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How to help kids with ‘long COVID’ thrive in school

When a student suffers a concussion, their school typically offers certain accommodations – lighter workload, rest breaks, more time to complete tests. Do kids with long COVID need the same?

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Many long COVID-19 symptoms – such as fatigue, brain fog and memory impairment – are similar to those experienced post-concussion. Cavan Images/Cavan Collection via Getty Images

Children who get COVID-19 typically recover quickly and will not require special support upon return to school. However, some people who contract the disease experience persistent symptoms and post-viral complications. These complications can include fatigue, shortness of breath, brain fog, changes in taste and smell, and headaches. This post-viral syndrome is called long-haul COVID-19, more commonly referred to as “long COVID” in the medical community.

Children who experience long COVID will need support at school. Some symptoms – such as fatigue, brain fog and memory impairment – are similar to those experienced after a concussion. But because these symptoms are challenging to identify or to track, it can be difficult for teachers to know how to help.

We are researchers who study how schools manage concussions and the prevalence of long COVID and associated mental health outcomes. We believe strategies that schools use to support students with concussions may also help those with prolonged COVID-19 symptoms.

Kids and long COVID

Not all physical symptoms experienced after COVID-19 illness indicate long COVID. When symptoms do last more than a few weeks, a thorough medical evaluation by a pediatrician with knowledge of long COVID is recommended. Pediatric post-COVID clinics are an excellent way to find such doctors. However, at this time, these clinics aren’t widespread in the United States.

Post-COVID complications have been reported frequently by adults. However, research on long COVID in children is scarce, with estimates of persistent symptoms varying widely. The wide-ranging estimates likely reflect differences in how study participants were recruited, how long after having acute COVID-19 they participated in the study, the symptoms researchers assessed and other methodological differences.

School accommodations

Students who continue to experience symptoms after they’ve tested negative and been cleared to return to school should notify the school of persistent issues. Even if the child is not officially diagnosed with long COVID, a gradual return to school and activities, as well as academic and environmental accommodations, can support children during recovery.

We recommend that parents, teachers and doctors work together to support the child’s recovery. This is what’s called collaborative care. It is helpful if a school-based professional – such as a school nurse, counselor or psychologist – serves as a central communicator. This involves sharing accommodations with teachers, talking with doctors (with a signed release) and communicating progress back to the family.

Together, these collaborative care teams can establish temporary accommodations for the affected student, such as:

  1. Allow a flexible attendance schedule with rest breaks to minimize fatigue.

  2. Reduce physical activity and minimize exposure to overstimulating environments to prevent fatigue and headaches.

  3. Modify the workload. This might include, for example, removing high-stakes projects and nonessential work, providing alternate assignments and allowing the student to drop classes without penalty. Base grades on adjusted work so the child is not penalized for memory problems.

  4. Provide extra time to complete assignments and tests so a child with brain fog can process information.

  5. Develop an emotional support plan for the student to prevent anxiety and depression. This might include identifying an adult at school to talk with if the child feels overwhelmed, or providing a support group for students to discuss their experiences and recovery.

  6. Encourage the student to explore alternative extracurricular activities that are nonphysical and not cognitively taxing.

We recommend that schools front-load adjustments for a student with long COVID and gradually withdraw them as the student recovers. The symptoms, recovery rate and trajectory will vary for each student. Therefore, a gradual and monitored return to activity is important to help ensure that symptoms don’t worsen when students engage in more activity. If symptoms do get worse, then accommodations should resume.

An evolving illness

We have much to learn about the long-term effects of COVID-19 and the prognosis for those who develop long COVID. These guidelines are based on what is known at this time and should be considered preliminary.

As COVID rates and treatments evolve, it is important for parents, educators and medical providers to continue talking with one another about persistent symptoms and effective treatments.

[Research into coronavirus and other news from science Subscribe to The Conversation’s new science newsletter.]

The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.

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Student loan borrowers may finally get answers to loan forgiveness issues

A major student loan service company has been invited to face Congress over its alleged servicing failures.

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U.S. Sen. Elizabeth Warren (D-MA) wants answers from one of the top student loan service companies in the country for allegedly botching its student loan forgiveness process involving the federal Public Service Loan Forgiveness program, leaving borrowers confused and without answers.

The senator sent a letter to Mohela CEO Scott Giles on March 18 inviting him to testify before Congress at a hearing on April 10 titled “MOHELA’s Performance as a Student Loan Servicer.” During the hearing, Giles will have to answer for why his company allegedly failed to send billing statements to student loan borrowers in a timely manner and miscalculated monthly payments for borrowers when it was time for them to repay their loans in September last year.

Related: Here's who qualifies for Biden's student loan debt relief starting next month

Also, in the letter, Warren highlighted a report that claimed that Mohela failed to perform basic servicing functions for borrowers eligible for PSLF, which led to over 800,000 public service workers facing delays in receiving student debt relief. The report also accuses the company of using a “‘call deflection’ scheme” to keep customers away from speaking to a customer service representative and instead redirecting them to parts of their website.

“Your company has contributed to student loan borrowers’ difficulties by mishandling borrowers’ return to repayment following the COVID-19 pandemic-related pause on payments, interest, and collections and by impeding public servants’ access to PSLF relief,” wrote Warren in the letter.

The move from Warren comes after the U.S. Department of Education withheld $7.2 million in payments to its servicer Mohela in October as punishment because it failed to issue timely billing statements to 2.5 million borrowers which resulted in 800,000 borrowers becoming delinquent on their loans. The department ordered Mohela to put those affected by the issues into forbearance until the mess was resolved.

U.S. President Joe Biden is joined by Education Secretary Miguel Cardona (L) as he announces new actions to protect borrowers after the Supreme Court struck down his student loan forgiveness plan in the Roosevelt Room at the White House on June 30, 2023 in Washington, DC. 

Chip Somodevilla/Getty Images

Mohela is also currently facing two class-action lawsuits, one filed in December last year and another in January this year, for its alleged “failure to timely process and render decisions for student loan borrowers enrolled in the Public Service Loan Forgiveness program.”

In response to recent criticism surrounding its alleged issues and failures regarding the PSLF program, Mohela claimed in a statement to the Missouri Independent that it “does not have authority to process loan forgiveness until authorization is provided by FSA, which can take months to occur.”

The company also claimed that there are “false accusations” inside of the bombshell report, which was released in February, that details the company’s servicing failures.

“It is unfortunate and irresponsible that information is being spun to create a false narrative in an attempt to mislead the public. False accusations are being disingenuously branded as an investigative report,” said Mohela. 

Related: Amazon just made a major announcement that will bring you big savings — and we have all the details

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Another airline is making lounge fees more expensive

Qantas Airways is increasing the price of accessing its network of lounges by as much as 17%.

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Over the last two years, multiple airlines have dealt with crowding in their lounges. While they are designed as a luxury experience for a small subset of travelers, high numbers of people taking a trip post-pandemic as well as the different ways they are able to gain access through status or certain credit cards made it difficult for some airlines to keep up with keeping foods stocked, common areas clean and having enough staff to serve bar drinks at the rate that customers expect them.

In the fall of 2023, Delta Air Lines  (DAL)  caught serious traveler outcry after announcing that it was cracking down on crowding by raising how much one needs to spend for lounge access and limiting the number of times one can enter those lounges.

Related: Competitors pushed Delta to backtrack on its lounge and loyalty program changes

Some airlines saw the outcry with Delta as their chance to reassure customers that they would not raise their fees while others waited for the storm to pass to quietly implement their own increases.

A photograph captures a Qantas Airways lounge in Sydney, Australia.

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This is how much more you'll have to pay for Qantas lounge access

Australia's flagship carrier Qantas Airways  (QUBSF)  is the latest airline to announce that it would raise the cost accessing the 24 lounges across the country as well as the 600 international lounges available at airports across the world through partner airlines.

More Travel:

Unlike other airlines which grant access primarily after reaching frequent flyer status, Qantas also sells it through a membership — starting from April 18, 2024, prices will rise from $600 Australian dollars ($392 USD)  to $699 AUD ($456 USD) for one year, $1,100 ($718 USD) to $1,299 ($848 USD) for two years and $2,000 AUD ($1,304) to lock in the rate for four years.

Those signing up for lounge access for the first time also currently pay a joining fee of $99 AUD ($65 USD) that will rise to $129 AUD ($85 USD).

The airline also allows customers to purchase their membership with Qantas Points they collect through frequent travel; the membership fees are also being raised by the equivalent amount in points in what adds up to as much as 17% — from 308,000 to 399,900 to lock in access for four years.

Airline says hikes will 'cover cost increases passed on from suppliers'

"This is the first time the Qantas Club membership fees have increased in seven years and will help cover cost increases passed on from a range of suppliers over that time," a Qantas spokesperson confirmed to Simple Flying. "This follows a reduction in the membership fees for several years during the pandemic."

The spokesperson said the gains from the increases will go both towards making up for inflation-related costs and keeping existing lounges looking modern by updating features like furniture and décor.

While the price increases also do not apply for those who earned lounge access through frequent flyer status or change what it takes to earn that status, Qantas is also introducing even steeper increases for those renewing a membership or adding additional features such as spouse and partner memberships.

In some cases, the cost of these features will nearly double from what members are paying now.

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PR55α-controlled PP2A Inhibits p16 Expression and Blocks Cellular Senescence Induction

“Our results show that PR55α specifically reduces p16 expression […]” Credit: 2024 Palanivel et al. “Our results show that PR55α specifically…

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“Our results show that PR55α specifically reduces p16 expression […]”

Credit: 2024 Palanivel et al.

“Our results show that PR55α specifically reduces p16 expression […]”

BUFFALO, NY- March 19, 2024 – A new research paper was published in Aging (listed by MEDLINE/PubMed as “Aging (Albany NY)” and “Aging-US” by Web of Science) Volume 16, Issue 5, entitled, “PR55α-controlled protein phosphatase 2A inhibits p16 expression and blocks cellular senescence induction by γ-irradiation.”

Cellular senescence is a permanent cell cycle arrest that can be triggered by both internal and external genotoxic stressors, such as telomere dysfunction and DNA damage. The execution of senescence is mainly by two pathways, p16/RB and p53/p21, which lead to CDK4/6 inhibition and RB activation to block cell cycle progression. While the regulation of p53/p21 signaling in response to DNA damage and other insults is well-defined, the regulation of the p16/RB pathway in response to various stressors remains poorly understood. 

In this new study, researchers Chitra Palanivel, Lepakshe S. V. Madduri, Ashley L. Hein, Christopher B. Jenkins, Brendan T. Graff, Alison L. Camero, Sumin Zhou, Charles A. Enke, Michel M. Ouellette, and Ying Yan from the University of Nebraska Medical Center report a novel function of PR55α, a regulatory subunit of PP2A Ser/Thr phosphatase, as a potent inhibitor of p16 expression and senescence induction by ionizing radiation (IR), such as γ-rays. 

“During natural aging, there is a gradual accumulation of p16-expressing senescent cells in tissues [76]. To investigate the significance of PR55α in this up-regulation of p16, we compared levels of the p16 and PR55α proteins in a panel of normal tissue specimens derived from young (≤43 y/o) and old (≥68 y/o) donors.”

The results show that ectopic PR55α expression in normal pancreatic cells inhibits p16 transcription, increases RB phosphorylation, and blocks IR-induced senescence. Conversely, PR55α-knockdown by shRNA in pancreatic cancer cells elevates p16 transcription, reduces RB phosphorylation, and triggers senescence induction after IR. Furthermore, this PR55α function in the regulation of p16 and senescence is p53-independent because it was unaffected by the mutational status of p53. Moreover, PR55α only affects p16 expression but not p14 (ARF) expression, which is also transcribed from the same CDKN2A locus but from an alternative promoter. In normal human tissues, levels of p16 and PR55α proteins were inversely correlated and mutually exclusive. 

“Collectively, these results describe a novel function of PR55α/PP2A in blocking p16/RB signaling and IR-induced cellular senescence.”
 

Read the full paper: DOI: https://doi.org/10.18632/aging.205619 

Corresponding Authors: Michel M. Ouellette, Ying Yan

Corresponding Emails: mouellet@unmc.edu, yyan@unmc.edu

Keywords: p16, p14, CDKN2A locus, p53, RB, PR55α, PP2A, γ-irradiation

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About Aging:

Aging publishes research papers in all fields of aging research including but not limited, aging from yeast to mammals, cellular senescence, age-related diseases such as cancer and Alzheimer’s diseases and their prevention and treatment, anti-aging strategies and drug development and especially the role of signal transduction pathways such as mTOR in aging and potential approaches to modulate these signaling pathways to extend lifespan. The journal aims to promote treatment of age-related diseases by slowing down aging, validation of anti-aging drugs by treating age-related diseases, prevention of cancer by inhibiting aging. Cancer and COVID-19 are age-related diseases.

Aging is indexed by PubMed/Medline (abbreviated as “Aging (Albany NY)”), PubMed Central, Web of Science: Science Citation Index Expanded (abbreviated as “Aging‐US” and listed in the Cell Biology and Geriatrics & Gerontology categories), Scopus (abbreviated as “Aging” and listed in the Cell Biology and Aging categories), Biological Abstracts, BIOSIS Previews, EMBASE, META (Chan Zuckerberg Initiative) (2018-2022), and Dimensions (Digital Science).

Please visit our website at www.Aging-US.com​​ and connect with us:

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