The 10-year-old case shows what we know and don’t know

She stayed home from school for two months before she felt ready to go home, even though she still had pain and other symptoms after more than four months.

“Sometimes it’s like burning and pain at the same time. It’s always there,” Shine said of the discomfort in his arms, shoulders, and calves. “I can’t eat a lot. I want to vomit.”

According to Solano, her daughter may have difficulty breathing, but she is afraid to return to the doctor and is trying to hide her breathing.

In many medical centers, including Kaiser, where doctors have diagnosed Shine as Postviral Syndrome, patients have not been treated for a particularly long COVID, but are sent to specialists for the individual illnesses they complain about.

“Children with persistent headaches may land in a neurology clinic,” said Matthew, a pediatric infectious disease expert at Stanford.

The general experience of long-term COVID patients of all ages suggests that their medical tests have returned to normal and that there are no problems. For example, Shine feels bruised, but nothing can be seen.

Researchers, including researchers at UCSF’s “Long-term Impact of Coronavirus Infection”, or LINCStudies, and point out three possible causes of strange symptoms of long COVID: persistent inflammation caused by the coronavirus, hidden fragments of the virus that remain in the body, and autoimmunity-the body’s own immune system. When turning on itself.

In February, researchers at the State University of New York said For an 11 year old girl The Journal of Pediatric Gastroenterology and Nutrition has persistent abdominal pain and nausea. After finding no problems with endoscopy, colonoscopy, and other treatments, doctors say that the coronavirus infection she received three months ago is still causing the problem. I wondered if there was one. They looked for evidence — and found it.

They found a nucleocapsid protein associated with coronavirus on the lining of her gastrointestinal tract. Her long-term symptoms with evidence of chronic inflammation “strongly suggest” the direct consequences of COVID, they wrote.

Researchers at the University of Southern California have also found evidence of COVID connectivity in three children with brain inflammation (autoimmune-mediated encephalitis). Published their study in January It is published in the Journal of Child Neurology. Studies have shown that after receiving high doses of intravenous corticosteroids, all three improved and inflammation was reduced.

However, clear clinical evidence of a link between coronavirus and ongoing symptoms is often lacking or difficult to find, so some doctors ask whether a child actually experiences a long COVID. Be skeptical.

Dr. Geraldina Rionetti, a pediatric rheumatologist at UCSF Beniof Children’s Hospitals, said that children have a long time because there may be other potential causes of symptoms, including the physical and psychological sequelae of the pandemic itself. He said he was reluctant to say whether the COVID was genuine.

“It’s very difficult to distinguish between long COVID symptoms and blocked symptoms,” says Lionetti.

Megan Carmilani who established a support group called Long COVID familyI thought such skepticism was annoying, but it settled. “For me, the only thing doctors say is,’I don’t have the knowledge or skills to help,'” she said.

Carmiliani, 43, did not have a long COVID, but has been strongly associated with children with long COVIDs because of post-viral symptoms since becoming mononucleosis at the age of 14. .. illness.

“I don’t want other children to wait decades for proper medical care,” Carmilani said from her home near Pittsburgh.

She points out studies showing that ongoing illnesses caused by the first viral infection are not uncommon. They include long COVID, chronic fatigue syndrome (myalgic encephalomyelitis), and Epstein-Barr, which can cause mononucleosis in particular. Still, the mysterious sequelae are “ignored and underfunded,” she said. “Especially in pediatrics.”

She said Carmilani founded the Long COVID family to provide children with the support she lacked. “I had to say an adult:’Your symptoms are true. There is a community to support you and we will work together to get the care you need.”

Currently, the group has about 2,000 participants and has “easily 500” children with long COVIDs, Carmilani said.

Shine’s mother appreciates the community. “It was mentally helpful to have a group of other people who understand what I’m experiencing,” she said.

As for Shine, understanding comes from Crysta Prasadi, 10 years old, who cares for friends as much as a child can hope.

“She tells me how much pain she feels,” Crysta said. “I ask her if she’s okay.”

“And I hope she feels better.”

Nanette Asimov is a staff writer for the San Francisco Chronicle. Email: [email protected] twitter: @NanetteAsimov