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A large analysis published Wednesday in the journal Pediatrics underscores the toll long Covid can take on children, in some cases leading to neurological, gastrointestinal, cardiovascular and behavioral symptoms in the months after an acute infection.

“Long Covid in the U.S., in adults and in kids, is a serious problem,” said Dr. Ziyad Al-Aly, chief of research and development at the V.A. St. Louis Health Care System and a clinical epidemiologist at Washington University in St. Louis, who studies the condition but was not involved in the new report. He said that the paper, which drew on numerous studies of long Covid in children, is “important” and illustrates that the condition can affect multiple organ systems.

The new review suggested that 10 to 20 percent of children in the United States who had Covid developed long Covid. However, Dr. Suchitra Rao, a pediatric infectious disease expert at Children’s Hospital Colorado and co-author on the paper, acknowledged that there are “lots of caveats” with the prevalence estimates used to arrive at that number. For example, some of the studies included looked only at the very small percentage of children who were hospitalized for Covid. Like adults, children who had more severe cases of Covid have a greater risk of lingering symptoms or new complications.

The Centers for Disease Control and Prevention puts the prevalence of long Covid closer to 1 percent of children who have had Covid. (The estimate in adults is 7 percent.)

Generally speaking, most parents should not be worried that their children will develop long Covid, said Dr. Stephen Freedman, a professor of pediatrics and emergency medicine at the University of Calgary Cumming School of Medicine. “I don’t get asked a lot, if at all, about ‘Is my child now at risk of developing long Covid?’ after we diagnose them with an acute infection,” he said. “And I think that’s appropriate.”

What does long Covid look like in kids?

Long Covid can be challenging to study in part because it is difficult to diagnose, as the symptoms are so wide-ranging. Making a diagnosis is perhaps even trickier in children because symptoms may present differently from how they appear in adults. Young children also may not have the language to describe what they’re feeling, so researchers advised parents to look for changes in behavior.