MONTREAL -- When 13-year-old Charles trudged into his mother’s room one morning and said “Mom, I’m not feeling well,” Sophie Lahaie immediately thought he probably had COVID-19.
It was a natural deduction seeing as how her son’s class at school had just been cancelled due to an outbreak that affected at least four other students.
“He was very exhausted, terribly exhausted. He was having trouble just to sit [up]. That was way too much effort for him,” Lahaie said.
“I really felt like that, it was horrible,” Charles Francoeur said in an interview with CTV News.
Sure enough, a COVID-19 test came back positive. But Charles largely bounced back after a few days - or so his mother thought - and as per public health guidelines, went back to school ten days later.
That meshes with the experience of other children who have contracted COVID-19. The vast majority are either asymptomatic or have mild symptoms during the active phase of infection and go on to make a complete recovery.
But it turns out Charles wasn’t fine. He told his mom he had struggled to make it through the day.
“As soon as he entered the house, he came to me. He was white, he was completely white. He was sweating profusely, his whole face was wet and he was grabbing his chest and saying, ‘Maman, my heart hurts, it’s painful.’”
Lahaie took her family doctor’s advice and immediately took Charles to Ste. Justine Hospital’s emergency room in Montreal.
“Right away the doctor had not even [examined] him yet and she was telling me, ‘We’re going to keep him, he’s too unwell to go back home,’” Lahaie said.
The boy’s symptoms, his fatigue, and a squeezing sensation in his chest have now lasted for months.
LONG-COVID CLINIC FOR KIDS
Charles Francoeur is not alone when it comes to lingering issues, post-COVID-19 infection.
“A minority of patients have persistent symptoms,” according to Dr. Sze Man Tse, a pediatric respirologist and researcher at Ste. Justine Hospital.
It’s an important minority, however, one that Dr. Tse realized required specialized attention in Montreal, prompting her to open a post-COVID clinic at the hospital.
She said there was “a clinical need,” the result of all the calls she was receiving from pediatricians and family doctors in the community, saying “we have these kids, we don’t know where to send them...not sure what to do with them,” Tse explained.
They held the first post-COVID clinic at the beginning of April, with six children, all adolescents, and are treating four additional patients in May.
Having lingering respiratory symptoms for at least a month is the main criteria for admission. The longest a patient has suffered so far is six months.
Complaints usually include chest pain, trouble breathing or catching their breath if they exert themselves, sometimes a cough, and general fatigue.
A BATTERY OF TESTS
The children are examined thoroughly and are run through basic lung function tests.
While Dr. Tse says they haven’t been able to establish a causal effect so far or spot particular abnormalities, she says their symptoms “can’t be explained by other infections or causes.”
“One of the things I hear from families is, ‘My tests are normal but I still feel abnormal’ so just part of treating these patients is to recognize their symptoms,” said the specialist.
That aspect becomes especially important since some of the children were referred to the Ste. Justine clinic after having the health problems dismissed and chalked up to stress.
“We don’t want to put all the symptoms on the back of mental health because we don’t know, we don’t know what COVID can do to the respiratory system in the long term,” Tse said.
HELP OFFERED
The young patients are offered personalized lifestyle support to facilitate and speed recovery.
It includes an exercise program that helps them get moving but go at their own pace. No specific medications are prescribed.
There’s no evidence yet that the approach works, but Dr. Tse said they’re “hoping that will help them get back on their feet faster.”
And they have seen patients improve, so Dr. Tse said she reassures the teenagers that “with time things get better,” even though “it might take months.”
In the meantime, the patients are part of ongoing research at the clinic so that specialists can learn more about how COVID-19 behaves long-term with the added benefit that the children's health concerns are properly evaluated.
CHARLES SEES RESULTS
Sophie Lahaie and Charles have learned how to manage his condition using over-the-counter medication for pain when needed, and lots of rest.
“He’s much better now,” said Lahaie, adding the first three months were the toughest.
“He still has episodes where he has a pain in his heart or trouble breathing but instead of lasting for days it lasts for a couple of minutes,” Lahaie explained.
For Charles’s mom, the reassurance and follow-up care are getting them through this challenging time.
“A lot of times parents get told, oh, it’s anxiety or he wants your attention,” she said.
“Just being told we believe you, that’s something that made the whole difference,” Lahaie said.
According to Dr. Tse, there are now plans afoot to create a “more general” post-COVID clinic at Ste. Justine to research a host of other related symptoms like headaches and difficulty concentrating.
“It’s in the works,” Tse said.
