Many patients infected with SARS-CoV-2 experience long-lasting effects.  An estimated 3.7-58% of pediatric patients with COVID-19 will develop PASC. PASC often involves neurological, behavioural, and psychiatric symptoms. PASC affects at least 500,000 American children, yet the full spectrum of neuropsychiatric symptoms among children with PASC is largely undocumented. 

This descriptive study outlines the demographics, symptoms, family histories, functional impacts, and treatment approaches to PASC in a pediatric tertiary care hospital. All patients were initially seen in an infectious disease clinic as part of a multi-disciplinary PASC program, where 38% overall were referred to neuroimmunology. All patients included in this study were those who were then seen in  neuroimmunology. Using a standardized history form, data were gathered as part of routine neuroimmunology clinic visits.

Between April 2021 and October 2023, the neuroimmunology clinic saw 115 patients (mean age = 15.3 years, range = 6.3-21.4 years; patients were skewed older.) Common PASC symptoms included fatigue (93.4%), headaches (86.1%), sleep problems (78.3%), and memory (74.8%) and attention problems (80.9%). Frequent psychiatric symptoms included new acute onset depression (25.2%) and anxiety (47.8%) Functional impact was significant; 14.8% took extended leaves of absence from school. A family history of autoimmunity was present in 75.7%. Treatment approach emphasized rehabilitation, school supports and accommodations, and symptomatic management with lifestyle modifications.

PASC can cause substantial functional limitations. Pediatric PASC patients experience significant neurological impacts, thus the most common subspecialty referral was neurology.  PASC treatment requires a coordinated team approach to manage numerous symptoms and their impacts.