Similarities of Long-COVID and Lyme disease in children
Both COVID-19 and Lyme disease can lead to long term illness in children. In their article, “Long COVID: major findings, mechanisms and recommendations,” Davis and colleagues summarized the symptoms of Long-COVID in children. 
The authors explored the current Long-COVID literature, and specifically addressed the cardiovascular, thrombotic and cerebrovascular disease, type 2 diabetes, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and dysautonomia seen in Long-COVID. The authors did not include Lyme disease in their discussion.
“One study found that fatigue, headache, dizziness, dyspnoea, chest pain, dysosmia, dysgeusia, reduced appetite, concentration difficulties, memory issues, mental exhaustion, physical exhaustion and sleep issues were between 2 and 36 times more likely in individuals with long COVID aged 15–19 years compared with controls of the same age,” wrote Davis, based on a nationwide survey in Denmark. 
The symptoms of Long-COVID in children overlapped with Orthostatic Intolerance and ME/CFS presentation, wrote Morrow. 
The authors did not discuss the overlap of symptoms of COVID-19 with Lyme disease. However, in 2001, Tager et al. described 20 children, ages 8 to 16, with Lyme disease who exhibited similar symptoms to Long-COVID.
These symptoms included “marked fatigue (100%), arthralgias (100%), frequent and severe headaches (100%), irritability/ depression (94%), short-term memory problems (94%), schoolwork deterioration (94%), myalgias (88%), brain fog (88%), neck pain (88%), insomnia (82%), distractibility (82%), word-finding problems (82%), severe flu (80%), sensory hyperacusis to sound (58%) and/or light (74%), insomnia (77%), and radicular pains (56%),” and did not resolve with antibiotic treatment. 
Additionally, Davis and colleagues did not discuss the overlap of Orthostatic Intolerance and Lyme disease. Kanjwal and colleagues reported Postural orthostatic tachycardia syndrome (POTS) in five women with a history of Lyme disease. These patients also presented with symptoms of fatigue and cognitive dysfunction. 
Davis and colleagues raised concerns for children born to woman with COVID. Fourteen of 222 [COVID-19] exposed offspring (6.3%) received a neurodevelopmental diagnosis within 12 months in a Massachusetts study.
The most common neurodevelopmental diagnoses were developmental disorder of motor function, expressive language disorder, and developmental disorder of speech and language, unspecified, wrote Edlow and colleagues. 
- Davis HE, McCorkell L, Vogel JM, Topol EJ. Long COVID: major findings, mechanisms and recommendations. Nat Rev Microbiol. Jan 13 2023:1-14. doi:10.1038/s41579-022-00846-2
- Morrow AK, Malone LA, Kokorelis C, et al. Long-Term COVID 19 Sequelae in Adolescents: the Overlap with Orthostatic Intolerance and ME/CFS. Curr Pediatr Rep. 2022;10(2):31-44. doi:10.1007/s40124-022-00261-4
- Tager FA, Fallon BA, Keilp J, Rissenberg M, Jones CR, Liebowitz MR. A controlled study of cognitive deficits in children with chronic Lyme disease. J Neuropsychiatry Clin Neurosci. Fall 2001;13(4):500-7. doi:10.1176/jnp.13.4.500
- Kanjwal K, Karabin B, Kanjwal Y, Grubb BP. Postural orthostatic tachycardia syndrome following Lyme disease. Cardiol J. 2011;18(1):63-6.
- Edlow AG, Castro VM, Shook LL, Kaimal AJ, Perlis RH. Neurodevelopmental Outcomes at 1 Year in Infants of Mothers Who Tested Positive for SARS-CoV-2 During Pregnancy. JAMA Netw Open. Jun 1 2022;5(6):e2215787. doi:10.1001/jamanetworkopen.2022.15787