Long COVID (LC) describes the wide range of symptoms persisting or appearing 4 or more weeks following acute SARS-CoV-2 infection. The risk factors are unclear, however an association between the severity of the acute episode and the subsequent symptoms has been hypothesized. The symptoms are manifold, the most frequent are fatigue, brain fog and dyspnea, which even the healthy population has, although in lower percentages. Among the pediatric population this phenomenon is still a topic of discussion; it is hard to establish whether the symptoms are related to LC alone or to the psychological malaise related to social distancing and restrictions, especially within the psychological-behavioral sphere. Possible pathogenetic mechanisms include protracted direct damage, antibody-dependent enhancement of the disease, immune dysregulation, presence of autoantibodies and persistence of the virus. The SARS-CoV-2 vaccine remains the only available defense against severe disease and LC, thanks to its high target specificity. Long-term implications are a source of growing concern. As clinicians we must acknowledge the existence of LC and commit ourselves to fully understand its pathogenetic mechanisms, identifying targeted and personalized approaches, through a multidisciplinary perspective.