Thankfully, as has been the case throughout the pandemic, most children experience milder cases of COVID-19 than adults. As the Academy of American Pediatrics explains, this is still true even in light of the delta variant. While more children are contracting COVID-19 these days, the vast majority do not experience severe cases. Still, it’s very important to take COVID-19 seriously in children. If your child catches COVID-19, you’ll want to be able to recognize the signs and do your part in decreasing the chances of them spreading it to others. You’ll also want to have a clear understanding of which symptoms might indicate that your child has a more serious case of the virus, and when to get medical attention for their symptoms.
Symptoms of COVID-19 in Children
Behnoosh Afghani, MD, a pediatrician and clinical professor of pediatrics at UCI School of Medicine, affirms that children are likely to experience less severe cases of COVID-19 than adults. In fact, many children will have very mild or asymptomatic cases, says Dr. Afghani. When children do have symptoms, these usually overlap with the common symptoms of other respiratory viruses, like sore throats, congestion, headache, fever, and muscle aches, Dr. Afghani explains. Some children will also have upset stomachs, decreased appetite, and loss of taste and smell, she adds.
Less Common Symptoms
Although most cases of COVID-19 involve symptoms similar to other cold and flu viruses, COVID-19 may present with some more unusual symptoms. Diego Hijano, MD, MSc, a pediatric infectious diseases specialist at St. Jude Children’s Research Hospital, says that there are certain signs of COVID-19 that parents sometimes miss. COVID-19 can cause vomiting, diarrhea, and nausea in children, says Dr. Hijano. Some children may also have skin manifestations of the virus. “Swelling and discoloration can begin on one or several toes or fingers, known as COVID toes," Dr. Hijano explains. “[This seems] to develop most frequently in children, teenagers, and young adults.” Dr. Hijano also reminds us that babies and young children will not always be able to express some of the discomforts and common symptoms they may be experiencing. It’s important that parents pay attention to any subtle changes in their child’s behaviors, feeding routines, or sleeping routines.
Severe Symptoms
Occasionally, children can experience severe symptoms of COVID-19. These include a serious cough, shortness of breath, chest pain, heart palpitations, and rashes, says. Dr. Afghani. Certain children are at higher risk than others of experiencing severe symptoms, explains the AAP. This includes children who are obese, immunocompromised, have heart conditions, lung conditions (including asthma), diabetes, kidney disease, sickle cell disease, and neurodevelopmental disorders.
Multisystem Inflammatory Syndrome in Children (MIS-C)
Multisystem inflammatory syndrome in children (MIS-C) is another potentially severe complication of COVID-19 in children, explains Dr. Afghani. MIS-C typically presents after your child has recovered from their initial COVID-19 infection. Symptoms can be severe, and MIS-C can require hospitalization. As the name suggests, MIS-C involves inflammation of multiple organs, including the heart, liver, skin, or kidneys, says Dr. Afghani. According to the CDC, the main symptoms of MIS-C in children include bloodshot eyes, a rash, stomach pain, vomiting/diarrhea, and dizziness. If your child develops breathing difficulty, pain in their chest, seems confused, has trouble staying awake, or develops pale, or grey/blue skin, lips, or nail beds, you should seek emergency medical care.
When to Get Tested for COVID-19
Because COVID-19 symptoms resemble symptoms from many other viruses, including RSV and the common cold, it’s not possible to know through symptoms alone if your child has COVID-19. That’s why you should get your child tested anytime they show symptoms, says. Dr. Hijano. This will also ensure that your child doesn’t unknowingly spread the virus to others, should they test positive. You should also get your child tested if they’ve been exposed to someone else who tested positive for COVID-19, says Derrick Soong, MD, FAAP, a pediatrician with Virginia Mason Medical Center. If your child is vaccinated, they should be tested three to five days after exposure, according to Dr. Soong. Unvaccinated children should be tested five to seven days after exposure. You should take some precautions as you await your test results. “While awaiting the result of the test, the child should limit any activities and stay in the house,” says Dr. Hijano. If your child does test positive, they should follow their pediatrician’s care plan as well as any quarantine and/or isolation recommendations. Additionally, if your child tests positive and is in school or daycare, you should inform these institutions, so that they can do any necessary contact tracing. You should also contact any others who may have been in close contact with your child in the days leading up to their positive test result.
When to Isolate
Anyone who tests positive for COVID-19 needs to isolate from others for 10 days, according to the CDC. This includes both children and adults. If your child has symptoms, they should isolate for 10 days and until their fever has been gone for at least 24 hours. If they have an asymptomatic case of COVID-19, they will still need to isolate for 10 days after their positive test. It’s nearly impossible for COVID-19-positive children to isolate from other members of their household, especially if they are young. To minimize the chances of the virus spreading within your household, the AAP suggests keeping your child in a separate room from other children, and having them use a separate bathroom if you have one. In addition, don’t allow your child to share dishes, utensils, and towels with others. Disinfect “high touch surfaces” like doorknobs and bathroom fixtures. While it may be difficult to isolate from your child, especially if they are young, it’s a good idea to take some steps to decrease the risk that you will contact COVID-19 from your infected child. You can decrease your own personal risk by keeping a safe distance from your infected child when you can, washing your hands frequently, and wearing a mask when you need to get close to your child. Taking these steps will decrease your potential for missed work, and minimize the likelihood of spreading the virus to your other children or close contacts. Since it’s possible you may still become infected, it’s important to isolate yourself and the rest of your potentially exposed family from others. Consider asking for help from others with basic errands like grocery shopping.
How to Care for Your Child’s Symptoms
Even mild cases of COVID-19 can be uncomfortable for children. Unfortunately, you have to just let the virus run its course, as medicines like antibiotics are not appropriate for viruses. “The best way to care for your sick child with COVID-19 is to provide what we call ‘supportive treatment,’” Dr. Hijano suggests. This should include plenty of fluids so that your child can avoid dehydration. Dr. Soong recommends other supportive measures, such as suctioning your child’s nose with a bulb syringe or NoseFrida with nasal saline. This can be done prior to feeding if your child is too congested to feed. Sleeping with a humidifier can also help with congestion. You can also give your child medication for fevers and body aches. Consult your doctor for advice about which medications are appropriate for your child and in what dosage.
Red Flags for COVID-19 in Children
You should contact your child’s doctor anytime your child has COVID-19 symptoms that concern you, says Dr. Afghani. Based on the symptoms you describe, they will tell you whether you should come in for a visit, or if your child’s symptoms necessitate a trip to the emergency room. Symptoms that may indicate a need for emergency medical treatment include difficulty breathing, lack of appetite, chest pain, extreme lethargy, or a rash that is getting worse, explains Dr. Afghani. If your child has an underlying condition that puts them in a higher risk category than other children, you should be especially vigilant and not hesitate to seek emergency medical care, Dr. Afghani emphasizes.
How to Handle COVID-19 Fears
If your child has a confirmed or suspected case of COVID-19, it’s natural that both you and your child will be experiencing increased anxiety. After all, we are in a pandemic, and there is lots of scary news out there about COVID-19. Even though COVID-19 is usually milder in children, we’ve all heard upsetting stories about children getting severe cases, and even dying. It’s important that you listen to your child’s fears, and not minimize them. Dr. Hijano suggests that if your child has access to technology and media sources, you monitor what they are exposed to and correct any COVID-19 misinformation they might encounter. You can also empower your child by showing them how to take care of themselves, like modeling effective hand washing and mask weaning, Dr. Hijano offers. As for your own parental fears, finding someone to confide in, especially other parents who share your concerns, can be very helpful, Dr. Afghani says. Managing your stress through exercise, healthy eating, meditation, and getting enough sleep, can be immensely helpful as well, according to Dr. Afghani.
A Word from Verywell
When it comes to COVID-19, it may feel that you have been inundated with information, some of it helpful, and some of it less so. As you search for information about COVID-19 and children, it’s important that you seek information and advice from trusted medical sources, such as the CDC and the AAP. Your child’s healthcare provider is also an invaluable source for accurate, up-to-date information. They also understand your child’s needs and medical history and can offer specific suggestions that pertain to your child and your family. Never hesitate to reach out to your pediatrician when it comes to questions and concerns about COVID-19 and your children.
