What Long COVID Looks Like in Teens and Young Adults

While older adults seemed to be at highest risk of severe complications and death from COVID-19, a growing number of studies suggest that, though not common, some young adults and teens are also experiencing detrimental long-term effects of the disease.

“My body is constantly fighting against me,” says 23-year-old Emma Stump from Boston, who is currently experiencing what have been diagnosed as long COVID symptoms, the name given to a collection of post-COVID conditions that still aren’t well understood by doctors. “It is super frustrating.”

Long COVID symptoms, per the CDC, are those which develop “four or more weeks after first being infected with the virus that causes COVID-19.” Long COVID patients can experience symptoms like chronic fatigue, brain fog, shortness of breath, and chest pain, according to Tregony Simoneau, MD, a pediatric pulmonologist and lead pulmonary expert at a recently-established long COVID clinic at Boston Children’s Hospital. While existing cases of long COVID among young people are becoming more known, it's still unclear how many young people experience the lingering disease, and what risk it imposes.

Stump, who believes she had COVID in March, 2020, before tests were commonly available, began developing what are believed to be long COVID symptoms in mid-January 2021, after she was vaccinated. “Whenever I am exercising, and my heart rate increases, I start breaking out in hives. If there is a severe temperature change, like if I am swimming, my body will respond like I am having an allergic reaction," she says. "If I am very stressed or overworked, I get extremely fatigued and am more inclined to have breakouts. I have a flushed face, and I will be warm or have chills.”

“People think I am a drama queen. I don’t want people to think I am extra and making a big deal out of this, but it is a big deal.”

Ashish Jha, MD, MPH, physician and Dean of Public Health at Brown University, explains that experts have multiple theories about why some develop post-COVID conditions, one being the “persistence of a viral reservoir” in long COVID patients. “Some part of your body continues to have the virus, and your immune system is not able to clear it. That is why people continue to have symptoms of an infection, like fevers or fatigue.”

“Another theory is that it is purely immunological and autoimmune,” says Jha. “Your body has an immunologic reaction to the virus, but then it starts having reactions to your own native tissue. But the truth is, we don’t know.”

Simoneau says symptoms of long COVID are similar in children, teens, and adults. But long COVID can be particularly discouraging to young adults who are high achieving athletes. “For me, it was super frustrating, because I was a very competitive athlete,” says Stump, who was a synchronized swimmer. “After having this, just going for a walk, I would get so fatigued. It just doesn’t make sense!”

“I have extreme fatigue and joint pain. I can’t walk for too long, and my whole body shuts down.”

Similarly, 17-year-old Elizabeth Eidson from Tennessee, a competitive volleyball and basketball player, began developing long COVID symptoms about a month after having COVID in December, 2020. “I have increased resting and active heart rate and I get fatigued very quickly,” she says.

Simoneau expresses concern for the mental health effects of long COVID in teens and young adults. “Many of these patients had a history, prior to their COVID infection, of anxiety or depression, and with long COVID, that gets amplified.”

“People think I am a drama queen,” says Stump. “I don’t want people to think I am extra and making a big deal out of this, but it is a big deal.”

Thirteen-year-old Lly Silva from Millis, Massachusetts began developing long COVID symptoms a few weeks after they had COVID in March, 2020. Silva’s symptoms include memory loss, brain fog, extreme joint pain, appetite issues, vertigo, and skin rashes. “Mental health has gone downhill,” Silva says. “As far as physical health goes, I have extreme fatigue and joint pain. I can’t walk for too long, and my whole body shuts down. Talking is harder. My brain is picky about what I eat, and my stomach rejects different foods. It is really hard to deal with.”

According to Simoneau, treatments for long COVID include working with pain specialists, physical therapists, and physicians. But Simoneau still faces challenges while treating post-COVID patients.

“The symptoms are so vague and we lack diagnostic tools. We have all these patients come in, and we don’t know that it is post-COVID," Simoneau says. "Their symptoms may seem consistent with a post-viral process, and their antibodies may be positive, so we go with that. But we don’t know for sure what defines it or how to diagnose it.”

“We don’t have clear clinical criteria,” adds Jha. “We don’t know how long your symptoms have to persist before they are called long COVID. After getting a viral infection, lots of people can feel pretty lousy for weeks. Is that enough, or do you have to wait months? What symptoms should we be looking for?”

“If you are a teen or young person and are not yet vaccinated, get vaccinated!”

Still, Stump and Silva express hope for the future. “I hope it is something that we will study more, and have more information about in the future,” says Stump. “Long COVID is something we should pay attention to.”

“I really, really hope that I get better,” says Silva. “I really hope that I can actually walk around and do normal stuff again.”

 Jha looks to vaccines as a possible way to mitigate the impact of long COVID. “It is not definitive data, but there is some data that getting vaccinated can help against long COVID. If you have long COVID, and haven't gotten vaccinated yet, you should.”

Regardless of whether you have long COVID or have never had COVID, Jha emphasized the importance of getting vaccinated.

“If you are a teen or young person,” Jha urges, “and are not yet vaccinated, get vaccinated!”

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Originally Appeared on Teen Vogue