesting children and adolescents are at risk for mental health conditions long after pandemic has ended. As of 2022 mental health disorders in children and teens have increased by 40%.

The direct cause of post viral illness is not known, but one theory that is currently being considered in Western medicine is that the virus ‘overloads’ the immune system, preventing healthy immune system resolution and ongoing inflammation mediated by proinflammatory cytokines. Pain, cognitive problems, headaches, depression and mood disorders, gastrointestinal problems, and fatigue, can all be caused by inflammation.

Whether or not the symptoms are the result of long-COVID or from the stress resulting from the pandemic measures, psychological support can play a fundamental role.

Inflammation

Inflammation is the first response of the immune system to infection, injury, or irritation from a foreign substance. The purpose of the inflammatory response is to remove debris, attack foreign invaders, remove cellular waste, and encourage the healing process. Initially, inflammation is a regulated response that provides protection and promotes healing when infection or injury occurs. However, if left unregulated, these same processes can cause tissue injury and damage in the entire body, which is commonly referred to as systemic inflammation.

Brain symptoms are some of the most common symptoms in people suffering from long-COVID including kids and teens. So, it is interesting to note that studies have shown that SAR-CoV2 virus causes high levels of inflammation in the olfactory bulb, a part of the brain involved in smell, emotions, behavioral changes, and learning and these symptoms persisted long after the infection had cleared. Cytokines one of the markers of inflammation, can cause mitochondrial dysregulation. The mitochondria are the power stations in our cells responsible that generate most of the chemical energy needed to power the cell’s biochemical reactions and produce energy (ATP). Without healthy mitochondria, cells die.

Another study has found that sustained inflammation and activation of the immune response continue for at least 8 months after the initial infection.

Professor Gail Matthews, the study’s senior researcher, mentioned: “But what we’re seeing with long COVID is that even when the virus has completely left the body, the immune system remains switched on. If you measure the same thing after a standard cough or cold, which we did in this study through one of our control groups, this signal is not there. It’s unique to sufferers of long COVID.”

Inflammation is a critical part of recovery, helping the body get rid of the source of damage and helping it repair injured tissue, but too much of it can have unwanted effects. Especially when the inflammation persists beyond any actual outside threat.

As with ME, and CFS, the PCS symptoms may vary person to person depending on which organs were challenged the most with the virus, however most people experience the symptoms mentioned previously.

No matter what virus and other factors are involved post viral illnesses are very complex and challenging for the physician and frustrating and most difficult for the individual at any age.

Natural Supplements for Long-COVID in Children

Mood disorders

• L-Theanine, an amino acid and clinical studies have shown that it reduces stress, improves the quality of sleep, and heightens mental acuity. These clinical effects are directly related to L-Theanine’s ability to stimulate the production of alpha brain waves as well as reduce beta waves (associated with nervousness, scattered thoughts and hyperactivity.
• Probiotics help to support the gut microbiome and the important two-way gut-brain connection and have been proven effective in supporting mental health disorders and the immune system.
• GABA (Gamma Aminobutyric Acid) reduces nervousness, promotes mental clarity, and improves cognitive functions including learning performance, concentration, memory and sleep quality. NOT recommended for children under 6 years of age.
• Ashwagandha is particularly helpful for fatigue and stress.

Sleep problems: Melatonin

Cognitive problems: Natural anti-inflammatory supplements. Inflammation is the root of many of the symptoms of long-COVID particularly the brain and cardiovascular system.

Omega-3 fatty acids are safe and effective as a natural anti-inflammatory for kids and teens.

Support for Teens and Adults

Inflammation support:

• Palmitoylethanolamide (PEA) was first marketed in the 1960s for the prevention of influenza and the common cold and the preventative action was due to PEA’s ability to increase the body’s nonspecific (innate) resistance to viruses. Some benefits related to long-COVID include: Anti-inflammatory effects, supports brain health, helps insomnia and supports the immune system. PEA is a very powerful tool to treat inflammation.
• Curcumin has potent antioxidant and anti-inflammatory properties that help with cognitive problems, depression, and anxiety associated with long-COVID in many people. Look for a brand that has been optimized for maximum absorption, such as Theracurmin or Meriva.

More specific supplements for heart and to prevent platelet aggregation and clotting could include:

• Nattokinase and omega-3 fatty acids both help to prevent and breakdown blood clots. Studies show that nattokinase helps maintain good blood vessel structure, improves blood flow and helps to prevent and dissolve blood clots. Omega-3 fatty acids have been shown to protect the vascular system and prevent heart related incidents due to the anti-inflammatory effects. In addition, omega-3 fatty acids decrease platelet aggregation helping to prevent clot formation. Note: supplements that support inflammation also support the vascular system.

Energy & stress support

Ask about formulations that contain category of herbs called adaptogens that have been proven to help regulated stress hormones and improve energy and stamina. Talk to the knowledgeable staff at the Vitamin Shop about various combination stress support products.

Gastrointestinal problems

Probiotics support the gut microbiome, the immune system and help prevent systemic inflammation.

Brain fog and cognitive issues

Products that combine some of the important memory support supplements including N-acetyl-L-cysteine, alpha-lipoic acid, ginkgo, vinpocetine, phosphatidylserine (PS), phosphatidylcholine (PC).

Mitochondrial regeneration

Support the mitochondria and help prevent inflammation with combination products that include acetyl-L-carnitine, coenzme Q10, L-glutathione and SOD (superoxide dismutase).

Mitochondria are most abundant in the tissues and cells of our bodies that need the most energy to function properly.

It is also very important to follow a healthy diet (ie. Mediterranean diet) as well as regular exercise to support overall health.