COVID in Children

What is COVID in children?

COVID-19 is a highly contagious respiratory illness that affects children and adults of all ages. Children are more likely than adults to have no symptoms or a mild infection from SARS-CoV-2, the virus that causes COVID-19. But some children experience severe illness that requires care in a hospital or intensive care unit (ICU). Children with underlying medical conditions like Type 2 diabetes or heart or lung disease have an increased risk of getting very sick from COVID.

Children without underlying conditions can also develop severe COVID-19, particularly if they’re unvaccinated. This is why pediatricians urge parents to get their children vaccinated. It’s also important for all members of a household to stay up to date with COVID vaccinations. Doing so can protect infants younger than 6 months (who aren’t eligible for a vaccine) and others who may be more vulnerable to severe illness.

What are the COVID symptoms in kids?

It’s not always easy to tell if your child has COVID just by looking at their symptoms. This is because COVID symptoms in kids resemble symptoms of other common infections, like the flu and RSV.

Symptoms of COVID-19 in children include:

• Fever (most common).
• Cough (most common).
• Shortness of breath.
• Sore throat.
• Headache.
• Muscle pain.
• Fatigue.
• Congestion.
• Runny nose.
• Gastrointestinal (GI) symptoms like nausea, vomiting and diarrhea.

Symptoms can vary from child to child. In some cases, children have no symptoms (they’re asymptomatic). Infants (babies under 1 year old) may have a fever and seem uninterested in feeding without any other symptoms.

It’s a good idea to call your pediatrician if your child has any symptoms of illness or just seems generally unwell. Your pediatrician can help you sort out what’s going on and will tell you if you should come in for an appointment.

What causes COVID-19 in children?

The SARS-CoV-2 virus causes COVID-19 infections in children and adults. SARS-CoV-2 is part of the coronavirus family of viruses, which can cause respiratory illness. The virus enters a person’s body through their mouth, nose or eyes. Once inside the body, the virus can start to multiply.

COVID-19 is highly contagious. Your child can get infected if they’re exposed to respiratory droplets from someone who has the virus. This can happen if a person with COVID coughs, sneezes, talks, sings or breathes near your child. It can also happen if your child touches a contaminated surface and then touches their face.

What are the complications of this condition?

Complications of COVID in children include:

• Croup.
• Bronchiolitis.
• Acute respiratory distress syndrome.
• Myocarditis.
• Acute kidney failure.
• Multisystem inflammatory syndrome in children (MIS-C).

Risk factors for severe COVID in children

Children with any of the following conditions face a higher risk of getting very sick from COVID or its complications:

• Premature birth (in infants).
• Asthma or other chronic lung conditions.
• Obesity.
• Type 2 diabetes.
• Congenital heart disease or cardiovascular disease.
• Sickle cell disease.
• Disorders affecting their brain or nervous system.
• Conditions that require the use of a feeding tube.
• Compromised immune system.

How is COVID diagnosed in children?

Healthcare providers diagnose COVID-19 with a laboratory test. A provider may take a sample of your child’s saliva or use a swab to collect fluid from their nose or throat. They send this sample to a lab for testing.

You may also choose to do an at-home test. If an at-home test shows your child has COVID-19, call your pediatrician and they’ll advise you on what to do next.

How do healthcare providers treat COVID in kids?

Healthcare providers tailor treatment to each child’s condition and needs. They focus on relieving symptoms and, in certain situations, preventing or managing complications.

Most kids have mild to moderate symptoms that go away with at-home care. Your pediatrician will advise you on how to care for your child. In general, you can:

• Help your child stay hydrated by giving them plenty of fluids.
• Manage your child’s fever (ask your pediatrician before using fever-reducing medication).
• Encourage your child to get plenty of rest.
• Run a humidifier in your child’s room to help with nasal congestion.

If your child has a high risk of severe COVID, their provider may prescribe antiviral medications. These are only used in select cases when providers feel they’re necessary.

Children who have severe symptoms or develop complications may need care at a hospital. Some children need care in the intensive care unit (ICU). If your child is hospitalized, their providers will tell you what you can expect. Supportive treatments your child may receive in the hospital include:

• Medications.
• Intravenous (IV) fluids.
• Supplemental oxygen.

How can I prevent my child from getting COVID?

It’s not always possible to prevent your child from getting common infections like COVID-19. However, you can take some steps to lower the risk and keep everyone in your household healthy:

• Disinfect commonly touched surfaces. Read the label on common household cleaners and follow the instructions for disinfecting. This kills viruses and other germs on surfaces like countertops and doorknobs.
• Wash your hands. It’s always important to wash your hands before eating or preparing food and after using the bathroom. During respiratory season, extra attention to hand hygiene is also worthwhile. For example, lather up after being in a public place or taking care of someone who’s sick. Keep hand sanitizer with you when you’re out and don’t have access to soap and water.
• Teach your kids cough etiquette. Cough etiquette involves coughing into a tissue or your elbow and avoiding coughing into the open air. Do this yourself and encourage your kids to do the same.
• Limit exposure. If you have a child or another household member at risk of severe COVID, think about which events and activities you can skip or modify, especially during respiratory season. This might mean turning down an invitation to a large indoor gathering or scheduling an outdoor, rather than indoor, play date for your child and their friends. Ask your pediatrician if masking is a good option for your child at school and other locations.
• Use caution when caring for a sick family member. If you’re caring for your child or someone else with COVID, wear a well-fitting mask when you’re close to them. They should also wear a mask if they’re over age 2 and able to do so. When possible, designate yourself or someone else as the main caretaker to limit how many people are exposed. Ideally, the person with COVID should stay in one room or section of your home and avoid contact with others.

Should my child get a COVID vaccine?

Healthcare providers recommend all children age 6 months and older get vaccinated against COVID-19. The vaccine trains your child’s immune system to fight off the virus. Your child may need one or more doses of the vaccine, depending on their age and other factors. The benefits of the COVID vaccine in children include:

• The vaccine may prevent your child from catching COVID-19.
• If your child does get sick, the vaccine greatly lowers their risk of serious illness and hospitalization.
• The vaccine also helps lower the risk of your child developing MIS-C, a serious complication of COVID-19 infection.
• Your child is less likely to spread COVID to other family members, including those who may be vulnerable to serious illness.

As with all medical care, you should talk to your pediatrician for advice tailored to your child’s needs. They’ll tell you what vaccines your child needs to have the most up-to-date protection against COVID-19. They’ll also make sure your child stays on track with other routine immunizations.

Keep in mind:

• Your child may need additional doses of a COVID vaccine if they have a weakened immune system or as new variants of the virus emerge.
• Your child may need to delay a dose of the COVID vaccine if they come down with COVID-19. For example, providers typically recommend delaying a dose by up to three months if your child was recently sick with COVID-19. But they should still get the vaccine to have strong and long-lasting protection against the virus.

Is the COVID vaccine safe for children?

Research shows COVID vaccines are very safe for children. Kids were included in clinical trials, and experts continue to monitor the vaccine for safety.

Some parents are concerned their teen will develop myocarditis (inflammation of the heart muscle). This is very rare. Viral infections like COVID-19 and the flu cause myocarditis much more often than vaccines do. This is why healthcare providers emphasize that the benefits of vaccination outweigh any possible risks.

What side effects could the COVID vaccine cause in my child?

Some children don’t have any side effects. Others develop mild side effects within 12 hours of getting the shot, including:

• Pain, redness and/or swelling in the area where they received the shot.
• Fatigue.
• Fever.
• Headache.
• Chills.
• Muscle aches and pains.

Side effects usually go away within 24 hours of when your child got the vaccine.

How long does COVID last in kids?

Most kids get better within one to two weeks. But children who develop complications may need longer to recover. Your pediatrician can tell you more about what to expect.

When can my child return to school?

Follow your healthcare provider’s advice about your child’s return to school or daycare. But be sure to check with your school, as well. Many schools and daycares have their own criteria for returning after illness.

What is the outlook for children with COVID-19?

Most kids recover and bounce back just fine after COVID. But some children develop post-COVID conditions, also known as long COVID. This is a collection of symptoms a person experiences within three months of their first COVID symptoms. Long COVID is less common in children compared to adults.

Children who develop long COVID most commonly have the following symptoms:

• Fatigue.
• Headache.
• Insomnia.
• Trouble concentrating.
• Muscle and joint pain.
• Cough.

Tell your pediatrician if your child has lingering symptoms of COVID or new symptoms develop.

When should I call a pediatrician?

Call your pediatrician if:

• Your child has symptoms of COVID-19.
• Your child’s symptoms aren’t improving or seem to be getting worse.
• Your child was exposed to COVID-19 and has a high risk of severe illness.
• You have questions about when you can send your child back to daycare or school.
• You want to discuss the appropriate vaccine schedule for your child.

When should I take my child to the ER?

Call your local emergency number or take your child to the ER if they:

• Have trouble breathing.
• Have persistent pain or pressure in their chest.
• Seem suddenly confused.
• Aren’t waking up from sleep or can’t stay awake.
• Have a bluish color to their lips or face.

A note from Cleveland Clinic

The SARS-CoV-2 virus has been living among us for a while now. Thanks to vaccines, it’s less of a threat than it used to be. But still, a little caution can go a long way. While you can’t always prevent your child from getting sick, you can take steps to protect them from serious illness. The first step is talking to your pediatrician about vaccination. Getting your child vaccinated is one of the most important things you can do to lower their risk of getting very sick or needing care at a hospital.

You can also take steps in your daily life to keep your loved ones healthy. Since kids might not develop symptoms, it’s a good idea to take precautions if you’re going to visit people at high risk for severe illness (like testing and wearing masks around grandma).