Postacute Sequelae of SARS-CoV-2 in Children
The coronavirus disease 2019 (COVID-19) pandemic has caused significant medical, social, and economic impacts globally, both in the short and long term. Although most individuals recover within a few days or weeks from an acute infection, some experience longer lasting effects. Data regarding the postacute sequelae of severe acute respiratory syndrome coronavirus 2 infection (PASC) in children, or long COVID, are only just emerging in the literature. These symptoms and conditions may reflect persistent symptoms from acute infection (eg, cough, headaches, fatigue, and loss of taste and smell), new symptoms like dizziness, or exacerbation of underlying conditions. Children may develop conditions de novo, including postural orthostatic tachycardia syndrome, myalgic encephalomyelitis/chronic fatigue syndrome, autoimmune conditions and multisystem inflammatory syndrome in children. This state-of-the-art narrative review provides a summary of our current knowledge about PASC in children, including prevalence, epidemiology, risk factors, clinical characteristics, underlying mechanisms, and functional outcomes, as well as a conceptual framework for PASC based on the current National Institutes of Health definition. We highlight the pediatric components of the National Institutes of Health-funded Researching COVID to Enhance Recovery Initiative, which seeks to characterize the natural history, mechanisms, and long-term health effects of PASC in children and young adults to inform future treatment and prevention efforts. These initiatives include electronic health record cohorts, which offer rapid assessments at scale with geographical and demographic diversity, as well as longitudinal prospective observational cohorts, to estimate disease burden, illness trajectory, pathobiology, and clinical manifestations and outcomes.
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![Myalgic Encephalomyelitis/Chronic Fatigue Syndrome [ME/CFS] Research Roadmap.—The
Committee recognizes the urgent need to advance research for ME/CFS, particularly given
its overlap with long COVID and its relevance across multiple Institutes and Centers, and
commends NIH for approving the ME/CFS Research Roadmap and developing an
implementation plan in response to prior Committee direction. Building on this work, the
Committee provides no less than $50,000,000 within the Office of the Director to support
implementation of the ME/CFS Research Roadmap. These funds shall be used to support
new and expanded research activities consistent with the Roadmap’s recommendations,
including but not limited to biomarker discovery, development and validation of diagnostic
tools, and interventional and clinical trials across relevant Institutes and Centers.
The Committee directs NIH to implement the ME/CFS Research Roadmap’s
recommendations and to include in the fiscal year 2028 Congressional Justification a
discrete summary of ME/CFS-related research investments, including projects supported
with these dedicated funds; a description of how Roadmap implementation is being
coordinated across Institutes and Centers; and an explanation of how ME/CFS research
supported under the Roadmap complements and informs NIH’s research on Long COVID,
post-acute infection syndromes, and related autonomic and neuro-immune disorders.
Thank you for your leadership and consideration of this request. With dedicated FY27 support,
Congress can help ensure the ME/CFS Research Roadmap becomes a real vehicle for progress—not
just a plan on paper—and finally move this field toward the diagnostics, treatments, and answers
https://notjustfatiguewebsite.cdn.prismic.io/notjustfatiguewebsite/abJ_fVxvIZEnjmR3_ME-CFS-FY27-Appropriations-Letter-Research-Roadmap-Funding.pdf](https://cdn.bsky.app/img/feed_thumbnail/plain/did:plc:szc7xq5qv7wg2abye6tlvet2/bafkreibmxaaky2m4py3v2er2434m5syee4hxcqx6elsjsyobgcxvlsqp5a)
