Q&A from September 15, 2026 R3 Seminar

Dr. Wallace: I think that just because a school or healthcare provider has seen one child with Long COVID, it doesn't mean that they've seen your child. And we saw the way it impacts a 5-year-old is different than an 8-year-old, is different than a 12-year-old, et cetera, et cetera. And even then, every case is unique.

One thing I've heard a lot is “your child just needs to ____. Other kids have done ____, and they're fine”. It’s not a one-size-fits-all approach, and schools need to understand that as well. I think these findings, that the RECOVER studies have produced, are really significant in being able to illustrate the wide range of effects. Kids have one shot at being school-aged and teenagers, and if a child falls behind in 10th grade, or 3rd grade, or wherever, it affects their life. I'm an educator, so this is profoundly important to me.

I teach college, and so I see it in my college students, too. If a child falls behind in any of those stages, for one, it impacts the way they view school. It affects their self-esteem, their sense of value, their sense of their own intelligence. And they fall behind, as well, academically. So, it has multiple effects on children, and also they're ostracized. They do feel the stigma, especially from their teachers, who might start to think of them as the lazy kid, the kid who doesn't do their work, who doesn't finish, who doesn't show up. And those things are not true.

I would say that kids with Long COVID are trying so hard to keep up. They're working so much harder in many regards than a child who doesn't have health issues that they're battling against. It's just that you don't see it. It's invisible, which is another factor that's come up.

One last thing is that we cannot leave colleges out of this conversation, because these kids get to college, and now they have to advocate for themselves. I cannot call my daughter's professors and arrange a meeting. She would hate it if I tried to, but I literally can't. It's illegal, unless she allows it or gives me permission, but it's inappropriate.

And so, you've got an 18-year-old in college, and they don't really know how to advocate for themselves while sick. I'd like to be sure that we don't forget that piece of this conversation as these young people get older and enter a new arena.

Ms. Covington: I would just say that our lives are burning down. We feel like we're in a fire, and we don't know if we're going to get out of it. And sometimes it feels like we're beating the fire, and it's under control, and then a hotspot pops up, and we're in the middle of it all over again.

I've been in some high-stress jobs, and I could, at the end of the day, go home and put my head on my pillow and go to sleep. I can't get out of this one. This is my kid, and we're all sitting here fighting for our kids' lives, our own lives, and it impacts everybody in the family. We talk about my 15-year-old, who we call the invisible child, that's what they call them, because his needs sometimes get overlooked, because his brother is sick.

When you're in the middle of a fire, nothing is happening fast enough. Even when people are working their butts off, and we recognize that it is happening behind the scenes, and we appreciate it. But man, it would be nice if it could go faster, and we could get the funding, and if people could realize this is a post-viral illness, without it being politicized or stigmatized. It's just a wild world we live in now.

But if you see a Long COVID family, we are in the middle of a fire, and it would be sure nice for someone to throw a bucket of water instead of whatever else they're doing.

Ms. Covington: Yes. I have heard of many stories from families who were referred to CPS due to attendance concerns.

Dr. Gross: We have collected this data and would be able to study it in future analyses.

Dr. Gross: Yes, all of the participants in Tier 3 are part of the group that can continue in Cycle 2. Cycle 2 visits are similar to the Cycle 1 Tier 2 visits.

Dr. Gross: We have been collecting data on diabetes and many other conditions since the beginning of RECOVER at every time point. This will continue into Cycle 2.

Dr. Gross: Yes, participants were asked whether they were ever diagnosed with Long COVID or were told by a doctor that they had Long COVID, so we are able to assess this in future analyses.

Dr. Reeder: RECOVER does collect biospecimens and performs imaging and other more in-depth assessments in selected participants. Research is ongoing to use these measures for a range of purposes, including identifying diagnostic markers for Long COVID, examining mechanistic pathways of Long COVID onset and recovery, and seeking therapeutic targets to develop novel interventions for Long COVID prevention and treatment.

Ms. Covington: I think for schools and school boards to understand the underlying medical picture, it is essential for medical providers to understand the impacts of COVID. Without the medical community supporting patients, it will continue to be very difficult for schools to understand the full impact of Long COVID and support affected students. In the meantime, advocating for policies to help students who are suffering from this post-viral illness AND for policies to prevent the spread of the virus helps.

Dr. Rhee: We continue to present this information at national conferences and meetings to educate our colleagues.

Ms. Covington: I wish I had an answer to this question. In January, my child will have been sick for 6 years. I wish I could see the light at the end of the tunnel, but I don't think it is realistic to think that my child will ever get to have a normal lifestyle again.

Ms. Covington: In general, believing someone who is expressing concerns for their health is probably the first thing that should happen. After that, I think the response depends on each person’s unique situation. Beyond the day-to-day needs a child or young person with Long COVID may have (physical help, emotional support, accommodations), long-term planning for how this condition will affect their future (ability to self-care, ability to work and/or financially provide for themselves, ability to provide basic needs) is really important and sometimes overlooked because families are struggling with the day-to-day/immediate needs. And always, advocacy—for awareness, for funding, for research.

Ms. Covington: The strategy that I suggest is to be proactive rather than reactive. It is absolutely essential to have medical providers supporting your child in order to get school accommodations. Sharing resources with schools and local CPS agencies (from local medical providers, medical journals, or the RECOVER website itself) may be helpful, but unfortunately, I do not see schools (in general) or CPS agencies being willing to make sweeping supportive policies for our kids until the medical community as a whole more widely recognizes Long COVID.

Ms. Covington: Some students are taking gap years or finding creative ways to make homeschool curriculums fit their situation.

Dr. Rhee: There have been some studies to suggest that children may experience challenges with memory, attention, and emotional regulation. But more studies are needed to tease apart whether these findings were secondary to a pandemic effect or to the infection itself.

Dr. Reeder: Yes, RECOVER is collecting an array of biospecimens [through its observational studies], collecting advanced ‘omics’ data, and performing imaging and other more in-depth assessments in selected participants. Research is ongoing using these measures for a range of purposes, including seeking therapeutic targets to develop novel interventions for Long COVID prevention and treatment. This will be a priority as RECOVER moves into Cycle 2 data collection.

Ms. Covington: Finding an established pediatric Long COVID clinic was essential for us. If you are able to travel, I suggest finding a clinic and working with them (some of them are able to accommodate telemedicine appointments). Generally, they can come up with a treatment plan that you can bring back to your local doctor. If you do not feel like your current doctor is helping you, definitely find a new one. The other thing that has helped our family is to be in online groups with other families of kids with Long COVID. We are able to see what has been working and what hasn't been for other kids and make treatment suggestions to our treatment team based on that information.

Dr. Rhee: I would agree with this statement. I would not say that the social determinants of health “cause” Long COVID. Rather, they may set up a child or individual to be more at risk for developing Long COVID. These social conditions may then interact with the biological or genetic causes of Long COVID and increase or decrease the risk of any individual developing the long-term sequelae after having the initial viral infection.

Dr. Rhee: Because of the design of the original RECOVER cohort, we could not assess [in this study] whether underlying structural or physiological abnormalities may have contributed to the risk of developing Long COVID. However, there are other studies, such as the Adolescent Brain Cognitive Development (ABCD) Study, that may be able to do this. The ABCD Study includes pre-pandemic cognitive, behavioral, social, and SDOH data on participants, so researchers could get a sense of their prior developmental trajectory and see if there are underlying patterns that may have predisposed someone to developing Long COVID. Additionally, there are ongoing RECOVER pathobiology studies that are examining underlying physiology or genetics that may have put some people at greater risk.