Children and adolescents face a significantly higher risk of developing long COVID after a second COVID-19 infection, according to a large new study published in Lancet Infectious Diseases and funded by the National Institutes of Health (NIH).
The study, which analyzed electronic health records from over 465,000 pediatric patients, found that the risk of long COVID doubled in children who were reinfected with COVID-19 compared to those who had only been infected once. This finding directly challenges the widespread perception that COVID-19 is always mild in children or that reinfections are less dangerous.
Among the many long COVID complications observed, myocarditis—inflammation of the heart muscle—was the most prominent. The risk of myocarditis tripled following a second COVID infection. Additionally, blood clots were more than twice as likely to occur after reinfection. Other health issues tied to long COVID after reinfection included kidney damage, irregular heartbeats, headaches, abdominal pain, and severe fatigue.
“These results further support one of the strongest reasons I give patients, families and physicians about getting vaccinated: More vaccines should lead to fewer infections, which should lead to less long COVID,” said Dr. Ravi Jhaveri, co-author of the study and Head of Pediatric Infectious Diseases at Ann & Robert H. Lurie Children’s Hospital of Chicago.
The research was conducted during the period when the Omicron variant was dominant, spanning from January 1, 2022, to October 13, 2023. The study is part of the NIH’s RECOVER Initiative, a nationwide effort involving 40 U.S. children’s hospitals and institutions dedicated to understanding the long-term effects of COVID.
“The level of coordination, data sharing, and analysis requires massive infrastructure and sustained support,” said Dr. Yong Chen, senior author and Director of PennCIL at the Perelman School of Medicine, University of Pennsylvania.
This study is the first and largest longitudinal investigation into long COVID in children and teens following reinfection. Going forward, researchers aim to track patients over longer periods, assess how emerging variants might influence long COVID risks, and explore prevention strategies to reduce severe outcomes in the pediatric population.
