New studies show that children and teens are developing long COVID at higher rates—especially after multiple infections. Here’s how clinical labs can play a vital role in identifying at-risk patients and supporting early intervention.
As the healthcare system continues to grapple with the lingering effects of COVID-19, new research is drawing attention to a growing—and often overlooked—population: children and teens with long COVID. For clinical laboratory leaders, these findings underscore the continued importance of SARS-CoV-2 testing, variant monitoring, and post-infection diagnostics in younger patients. Studies reviewed by the Center for Infectious Disease Research and Policy (CIDRAP) and others show that long COVID is not only prevalent in youth but more likely to develop after reinfection. With an estimated one million U.S. children already affected, labs play a critical role in helping clinicians identify and manage post-viral complications while providing data that inform vaccine and reinfection risk strategies.
The pooled results of the studies found that long COVID prevalence was 36% among patients who had become infected with the SARS-CoV-2 infection. The highest prevalence was found in South America, and risk factors included being unvaccinated for the virus, contracting a pre-Omicron variant, and being of the female sex.
Another study analyzed from The Journal of Infectious Diseases focused on the effects of long COVID on adolescents in the summer of 2022. In that study, at least one symptom lasted for four weeks or more for 41% of the respondents who also tested positive for a SARS-CoV-2 infection. Adolescents in the study who tested positive also had increased odds of developing neurological symptoms that lasted three months or longer compared to the adolescents in the study who tested negative for SARS-CoV-2. However, the study also concluded that most symptoms are resolved within three months of infection.
Risk Increases with Multiple Infections
The New York Timesrecently reported that a study published in Lancet Infectious Diseases found that children and teenagers are twice as likely to develop long COVID if they became infected with the virus more than once. The study was a part of the National Institutes of Health’s RECOVER Initiative by examining the records of around 465,000 young people under 21 at 40 United States children’s hospitals.
Over a six-month period, it was found that 1,884 per million young people would develop long COVID after being infected with the virus twice, whereas only 904 per million young people developed long COVID after one infection. The exact numbers of young people with long COVID is not known. However, the Centers for Disease Control and Prevention (CDC) estimates the number stands at about 1 million American children, or 1.3% of the population under 18. A similar trend is seen in adults with long COVID.
These numbers are likely conservative, and the issue of long COVID among youth may be more widespread. According to the same study, tens of thousands of young people in the study were treated for conditions associated with long COVID, such as respiratory symptoms and abdominal pain. Yong Chen, PhD, senior author of the study and professor of Biostatistics at Department of Biostatistics, Epidemiology, and Informatics (DBEI), and a Senior Scholar at Center for Clinical Epidemiology & Biostatistics (CCEB) at the University of Pennsylvania (Penn) Perelman School of Medicine, noted the limitations of the diagnostic code. As quoted by The New York Times, he called the findings a mere “subset of the long COVID.”
Yong Chen, PhD, professor of Biostatistics at DBEI, and a Senior Scholar at CCEB at the University of Pennsylvania (Penn) Perelman School of Medicine said, “Your body really has a memory system and is really going to be hurt from recurrent infection.” (Photo credit: University of Pennsylvania)
Mitigating Risk
Now that we are over five years past the initial worldwide lockdowns, the public has begun to live with significantly less fear–– but the risk remains. “People think that reinfections don’t matter as much and don’t take them seriously,” Chen told Time, “Our primary message is that reinfections still matter, and you should do what you can to avoid reinfection by taking a vaccine or wearing a mask.”
However, the CDC has recently approved recommendations made by Health and Human Services Secretary, Robert F. Kennedy Jr., to remove the blanket recommendation for adults 65 and older to be vaccinated against COVID-19 and recommended that patients between six months and 64 years should discuss with their doctors. Critics of the move warn that these ‘softer’ recommendations may limit insurance coverage of the vaccines.
Clinical laboratory professionals should remain vigilant as research continues to reveal how long COVID affects younger populations. The persistence and variability of post-COVID symptoms highlight the need for continued diagnostic vigilance and testing innovation—not only to confirm infection but to monitor lingering inflammatory, respiratory, or neurological effects. By maintaining awareness of evolving studies and updated guidance from public health agencies, labs can help clinicians identify which patients may be at higher risk for long-term complications. Moreover, laboratory data can support broader efforts to track reinfection patterns, inform vaccine strategies, and guide local health systems in managing the ongoing burden of COVID-related chronic illness.
Some of the former employees worked for public health labs involved in tracking HIV, hepatitis, and STDs
More than 450 federal employees who were laid off from the Centers for Disease Control and Prevention (CDC) during the April cutbacks are being reinstated by the Department of Health and Human Services (HHS).
Nearly half (214) worked for the National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention (NCHHSTP), which includes specialized public health laboratories. Another 158 worked at the National Center for Environmental Health (NCEH). Others were employed by the Immediate Office of the Director and Global Health Center.
“I think people are very tacitly hopeful that this means they can get their jobs back and continue serving in ways that they love,” NCEH health scientist Kathryn Sisler, MPH, told NPR. “But there has been so much instability and chaos that I think a lot of people would hesitate to say it is good news.”
Sisler, who works in NCEH’s Division of Environmental Health Science and Practice, received an email notification of her reinstatement on June 11, NPR reported.
She described the rehiring as “a step in the right direction,” but noted that she was among some employees in her division who had moved away from Atlanta, where the CDC is based. “Other employees had taken other jobs or had been offered them,” NPR reported.
In an interview with NPR, Scott Becker, CEO of the Association of Public Health Laboratories, admitted to being “happily flabbergasted” to hear about HHS’ offer to rehire the former federal workers. (Photo copyright: Association of Public Health Laboratories.)
Impact at Critical Labs
As part of the cutbacks, the CDC shut down two laboratories at NCHHSTP that were involved in tracking viral hepatitis and sexually transmitted diseases, even as “some of those scientists performed disease surveillance work unlike any other labs in the world,” NPR noted.
NCHHSTP staffers told NPR that some of the division’s labs were damaged due to the “lapse in activity” during April and May, and that “some disease outbreaks had not been properly tracked.” One employee said that, due to the cutbacks, the division’s hepatitis lab was unable to assist health workers tracking a hepatitis C outbreak in Florida. The CDC employees requested anonymity.
“It’s great to see that there is some recognition of the importance of these workers and that being in those positions is critical for the public health of America and that they are being reinstated in order to continue their important work,” Carmen J. Marsit, PhD, of Emory University’s Rollins School of Public Health, told NPR. He added, however, that “there’s still a lot of people that are not being reinstated.”
HIV Not Being Tracked
KFF Health News reported that the reinstatements included “dozens of HIV experts” who were laid off in April. At the time, they were working on a national survey conducted among 30,000 individuals at risk of acquiring the infection. They haven’t been told if the project will resume.
Public health departments use data from the survey as part of their efforts to reduce spread of the disease, KFF Health News stated, noting that “preventing HIV is far cheaper than treating people once they’re infected.”
Since the cutbacks, many HIV researchers at CDC have obtained new jobs or moved. Some employees “called the reinstatements perplexing because the notices don’t say what they’ll be doing when they return and for how long,” KFF Health News reported.
“I am concerned about how many of the people have already moved on or might move on and the trauma that they really must be going through with the uncertainty,” Scott Becker, CEO of the Association of Public Health Laboratories, told NPR about the reinstatements at CDC. “But all in all, it’s good news and I’ll take it.”
Programs Cut by Mistake
The reinstatements amount to approximately 20% of the 2,400 CDC employees laid off following the March 27 announcement of a massive restructuring at HHS.
HHS secretary Robert F. Kennedy, Jr. told ABC News in early April that some programs had been cut by mistake. “Personnel that should not have been cut were cut—we’re reinstating them, and that was always the plan,” he said.
In May, Kennedy said that 328 employees of the CDC’s National Institute for Occupational Safety and Health (NIOSH) would be reinstated, NPR reported, following “considerable pushback from labor organizations and congressional lawmakers.”
NPR and other outlets had earlier reported that HHS planned to cut at least 900 NIOSH employees, amounting to 90% of the institute’s workforce.
Industry commenters point to a void since the federal government shuttered the Clinical Laboratory Improvement Advisory Committee
For readers wondering what has happened to the Clinical Laboratory Improvement Advisory Committee (CLIAC), the bottom line is the panel has been terminated, causing a significant void for the lab industry at the federal level.
Dark Daily’s sibling brands, including The Dark Report, G2 Intelligence, and Today’s Clinical Lab, have been exploring various aspects about the demise of CLIAC.
The Centers for Disease Control and Prevention (CDC) confirmed to G2 Intelligence that CLIAC was terminated as of March 31, citing an executive order from President Donald Trump intended to reduce federal advisory committees. The decision blindsided even those closest to CLIAC. Incoming committee chairman Jordan Laser, MD, revealed in an email to colleagues that he did not have more insight into CLIAC’s demise beyond media reports, G2 reported.
Since its founding in 1992, CLIAC has played an influential—though non-regulatory—role in shaping updates to the Clinical Laboratory Improvement Amendments of 1988 (CLIA). The committee brought together pathologists, lab directors, public health leaders, and representatives from federal agencies such as the CDC, Centers for Medicare and Medicaid Services, and Food and Drug Administration.
The federal government’s decision to eliminate CLIAC “risks stalling progress in laboratory medicine, which could ultimately hinder efforts to improve patient care,” CAP President Donald Karcher, MD, FCAP, told The Dark Report. (Photo copyright: College of American Pathologists.)
‘Critical Venue’ for Labs Has Been Eliminated
Industry groups are sounding alarms about what comes next. In an interview with Today’s Clinical Lab, Anthony Killeen, MD, PhD, president of the Association for Diagnostics and Laboratory Medicine (ADLM), said CLIAC was an important forum for medical lab scientists to discuss CLIA.
“[CLIAC] served as a critical venue for working through current problems with the rule and also for expert input on how new technologies—such as next-generation sequencing, digital pathology, and artificial intelligence-assisted diagnostics—should be assessed and integrated under CLIA,” Killeen said.
ADLM has formally urged Department of Health and Human Services Secretary Robert F. Kennedy, Jr. to reverse the CLIAC decision. In a May letter, the association emphasized that CLIAC’s work was funded entirely through user fees paid by clinical laboratories rather than taxpayer dollars—a point many in the lab industry say underscores CLIAC’s value.
CAP President Wonders about Future Communication Gaps
The Dark Report noted that the disbanding of CLIAC may cost labs time in certain cases, a commodity that few diagnostic settings have in abundance.
“The absence of this advisory body may lead to gaps in communication and slower response times in addressing [industry] challenges,” Donald Karcher, MD, FCAP, president of the College of American Pathologists (CAP), told The Dark Report.
The absence of CLIAC raises uncertainty for clinical labs because federal agencies have lost a prime source to gather specialized input on complex scientific and operational issues facing the lab industry. Dark Daily’s partner brands will continue to track this matter closely. If you’re not a subscriber, you can check out The Dark Report’s insider coverage with a 14-day free trial.
