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Sarah Varney, Kaiser Health News
Sarah Varney, Kaiser Health News
Since the pandemic began, children have largely been spared from severe illness and hospitalization. But nearly a year and a half later, the number of adolescent COVID cases is rising. While rare, for many it includes debilitating symptoms that can drag on for months. Black and Latino children have been especially impacted. Special correspondent Sarah Varney reports.
Amid all the other concerns around the spread of the Delta variant, many parents remain concerned about children.
So far, children largely have been spared from severe illness and hospitalization. But the number of adolescent COVID cases is rising. And a growing number of children are showing up in pediatricians' offices and emergency rooms. While rare, that includes debilitating symptoms that can drag on for months.
As special correspondent Sarah Varney reports, black and Latino children have been especially impacted.
This story, part of our ongoing Race Matters series, was produced in collaboration with our partner Kaiser Health News.
Just a few weeks ago, 15-year-old Yazmen Salermo didn't have enough strength to even play with her beloved pet ferret.
I just like remember feeling, oh, I'm never going to get better. I mean, I had COVID during my birthday. Like, my mental health was just absolutely declining. My anxiety was on the highest point ever.
When Yazmen first tested positive for the coronavirus, she felt nauseous. She couldn't breathe and had piercing headaches.
Her mother, Bakeya Ali, took Yazmen to a local emergency room three separate times for migraines and severe vomiting.
Four months later, Yazmen's symptoms have still not gone away. Most people with COVID feel better within weeks but some develop what's called long COVID, or long-haul COVID, four or more weeks after their initial infection. The symptoms, first identified in adults, include overwhelming fatigue, brain fog, stomach pain, and difficulty breathing.
Just going up and down the stairs. When I go with walks with my family, I realize that I get winded easily, start coughing. — when I see something funny, anyone tells a joke, laughing is probably the worst. I start coughing uncontrollably.
At first, doctors told Bakeya that her daughter's health would improve.
That was what I was told, that she's young, she's healthy, she's going to be fine. Just go home and wait it out.
And, at this point, people have been starting to hear about long-haul COVID cases among adults. But what, at that point, did you understand about this being a phenomenon that we were seeing in children?
Nothing. And I didn't hear, I didn't know anything.
Children are less likely than adults to become severely sick with COVID-19. But 4.1 million children have tested positive so far. Even though many have mild or no symptoms at all, close to 500 have died.
Black, Hispanic, and American Indian children have been hardest-hit. They account for three out four deaths under the age of 21. And researchers are finding somewhere between 2 and 10 percent of infected children have long-haul symptoms.
Dr. Uzma Hasan:
Hello. How are you guys doing?
Yazmen's mother eventually found a pediatric infectious disease specialist named Dr. Uzma Hasan.
So, catch me up on how things have been since we last met.
I'm experiencing more hair loss.
As the number of children with long-haul COVID kept growing, she started this pediatric post-COVID care program at Saint Barnabas Medical Center in Livingston, New Jersey.
The initial myth that children don't get infected has clearly been dispelled. I think we have seen the impact where children can get overwhelming illness from COVID.
The majority of patients in Hasan's clinic are Black and Latino. Nationwide, these communities have faced systemic barriers, like lack of health insurance and overt racism in the health care system, for decades.
The pandemic has only deepened that mistrust.
How do you confront that? How do you ensure that people trust the hospital, that they are actually bringing their kids in when they might need the treatment?
As physicians and health care professionals, we have our roles cut out for us to provide the constant reassurance, the need to recognize an illness that's real, and to reach out.
I think it's our role to make sure that we address every single concern that's put out there.
While the racial demographics nationwide have been more mixed than in Hasan's clinic, physicians don't yet understand what causes long COVID and why certain children get it.
Some speculate it could be the immune system going into overdrive. So, doctors are borrowing treatments used in other post-viral syndromes, like mononucleosis, Epstein-Barr, and Lyme disease, treatments that work best when symptoms are detected early.
The quickest way to prevent more of these cases, doctors say, more vaccinations.
All of this remains troubling because most children are not yet eligible for the vaccine. In some parts of the country, like here in Mississippi, adult vaccination rates remain low, and that puts children at greater risk.
Kevin Bass was an active and good-spirited 5-year-old boy. Then, one day last December, before vaccines were widely available, Kevin lost his appetite and said his head hurt. Angela Bass took her son to the doctor, where he tested negative for COVID. But even after days of high fevers, stomach pain, and a rash, doctors in the emergency room sent Kevin home.
I kept going back to the E.R., saying, this is not normal. And I think on that — on the second time that I went to the E.R. is when people started to really take me more seriously.
A rare illness linked to COVID-19 is reappearing in children this winter.
By then, Angela had learned about a post-COVID condition called multisystem inflammatory syndrome in children, or MIS-C.
And Angela pressed the doctors.
I asked specifically, like, could this be MIS-C? I saw it on the news. I saw some — and there's another family that I knew whose little girl had the same symptoms. And I asked specifically. And they were like, no, he doesn't — he hasn't had COVID, so it's probably not MIS-C.
But follow-up tests showed dangerously high markers for inflammation, and a blood test found antibodies for COVID. That meant Kevin had been infected perhaps weeks before, but never showed any COVID symptoms.
His eyes were swelling shut. His face was, like, huge. His legs — like, everything was just really swollen. And it was getting, like, in his lungs. He was he had fluid on his heart. And he had to get a blood transfusion because he lost blood.
He was really sick.
He was really sick. I was really preparing myself for the worst.
Kevin spent 15 days in the hospital.
As soon as I got from the hospital, I couldn't run.
Because there's — my legs was swollen. Every part of my body was swollen.
Wait. Was this the bear that came from the hospital — when you came home from the hospital?
Yes. It's my favorite bear.
About two out of three kids with multisystem inflammatory syndrome are Black or Hispanic. To understand why, a massive National Institutes of Health research effort is probing everything from genetic factors to repetitive exposure from parents considered essential workers.
Angela Bass says doctors also need to be aware that MIS-C might look different in Black and Latino children.
To me, like, I could see the rash. It was all over his belly, all over his arm. And I was like, there's a rash there. Please look at it. And they were like, OK, are you sure?
And I saw some of the images on the Internet, and they were very much more pronounced. But they were on, like, very, like, white bodies, and his skin is darker.
But children of color aren't the only ones affected. Angela Bass joined an online community of mothers supporting each other, often when the medical community wasn't.
There, she met Leann Henderson (ph) and her 14-year-old daughter, Allie (ph). So little is widely understood about MIS-C that doctors mistakenly removed Allie's appendix before realizing that appendix before realizing that she was having a near-fatal inflammatory reaction from an undetected COVID infection.
While it's unclear what the longer-term impacts will be, researchers agree that kids with long-haul COVID and MIS-C will need to be followed closely for the next five to 10 years.
Surprisingly the MIS-C kids have actually done fairly well.
The good news, Dr. Hasan and her colleagues say, is that many of these children, if treated, do improve with time, though it varies widely from case to case.
Kevin is back on his four-wheeler. Allie recently played softball in the World Series in Panama City, Florida. And even Yazmen, who still suffers from long COVID, can now take short walks with her mom, step by step, getting back to the business of being a kid.
For the "PBS NewsHour" and Kaiser Health News, I'm Sarah Varney in Elizabeth, New Jersey.
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Jason Kane is a PBS NewsHour producer, focusing on health care and national affairs.
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