Since October 2020, Norton Children’s Infectious Diseases, affiliated with the UofL School of Medicine, has offered a clinic for children who continue to feel unwell long after they recover from acute COVID-19. As the pandemic persists, we are learning more about children with long-term post-COVID-19 symptoms.

These may be specific and localized, such as headaches, exertional dyspnea and anosmia, or nonspecific and difficult to characterize, such as fatigue, generalized weakness and “brain fog.” Moreover, many patients — teenagers in particular — are experiencing anxiety after having been through the acute illness and continuing to wrestle with social isolation and activity restrictions.

While best practices in managing these patients have yet to be established, a reasonable first step is a thorough evaluation and proper triage based on symptoms and screening laboratory tests, if appropriate. The COVID-19 Follow-up Clinic provides a gateway into comprehensive assessment and targeted management, often involving other pediatric subspecialties, such as cardiology, pulmonology, neurology, behavioral health and rehabilitation.

The clinic is open to children who have had proven or strongly suspected COVID-19, are beyond the acute phase of the illness (no fever and at least 10 days out from acute symptoms), and have new or lingering symptoms.

As we all navigate this pandemic together, we hope to gain a better understanding of why symptoms persist in some patients and what can be done about it. COVID-19 may be around for a long time, and we are committed to collaborating with the primary care community to provide gold-standard care in the region.

Gary S. Marshall, M.D., is a pediatric infectious diseases specialist with Norton Children’s Infectious Diseases and chief of pediatric infectious diseases for the University of Louisville School of Medicine Department of Pediatrics.