The Pan-London Post-COVID (Long Covid) Service was established in response to an urgent need for specialist services in Children and Young People (CYP). Our clinical experience has contributed to a framework used around the UK.  

Persistent symptoms are not uncommon after COVID-19 infections and a small percentage of children have significant symptoms that get in the way of normal activities and need expert specialist care and support. We have evolved in response to the lived patient experience and growing recognition and understanding of Post-COVID symptoms in children and young people.

The TRACCS team experience is that early intervention and support is important in helping and improving the lived experiences of children and young people.

The service is for children and young people (aged 0-18 years) suffering from symptoms 12 weeks after a likely or proven COVID-19 infection. Usually, symptoms are severe enough to be impacting on the child or young person’s life. We accept patients from their paediatrician who will have undertaken an assessment to look for complications needing urgent management or another diagnosis to explain the symptoms. For young people, 17-18 years old in education who are too old for paediatric services we would accept a referral from GP.

All patients should have filled in the questionnaire from our team.

The paediatrician or GP will present the case for discussion at weekly virtual MDT(multidisciplinary team) meeting with specialists such as paediatrician, adolescent medicine, respiratory, infectious diseases, rheumatology, cardiology, neurology, psychiatry, psychology, physiotherapy, occupational therapy and clinical nurse specialist. Patients’ paediatricians remain involved throughout their care to ensure appropriate local service involvement as well.

After discussion, Patients get specialist educational leaflets and virtual groups to manage the common symptoms and concerns. If patients meet a threshold, they will be referred for face to face assessment in UCLH multidisciplinary clinic.

Patients are seen face to face for an initial appointment by a paediatrician and one or more of psychology or psychotherapy, physiotherapy or occupational therapy.

MDT rehabilitation treatment will then continue in a mix of virtual and face to face appointments.

Symptoms after COVID infection including:

  • fatigue, 
  • muscle aches and pains, 
  • temperatures, 
  • abdominal symptoms, such as pain, and diarrhoea
  • anosmia, 
  • sleep difficulties, 
  • emotional and behavioural difficulties
     

Post-COVID syndrome pathway for children and young people

History:

  • Confirm if/when the patient is believed to have had COVID-19
  • Consider potential fluctuating symptoms and trends
  • Consider potential cardiac, respiratory and autoimmune symptoms
  • Gain understanding of patient’s functional baseline prior to contracting COVD-19
  • PsychoSocial assessment: impact of condition on family, education etc.

 

Investigations:

  • Pulse, oxygen saturations, blood pressure, urinalysis (protein, blood glucose)
  • Blood tests (dependent on symptoms): FBC, blood film, U&E, creatinine, LFT, TFT, ESR, CRP blood glucose, coeliac screen, CK, ferritin
  • Trial of simple measures e.g.: gentle exercise, sleep hygiene, liaison with school.
  • Additional tests (depending on symptoms/clinical judgement): e.g. brain MRI, faecal calprotectin

 

Patient to complete ISARIC questionnaire

Refer if >12 weeks of persistent symptoms, or sooner (4-12 weeks) if concerned.

Red flags for referral include missing school despite simple measures.

Discuss with paediatrician if there is an unclear diagnosis.

Screening tests ahead of the Virtual MDT (as appropriate):

  • FBC, ESR, CRP, Blood film, Thyroid function, Liver function tests, renal and bone profile, CK, Ferritin, coeliac screen, ANA, SARS-CoV-2 serology, vit D, vitamin B12, iron studies, EBV and CMV serology and PCR.
  • Additional investigative bloods including Troponin, D-Dimers and VWF/ADAMTS may be undertaken based on clinical judgement
  • Faecal calprotectin (if abdominal symptoms)
  • Urine albumin/creatinine ratio
  • ECG (if palpitations, breathlessness etc); cardiac ECHO only following MDT discussion
  • Imaging as appropriate (e.g CXR, abdominal USS)
  • 1 minute sit-to-stand test

Ensure ISARIC questionnaire completed

Inclusion criteria: <18 years, or 18 years and in education

History of suspected COVID-19

Refer to inclusion and exclusion criteria for referrals

Email referral form to: london.cyppostcovid@nhs.net

Patient contact

General enquiries

Service management

Address

Children and young peoples outpatient dept
Lower ground floor
Elizabeth Garrett Anderson Wing
University College Hospital
25 Grafton Way
London, WC1E 6DB

Other referral information

To make a referral, please download and complete this form. Completed referrals should then be sent via email to the team at london.cyppostcovid@nhs.net.

Referral address

Post COVID and TRACCS admin team,
Paediatric department,
6th Floor ,
250 Euston Road,
NW1 2PG