The corona pandemic poses new challenges for the health care system and also for pediatric medicine. Currently, it is also the “Long-COVID” syndrome that puzzles doctors and scientists and causes suffering in an increasing number of children. Little is known about this disease, but there is an increasing number of cases in which children who had COVID-19 present with symptoms of the disease again – regardless of whether the disease was severe, mild or even asymptomatic. These include chronic fatigue, headaches, breathing difficulties, circulatory problems, sleep disorders, attention deficits, inflammation of the heart and large and small blood vessels, and autoimmune diseases that can affect any organ. Long-COVID is still a rare disease in children, but experts believe that more and more cases will occur. It is crucial that all affected children receive the best possible help immediately.

Acutely, Bavaria lacks a specialized, interdisciplinary and child-oriented treatment for children suffering from Long-COVID as well as accompanying research on the manifold dimensions of this novel disease. In order to offer affected patients the best possible care, the Care-for-Rare Foundation will establish the first Bavarian specialized outpatient clinic for children and adolescents suffering from “Long-COVID” as soon as possible. In addition to medical care, all patients will have the opportunity to participate in a study to research the long-term effects of COVID-19.

Treatment and research at two locations

The outpatient clinic will have one location at each of Munich’s two university children’s hospitals: Dr. von Hauner Children’s Hospital of Ludwig-Maximilians-Universität (LMU) and the Schwabing Children’s Hospital of Technische Universität München (TUM) are ideally positioned in terms of expertise to close the currently existing gap in the treatment and research of long-COVID in children. The two outpatient units are to be established by September 2021 and will initially treat young patients until the end of 2026. In the future, the outpatient clinic will be extended to the whole of Bavaria.

Via the outpatient clinic as an initial reception point, the patients – depending on the type of symptomatology – will be referred to the specialists there in the individual departments (in particular pediatric infectiology, immunology, hematology, hemostaseology, neurology, psychology, cardiology, nephrology, gastroenterology and pneumology) and receive first-class specialized treatment. To ensure that children in Bavaria can receive comprehensive care, the presence of the Long-COVID outpatient clinic will be supplemented by a telemedicine structure. In this context, a digital registry of Long-COVID patients will also be created.

In the recently established Munich Child Health Alliance (Munich CHANCE), the physicians and scientists of the two university children’s hospitals work together with Helmholtz Zentrum München and the Max Planck Institute of Biochemistry – within the framework of this collaboration, the clinical, immunological and molecular causes of the disease can now be investigated using modern interdisciplinary techniques. As a result of the scientific knowledge gained and its dissemination to the scientific community, all children worldwide suffering from Long-COVID symptoms will ultimately benefit from the work of the outpatient clinic. In the spirit of agile, practice-oriented planning, the project will be evaluated for the first time in March 2022, with further evaluations to follow on an annual basis.