Vaccination can occur immediately following the recommended isolation period unless the patient has a history of multisystem inflammatory syndrome in children (MIS-C), in which case delaying vaccination until after they have recovered from illness (including return to normal cardiac function) and for at least 90 days following their diagnosis of MIS-C should be considered (see AAP interim guidance on MIS-C and the Centers for Disease Control and Prevention Interim Clinical Consideration for Use of COVID-19 Vaccines Currently Authorized in the US). What should the pediatrician discuss in the evaluation of a child or adolescent after a SARS-CoV-2 infection, regardless of residual symptoms?ĬOVID-19 vaccination is recommended for all children who do not have contraindications, including those who have a history of previous SARS-CoV-2 infection. Patients with continued symptoms should receive coordinated follow-up depending on the specific signs or symptoms (see below) and their duration. Telehealth has become invaluable in providing health care to individuals during the COVID-19 pandemic and can also be a useful tool in providing care to individuals with post-COVID-19 conditions. For patients with moderate disease, follow-up visits should take place after the recommended isolation period and prior to return to physical activity. For asymptomatic infection or mild disease severity (100.4☏ 4 days of fever >100.4☏ >1 week of myalgia, chills, or lethargy non-ICU hospital stay) or severe disease (ICU stay and/or intubation) may be at greater risk for subsequent cardiovascular disease therefore, an in-person visit is recommended. Because of the wide range of post-COVID-19 manifestations, a coordinated conversation is necessary to monitor residual symptoms, explore the development of any new signs or symptoms, and help guide return to activities of daily living (eg, sports, school, camp, employment, volunteer activities).Īcute COVID-19 severity does not necessarily predict subsequent or ongoing signs or symptoms. The medical home is a trusted source of information for patients and families, including information about asymptomatic infection or symptomatic COVID-19 and its sequelae. We recommend that this encounter occur prior to resuming sports or physical activity or within 2 to 4 weeks of a positive SARS-CoV-2 test, whichever is sooner. ![]() Do all children who have experienced a SARS-CoV-2 infection, whether symptomatic or not, require a follow-up visit?Īll patients who test positive for a SARS-CoV-2 infection should have at least one follow-up conversation or visit with their primary care medical home. This interim guidance provides pediatricians with direction to navigate the follow-up care of infants, children, and adolescents following a SARS-CoV-2 infection. Guidance on routine care during the COVID-19 pandemic can be found here. Telehealth is playing an increasingly important role in follow-up for these patients with potentially long-term signs and symptoms that require ongoing monitoring. Pediatric visits are critical to monitor complete resolution of COVID-19 signs and symptoms, administer COVID-19 and other routine vaccines, screen for and address mental health concerns, document physical and psychosocial development, coordinate care with specialists as appropriate, and emphasize anticipatory guidance for optimal health. Pediatricians play an important role in caring for children and adolescents during and following a SARS-CoV-2 infection. Long-term effects from SARS-CoV-2 infection may be significant, regardless of the initial disease severity. Although some children and adolescents may have less severe acute illness than adult populations, COVID-19 can lead to many secondary conditions, which can range from mild to severe, with some becoming chronic. ![]() ![]() This is likely a large underestimate, given that many tests have been performed at home. Over 14.2 million children have tested positive for SARS-CoV-2 in the United States.
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