The Neurological Effects of COVID-19 in Children

What we have learned about COVID-19 and children's brains.

Posted Mar 25, 2021 | Reviewed by Chloe Williams

  • Children experience neurological symptoms at a higher rate relative to their COVID infection rate compared to adults, although severe cases are rare.
  • Some ways parents can minimize risk include making sure their child understands the importance of wearing a mask, washes their hands, eats a healthy diet, and gets enough sleep.
  • Some common neurological symptoms, which are generally resolved in a few weeks, are loss of smell and taste, fatigue, headaches, and an inability to focus. 
  • More concerning symptoms that may require professional attention include impaired memory, reduced vocabulary, and a child acting as though they are several years younger.

Children are at relatively low risk from COVID-19, but they’re not immune. Parents should not overreact and keep their children locked away, but they should take a few simple precautions to limit their children’s exposure, and they should know which symptoms to watch for.  

By this point, most people have become aware that COVID-19 can cause a variety of neurological symptoms — the most well-known perhaps being anosmia, the temporary loss of the sense of smell.

It’s also well-known that children are generally substantially less at risk than adults. Yet surprisingly, although they’re far less likely to die or suffer from a severe case, children actually experience severe neurological symptoms at a higher rate relative to their infection rate (not necessarily per unit of population) than adults.  

In extreme cases, a few children develop encephalitis — inflammation of the brain — as well as MIS-C — multi-system inflammatory syndrome in children.

In one high-profile case, 15-year-old Nia Haughton of the UK suffered from profound mental effects following a severe bout of COVID-19. Following her physical recovery, her personality, voice, behavior and mental capabilities seemingly regressed to a younger version of herself.  

But just how common is this, really?

Approximately 6 percent of children who contract COVID-19 are hospitalized, and data suggests that at least one-third of hospitalized COVID patients — as well as many non-hospitalized patients — suffer from lasting neurological symptoms.  

However, “lasting neurological symptoms” are a very broad category, and these symptoms are almost always far less severe than MIS-C. Most commonly, patients suffer from lingering anosmia and dysguesia (loss of smell and taste) and post-viral fatigue.  

Dr. Pablo Parente-Arias of Augusto University Hospital in Lugo, Spain, notes that most adult patients recover from anosmia within a month, although a small minority may take over three months.  

According to Liam Townsend of St. James’s Hospital in Dublin, Ireland, recovery from post-viral fatigue may take longer — often more than three months. However, note that a) this is based on a sample of mostly middle-aged adults, and b) post-viral fatigue is not uncommon after the flu, either.  

In short, children are still far safer than adults, and nothing we’ve learned so far has changed that assessment. Nonetheless, parents will always be concerned for their children, and practitioners will need to address that concern. Here is some advice that medical and psychological professionals can give to parents concerned about their children.

L N on Unsplash
For professionals, it’s important to help parents put the risks in perspective. 
Source: L N on Unsplash

What Parents Can Do to Minimize Their Child’s Risk

Mask wearing. Make sure your child understands the importance of wearing a mask at all times while at school or in any public area that is either crowded or indoors.  If they wear cloth masks, switch to a new mask every day, washing used masks after a day of use just as you would clothing. 

Hand washing. Make sure they wash their hands after every time they use the bathroom, and before and after every meal.  

Healthy diet. Make sure your child is eating fruits, vegetables and protein with every meal. Limit added sugars to one meal a day.

Sufficient sleep. Put your child to bed at the same time every night. Ensure that they are in bed for at least 9 hours if in high school, 10 hours if in elementary school or junior high, or 11 hours if in preschool or kindergarten.  

Hydration. Have them drink more water than usual to ensure sufficient mucus production.   

Use a UV sterilizer. You can use a small, portable UV sterilizer wand to kill germs on some of the most germ-covered areas of your home, such as light switches, bathroom counters, and toilets, as well as the inside of your child’s backpack.  

Practitioners should also emphasize to parents that minimizing exposure not only reduces the risk of infection but will also reduce the likely severity of infection if and when it does happen.   

Neurological Symptoms to Watch For

Some neurological symptoms are more concerning than others. The following are common, generally resolve on their own in a few weeks, and not necessarily unique to COVID-19:

Loss of smell and taste. This appears to be caused by neurological damage, rather than damage to the nose. It’s common and almost always resolves in a few weeks. However, it can cause a drop in appetite; affected children may need to be pushed to eat despite not being hungry.  

Post-viral fatigue. Are they tired all the time for no clear reason? And does this last for weeks, even over weekends when they can catch up on sleep? In this case, the child may need bed rest, a healthier diet, and reduced activity for some time.

Chronic headache. Headaches are common, but watch for ones that occur frequently, for no clear reason, and are not easily fixed by NSAID’s or hydration. In some cases, this may be worth a quick visit to a pediatrician.  

Inability to focus. Is your child suddenly unable to keep their mind on one task for as long as they used to? This could be a symptom of post-viral fatigue. 

On the other hand, the following symptoms are more concerning, and likely warrant a visit to a psychologist, psychiatrist or neurologist to assess their severity:

Aaron Burden on Unsplash
Minimizing exposure not only reduces the risk of infection but will also reduce the likely severity of an infection.
Source: Aaron Burden on Unsplash

Impaired memory. Does it take them longer to remember things that should come easily to mind?

Reduced vocabulary. Do they suddenly seem to know or use a much more limited range of words?

Age regressionIs your child suddenly acting as though they’re several years younger?  

Even these symptoms will probably go away on their own — but that can take months, and in the meantime, a child may be in danger of falling behind academically, particularly if they’re also having trouble with remote learning.  

That said, most children won’t get symptomatic COVID-19, and the vast majority who do won’t have long-lasting issues as a result. As a medical or behavioral health professional, it’s important for you to help parents put the risks in perspective.   

References

https://www.nbcnews.com/health/health-news/covid-19-children-doctors-see-link-between-virus-neurological-side-n1235501

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7284232/