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Teens and kids with long COVID are showing surprising new symptoms

Rose Lehane Tureen is one busy teenager.

The 16-year-old is class president, an Irish step dance champion, singer, cross-country runner and straight-A student at her high school in Maine.

Her accomplishments belie the reality that she suffers from a debilitating headache that has lasted for more than four years, one of the several long COVID symptoms she's endured since an infection in March 2020.

At the beginning of her illness , Rose went to the emergency room half a dozen times and was hospitalized twice with dizziness and blinding head pain. She also had red and swollen fingers, toes and ears; peeling skin; joint pain; problems controlling her temperature and terrible dreams.

She lost years of her life to long COVID and is trying to make up for it.

“I had to decide if I wanted to wither away on the couch in the dark or push through and do things that made me happy,” she said. "I'm reclaiming what it's taken and trying to live my life."

Rose is one of the estimated 5.8 million children in the U.S. with long COVID, many of whom have not been diagnosed because doctors, parents and patients fail to recognize the constellation of symptoms, experts say. A new study funded by the National Institutes of Health aims to arm families with information, identifying the most common long COVID symptoms in school-age children and teenagers.

“Children aren’t just little adults,” said Dr. Melissa Stockwell, the study's coauthor and division chief of child and adolescent health at Columbia University. The more providers understand how long COVID impacts people at different ages, the easier it will be to diagnose children and provide prompt care.

Long COVID kids: Most get better. Doctors worry about those who don’t.

Long COVID symptoms in kids, teens

The study included 5,300 younger school-age children and teens from more than 60 health care facilities across the U.S. between March 2022 and December 2023.

Researchers found teenagers between 12 and 17 were more likely to report fatigue, pain and changes in taste and smell, whereas, younger schoolchildren between 6 and 11 were more likely to have difficulty focusing, sleep problems and stomach issues, according to the report published Wednesday in JAMA.

Long COVID symptoms affected almost every organ system, and most patients reported symptoms that affected more than one part of their body. 

In the report, younger schoolchildren and teens commonly reported back or neck pain, headaches, lightheadedness or dizziness and trouble with memory or focus. The study authors were also surprised to find that shared symptoms among the younger children included phobias, specifically the fear of crowded or enclosed spaces, and refusal to go to school.

The symptoms that showed up in younger children were less likely to overlap with symptoms experienced by adults with long COVID. The authors said this underscored the importance of age-based research.

“The symptoms that make up the research index are not the only symptoms a child may have and they’re not the most severe, but they are most predictive in determining who may have long COVID,” said Dr. Rachel Gross, the study's lead author and associate professor of pediatrics and population health at New York University Grossman School of Medicine.

Rose could have benefited from this research in 2020. It took more than a year to find doctors who would take her cluster of symptoms seriously. She eventually found that team at Boston Children's Hospital.

“I went from running a junior Olympic qualifier to being unable to walk,” Rose said. “It was dramatic and confusing.”

Missing 'whole boat' of data

Despite the new research, health experts say a great deal is still unknown about long COVID.

For example, most of the data from the study comes from patients who were infected with earlier COVID-19 variants, not the latest version of omicron, said Dr. Alexandra Yonts, a pediatric infectious disease specialist and director of the post-COVID program at Children’s National Hospital in Washington, D.C.

The study suggests kids infected with omicron are less likely to develop long COVID, however, Yonts argues there isn't enough data to support that theory since omicron hasn't been on the scene long enough to allow for robust long COVID data.

"If we’re looking at kids that have been newly infected (and) what is their risk of becoming long COVID patients?" she said. "We’re missing that whole boat."

Authors of the JAMA study say their next research will be long COVID symptoms in children 5 and younger. Yonts said the most urgent need for these patients is access to post-COVID clinics that specialize in identifying and treating lingering symptoms from a COVID-19 infection. She said these types of efforts are beginning to close down across the country because of a lack of funding and support.

"These are such complex patients," Yonts said. "It's hard to find a multidisciplinary team that can define those symptoms and support them."

That's why Rose, a California native, eventually moved with her family to southern Maine so they could be driving distance from Boston Children's Hospital, where she visits the long COVID clinic at least once a month. In addition to doctors at the hospital's specialized COVID clinic, she's seen nearly a dozen specialists including a sleep neurologist, acupuncturist, gastroenterologist, endocrinologist, rheumatologist and cardiologist, among others.

Rose is disheartened that post-COVID clinics are shutting down for patients like her, but not completely surprised. She sees the world moving on from the pandemic, but she's still in pain. She hopes the JAMA study brings renewed attention to the condition.

"There’s this illusion now that lockdown is over, that COVID is gone," she said. "It’s really, really difficult and invalidating for all the people with long COVID – especially children."

Adrianna Rodriguez can be reached at [email protected].

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Australia said it would jointly manufacture long-range Naval Strike Missiles and Joint Strike Missiles with Norway's Kongsberg Defence in the city of Newcastle on Australia's eastern coast, the only site outside of Norway.

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7 Last-Minute Escapes for Labor Day Weekend

If you’re still hoping to stretch out the last days of summer, there are places in North America that are not too hot, not too crowded and not necessarily that far away.

By Shannon Sims

It might sound like an impossible request: a last-minute Labor Day getaway with gorgeous weather and minimal crowds that you can squeeze into a long weekend. There are good reasons many destinations across North America won’t fit the bill. Wildfires are burning in some parts of the West, tropical disturbances are brewing in the Caribbean, the East Coast’s coastal retreats are packed, and much of the South is sweaty and oh so steamy. But if you’re still hoping to stretch out the last days of summer, there are places that are not too hot, not too crowded and not necessarily that far away.

Here are seven inspirations in North America for a Labor Day getaway.

North Carolina

Hike to magical waterfalls

Less than an hour’s drive from downtown Asheville, N.C., and covering 500,000-plus acres, Pisgah National Forest is a magical place to be immersed in nature. American goldfinches and Carolina chickadees sing high above waterfalls framed by lush green trees, and babbling streams pour down moss-covered rocks hiding salamanders, newts and crayfish.

During the summer, these wooded areas are chock-full of children at summer camp, and the trails are often busy with hikers. But by Labor Day, most of the kids have returned home, while the weather is often perfect, with average temperatures in the seventies. You have your pick of activities — bird-watching, fly fishing, waterfall dousing and hiking.

Easy trails can be found at the North Carolina Arboretum , but for a shaded, moderate hike to a waterfall in which you can douse, check out Catawba Falls Trail . For another moderate hike (but no swimming), there is Linville Gorge and Falls , nicknamed the Grand Canyon of the Southern Appalachians. Advanced hikers can summit the 6,684-foot Mount Mitchell , the highest peak in the Eastern United States, in Mount Mitchell State Park, which is surrounded by Pisgah Forest.

Later, make your way back to Asheville , where a robust restaurant and brewery scene offers a perfect setting for sharing stories of your day. Local favorites include Cúrate for upscale tapas, Chai Pani for Indian food and Wicked Weed Brewing for hoppy deliciousness.

See San Francisco’s best-loved sights

“The coldest winter I ever spent was a summer in San Francisco,” may be a clichéd phrase, but anyone who has visited this California city during the summer most likely experienced fog, dank air and brisk wind. But September and October are San Francisco’s warmest and brightest months of the year.

A long weekend is just enough for first timers to sample the city’s best-known attractions. Walk or bike across the Golden Gate Bridge . Board a cable car as it clangs up and down the city’s hills. Explore Alcatraz Island on a three-hour tour (book ahead). Take in the Fisherman’s Wharf area, which may be less chaotic with many children back in school. Watch a home game of the San Francisco Giants at Oracle Park , right on the bay. Or check out the Presidio Tunnel Tops , a newly developed stretch of national park land featuring stunning panoramic views.

The city is a particularly special destination for those interested in L.G.B.T.Q. history. The GLBT Historical Society Museum , nicknamed the Queer Smithsonian, is a good place to start, as is a stroll through the Castro neighborhood or a stop at the Castro’s first gay bar, opened in 1963 as the Missouri Mule (now called Beaux).

Swim, fish, boat, then sip, at the Finger Lakes

One of the largest Finger Lakes in upstate New York, Keuka Lake stretches about 20 miles and draws visitors with clear-water swimming, paddling, kayaking and fishing. Labor Day marks the end of its high summer season.

Visitors can use picnic tables, playgrounds and swimming areas off sandy beaches at Keuka Lake State Park near Branchport or Red Jacket Park in the village of Penn Yan, on the lake’s northern end.

On its southern shores, the charming village of Hammondsport has cafes, shops and restaurants, many of which are clustered around the Pulteney Square Historic District .

Fishing is a big draw, with brown trout, yellow perch and more inhabiting the lake’s deep waters. You can buy your own fishing equipment at Jake’s Boat Livery , or get the professionals to do it by chartering a fishing expedition through Summit to Stream Adventures .

Don’t forget the wine: 20 vineyards are scattered around the lakeshore, with six part of the Keuka Lake Wine Trail . You can visit most wineries on your own or with a tour.

Keuka Lake is a one- to two-hour drive from airports in Rochester, Ithaca, Syracuse or Buffalo. The lake is about a five-hour drive from New York City.

Soak your stress away in alpine splendor

During Labor Day weekend, the I-70 corridor that connects Denver to the ski towns to the west, like Winter Park, Keystone and Breckenridge, can be bumper to bumper, especially getting back on Monday.

But nestled in the San Juan Mountains, about an hour’s drive from Telluride, is Ouray, an often overlooked gem for outdoor fun. Sure, there’s great hiking and canyoning, but there aren’t many towns where you can stroll down Main Street and stop into a boutique for shopping, a cafe for coffee and a hot springs for soaking. Ouray Hot Springs Pool is sulfur-free — in other words, no rotten-egg stink — and offers not just one pool but many: The family-friendly pools feature water slides, a volleyball net and a rolling log, while the adults-only soaking section is kept between 102 and 106 degrees.

Montrose Regional Airport , about an hour’s drive from Ouray, has direct flights to Chicago, Houston, Dallas-Fort Worth and Denver.

Sample delicious urban delights

You won’t scratch the surface of what Mexico City offers in a long weekend, so consider tossing away those checklists and instead soak up the atmosphere in one or two neighborhoods.

Start by signing up for the city’s bike share app, Ecobici , for an easy way to get around town. The Roma neighborhood, a favorite among travelers, has shaded, walkable streets; inviting plazas; and some of the city’s best restaurants. For a neighborhood with a tad fewer tourists, try La Condesa , a short bike ride from Roma and between the two lovely green spaces called Bosque de Chapultepec and Parque México . Shopaholics should visit Polanco , where the commercial thoroughfare Presidente Masaryk Avenue offers luxury stores.

Whichever neighborhood you pick to explore, you’ll be delighted by the quality and flavors of food offered at the city’s restaurants, food carts and 11,000-plus taco shops. Even if a corner spot looks shabby, it might be producing food that could rank among the best bites you’ve ever had. Look no further than Taquería El Califa de León, an unassuming taco stand that won a Michelin star this year , as an example of the culinary magic that lies around any given corner.

Nova Scotia

Time-travel in a 1700s fishing village

About 62 miles southwest of downtown Halifax along Nova Scotia’s South Shore, breezy Lunenburg is a fishing village with charm — and fresh seafood — to spare.

Old Town Lunenburg is considered by UNESCO as the best surviving example of a planned British colonial settlement in North America. Its colorful homes face tall ships moored in the harbor, transporting visitors back to the 1700s. Stroll around the area on your own, popping into local shops and restaurants, or sign up for a walking tour .

At the Fisheries Museum of the Atlantic , part of the Nova Scotia Museum , you can experience what life was like in a fishing village throughout the centuries, from early Mi’kmaq communities to the arrival of Black Loyalists in 1783 to today. The museum is housed in an old fish processing plant, and the Old Fish Factory Restaurant now serves Nova Scotia lobster rolls on a wharf-side patio.

Fresh lobster is available year-round in Nova Scotia, so check out some stops on the Nova Scotia Lobster Trail . But don’t forget much of the Atlantic’s bounty: mussels, scallops, halibut, Arctic char, cod — even a seaweed called dulse — can be found on local menus.

Roam and ride in the sand dunes

The Great Lakes were made for summer, but the challenge is finding a spot that isn’t too crowded. Silver Lake Sand Dunes is a destination even many Michiganders don’t know about.

Located an hour-and-a-half drive from Grand Rapids on Lake Michigan’s eastern coastline, the dunes comprise 2,000 acres and are part of Silver Lake State Park. Even though they are situated in the heart of the United States, the dunes will make you feel as if you’re roaming the sands of Arabia.

Activities at the park include swimming, canoeing and horseback riding along the beach, or hiking through the surrounding evergreen forests.

But a classic way to explore the dunes is through Mac Wood’s Dune Rides , a local company that for nearly a century has been taking visitors in open-top trucks for thrilling and informative rides through the sand.

While in the area, be sure to visit the Little Sable Point Lighthouse , an 1874 tower that was made more accessible to the public in 2010. Climb the tower and take in the lake, forests and dunes below.

Follow New York Times Travel on Instagram and sign up for our weekly Travel Dispatch newsletter to get expert tips on traveling smarter and inspiration for your next vacation. Dreaming up a future getaway or just armchair traveling? Check out our 52 Places to Go in 2024 .

An earlier version of this story included a photo caption that misstated the location of the Palacio de Bellas Artes in Mexico City. It is in Centro district, not Polanco. It also misstated the location of the Silver Lake Sand Dunes. The dunes are on Lake Michigan’s eastern coastline, not western.

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Considering a trip, or just some armchair traveling here are some ideas..

52 Places:  Why do we travel? For food, culture, adventure, natural beauty? Our 2024 list has all those elements, and more .

Provincetown, Mass.:  Located at the tip of Cape Cod, P-town (as locals call it) has overlapping — and sometimes competing — identities : one of America’s oldest art colonies, nature preserve, thriving L.G.B.T.Q. resort and historic Portuguese fishing village.

Lake Como, Italy:  Stars like George Clooney frequent this scenic corner of northern Italy, but you might be surprised by how affordable it can be. Here’s an insider’s guide .

South of France:  Horses, bulls and birds of all types live among the pink marshes of the Camargue, a rugged landscape shaped  by the relentless push and pull of sea and river.

Disney Theme Parks:  As Disney has raised the cost of tickets and hotel rooms at its theme parks, and added pricey, difficult-to-navigate tools, even its most loyal fans are asking themselves  if they should rethink their vacations.

Helsinki, Finland:   Explore the stunning architecture  of the new central library, browse treasure-filled shops in the Design District, sweat in a wood-burning sauna, sip cocktails on a schooner and trek across islands in the surrounding archipelago.

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