What parents need to know about the cognitive impacts of Covid-19
At the end of October, reports began to circulate on new search in the cognitive costs of contracting Covid-19. Disturbing warnings shared that the infection can cause neurological impacts equivalent to 10 years of brain aging. But with the research still considered preliminary (not yet peer-reviewed), and with none of the more than 80,000 participants followed being under the age of 16, parents wondered how these findings might apply to their children. .
What we know about children and Covid-19
Song of Elisa, MD, is an integrative pediatrician trained at Stanford, NYU, UCSF and an expert in pediatric functional medicine in private practice. Not only has she helped many families through the pandemic as a pediatrician, but she is also the mother of two young children (9 and 10), both of whom had Covid-19 in March.
“While the vast majority of children seem to be doing well even if they contract Covid-19, there is a small group of children who develop a rare inflammatory disease called multisystem inflammatory syndrome in children (MIS-C),” explained Song.
In March, her son was hospitalized with what she says in retrospect are all signs of the onset of MIS-C, although doctors didn’t even know how to look for it yet. So, as a parent, she has personal experience of the fears that accompany a child who contracts Covid-19.
“What we don’t know yet is whether children are at risk for the same long-term complications and the same ‘long-Covid’ symptoms that we are starting to see in up to 80% of adults who have recovered of Covid-19, “she said. , explaining that reports of “long-haul” children are just starting to emerge.
Song acknowledges that data on children and Covid-19 is lagging behind.
“We know that children with Covid-19 are more likely to have mild to moderate symptoms,” she said. “However, if even mild symptoms have a lasting and severe cognitive impact on children as it seems for adults, parents need to understand how to identify these cognitive impacts on their children, how their schoolwork may be affected, and what they are doing. can do to help. “
Understand the latest research
Adam Hampshire led the latest research, analyzing data from cognitive tests of 84,285 participants suspected of Covid-19. It should be noted that only 361 of the participants had confirmed Covid-19 testing.
“The most important finding from this latest Covid-19 research is that people who have recovered from Covid-19, even with mild illness, can have long-term cognitive impacts,” Song said, adding that those who recovered from Covid-19 in this study showed significantly pronounced problems in the areas of executive function and higher cognitive skills.
“Executive function is necessary for success in all aspects of our life,” Song explained. “Executive function includes the ability to pay attention; organize, plan and prioritize your work, manage your time, stay focused, be flexible, have self-control and regulate our emotions.
Severe cases of Covid-19 requiring hospitalization and ventilation have been associated with greater cognitive impacts, but these impacts have been detected even in people with mild illness.
It’s not entirely surprising, however, according to Leann Poston MD, MBA, M.Ed. of Invigorating Medical.
“Cognitive deficits are not unusual after recovering from a viral infection,” she said, explaining that these deficits may be secondary to an inflammatory process of the infection, a lack of oxygen, to strokes or to the overall physical and psychological stress of having a serious illness. “Long-term follow-up of people who have recovered from Covid is not available, and therefore, no conclusion can be drawn on the permanence of these impairments. “
Song agreed, adding the following study limitations that parents should keep in mind when reviewing the study results:
- Study participants were 16 years and older
- No children were included in the study, and it is possible that cognitive impacts were not seen in children who had COVID-19 as was found in adults.
- This study also does not specifically examine the pre- and post-COVID-19 cognitive test results of each participant, nor does it report pre-existing neurological and psychiatric conditions.
“However, until research on children and COVID-19 catches up, being prepared and aware of the possibility of cognitive impacts will help parents support their children’s academic and emotional needs during the pandemic, d ‘especially since schools are probably back full time. distance learning during the winter months as COVID-19 and influenza converge, ”Song said.
Potential impacts on children
Poston noted that this is not the only study of its kind.
“A growing body of research indicates that there are cognitive side effects following COVID infections,” she explained. “These effects may be due to the virus itself, secondary to severe respiratory failure due to COVID, or the physical and psychological strain of severe infection. “
No one knows, at this point, what the long-term effects of Covid-19 infections are on the brain, and especially in children, she said. But she encourages parents to do what they can to protect their children’s self-esteem and psychological health as they recover from this illness.
Encouraging information shared by Poston is that children’s brains are more resilient than adults’ brains and should hopefully recover better than that of more recent study participants.
“However, especially for children critically ill with Covid, cognitive deficits can persist long enough to impact their schoolwork and other areas of life,” she said.
It is important for parents to be aware of this potential so that they can monitor their children for lasting complications, even if they were only mildly ill.
“Adults who have been able to express their perceptions of dementia report that it looks like brain fog and difficulty paying attention,” Poston explained. “I suspect it would be the same with children.”
She said most teachers have basic student work, which may enable them to detect impairments better than parents if the quality of schoolwork declines.
Song said the executive functioning skills that appear to be most affected by Covid-19 typically begin to emerge in elementary school, solidifying throughout the middle and high school years. “If not recognized, deficits in executive functions will contribute to children falling further behind academically and socio-emotionally – already a concern during the pandemic. “
For this reason, it is important for parents and teachers to team up to look for signs of potential impairment in children who have recovered from Covid-19.
Signs of cognitive impact in children
Monitoring the possible cognitive impacts of Covid-19 in their children, Song said parents should look for any changes in executive functioning skills and emotional regulation.
“Of course, the increased anxiety felt by children and adults during the pandemic will also affect them,” she explained. “But it’s important not to think of them as just ‘pandemic stress’.”
She described these signs that parents should watch out for:
- Having difficulty starting and / or completing tasks
- Having difficulty prioritizing tasks
- Forget what they just heard or read
- Having trouble following instructions or a sequence of steps
- Panic when rules or routines change
- Having trouble switching from one task to another
- Getting too emotional and focusing on things
- Having trouble organizing your thoughts
- Having trouble keeping track of their belongings
- Having trouble managing your time
If your child seems to have cognitive problems
If you are concerned that your child will have cognitive difficulties after a Covid-19 infection, Poston said your first step should be to contact your child’s school to set up a conference where you can discuss your concerns.
“Especially if the same concerns are noted in the school environment, neuropsychological testing can determine the level and types of impairment,” Poston explained, adding that some children might need modified lessons as they recover from the condition. Covid-19.
Song said it was also a good idea to make a loop with your child’s pediatrician.
“Educators can work with parents and children on developing strategies to optimize executive functioning skills and work with the school to provide educational accommodations as needed,” she explained. “Pediatricians may perform an initial cognitive and neurological screening and refer to appropriate specialists, who may include a neurologist, developmental pediatrician, or child psychologist for additional testing, including neuropsychological and psychoeducational testing. “
She said this multi-pronged team approach is the best way to meet a child’s needs.
“While this information may be alarming for some parents, ‘knowledge is power,’” Song said. “Understanding how to recognize the potential cognitive impacts of COVID-19 on our children and knowing how to support them will have even greater long-term positive impacts on their academic and socio-emotional health and well-being.
She understands how helpless some parents can feel right now, especially since the job of parents is to raise and protect their children, which can seem impossible while navigating these unexplored times.
But armed with knowledge, she said, “We can regain some power by making sure our children come out of the pandemic as healthy as possible.”