Some kids who develop shortness of breath and other lung symptoms after recovering from COVID-19 have evidence of obstruction in the smallest airways that can be treated and is reversible, according to a small study conducted at National Jewish Health.
The study at the leading respiratory hospital in the U.S. involved 30 patients – some preschoolers, but mostly teenagers between 13 and 17 years old. The facility conducts research on and sees patients with rare conditions.
The condition, peripheral airway obstruction, is not the typical constriction of the large airways, but of the really small airways that can’t always been seen with a regular pulmonary test. It’s identified using a sophisticated, impulse oscillometry, pulmonary function test.
“Because some of the usual tests that people use are negative, a lot of times they’ve been told, ‘This is anxiety, this is in your head, this is going to go away.’ Now, most of the time, it does go away after a few months, but in the kids that we’re seeing, it could last for a long time – for months, and sometimes even for over a year,” said Dr. Nathan Rabinovitch, the lead study author.
“A lot of it is a quality of life issue. These are not kids who are ending up in the emergency room,” Rabinovitch said. “They are kids [who often] were competitive athletes, who no longer can exercise like they did before. Sometimes, it’s younger kids in school who just can’t keep up with sports. Some of them also have shortness of breath, not with exercise, but a lot of what we’re seeing is exercise intolerance. And that’s really the quality of life issue … for a kid or an adolescent, not being able to participate in athletics, you know, is a big deal,” he said.
Similar to asthma, the condition can be treated with physical therapy and medications administered with inhalers.
Rabinovitch emphasized that “long COVID happens in kids, and not just in adults” – and because it is treatable, parents shouldn’t dismiss persistent symptoms.
“Kids that have sleep issues, kids that are complaining of chest pain have chronic cough, shortness of breath, or just can’t exercise like they’ve been able to do before … should see a specialist who could do some sort of sophisticated testing on the lungs, and someone, preferably, who knows about long COVID,” he said.
Rabinovitch noted that lung symptoms frequently happen in conjunction with other issues, including behavioral health symptoms, such as anxiety and depression.
“You need a really integrated approach, including rehab, behavioral health, pulmonary, sometimes other sub specialties to really put it all together.”
