COVID in kids is generally less common and tends to cause milder symptoms than COVID-19 in adults. Symptoms may include fever, cough, fatigue, skin changes, and diarrhea.
Some children can develop a more serious complication called multisystem inflammatory syndrome in children (MIS-C). This condition can cause more severe symptoms, including a very high fever, vomiting, and severe abdominal pain.
If COVID-19 is suspected, the child should be evaluated by a pediatrician for a more complete assessment. Regular handwashing and avoiding close contact with others can also help prevent children from spreading the virus to people at higher risk, such as parents or grandparents.
Main symptoms
The most common symptoms of COVID-19 in children include:
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Fever above 100.4°F (38°C)
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Persistent dry cough
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Loss of smell or taste
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Nausea and vomiting
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Diarrhea
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Excessive fatigue
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Decreased appetite
Symptoms can last from 6 to 21 days and may be similar to those caused by other viral infections. Some children may also have gastrointestinal symptoms, such as abdominal pain, diarrhea, or vomiting.
Unlike adults, children are less likely to experience shortness of breath. Some children can also have COVID-19 without developing any symptoms.
Multisystem inflammatory syndrome
Multisystem inflammatory syndrome in children (MIS-C) is a rare complication of COVID-19 that primarily affects children. According to the Centers for Disease Control and Prevention (CDC), MIS-C can cause inflammation in several parts of the body, including the heart, lungs, kidneys, brain, skin, eyes, and gastrointestinal tract.
In these cases, COVID symptoms tend to be more severe.
Skin changes
Skin changes can occur in children with COVID-19 and, in some cases, may be the only sign of the infection.
These changes may include red spots, hive-like rashes, swollen areas, or lesions on the fingers and toes known as "COVID toes."
In more serious cases, such as MIS-C, these skin changes may occur along with red eyes, swelling of the mouth or tongue, and a widespread rash.
Treatment
Treatment for COVID-19 generally focuses on relieving symptoms and preventing the illness from getting worse.
In most cases, COVID-19 can be managed at home with rest, fluids, and medications recommended by the child's pediatrician. Acetaminophen can help reduce fever.
According to the US Food and Drug Administration (FDA), over-the-counter cough and cold medicines are not recommended for children younger than 2 because they can cause serious side effects, and manufacturers generally label these products for children ages 4 and older.
Hospitalization may be recommended in some cases, especially if the child develops more serious symptoms, such as shortness of breath or difficulty breathing, or has another health condition that increases the risk of severe illness, such as diabetes or asthma.
Prevention measures
Children should follow many of the same precautions as adults to help prevent COVID-19, including:
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Washing their hands regularly with soap and water, especially after being in public places
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Keeping their distance from other people, especially older adults
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Wearing a protective face mask when appropriate
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Avoiding touching the face, especially the mouth, nose, and eyes
These precautions can become part of a child's routine. In addition to helping protect the child from the virus, they can reduce transmission to more vulnerable people, such as older adults.
COVID vaccines
In the United States, FDA-approved COVID-19 vaccines are available for certain children based on age and risk factors.
Spikevax, made by Moderna, is approved for children 6 months and older who are at higher risk of severe COVID-19. Comirnaty, made by Pfizer-BioNTech, is approved for children 5 years and older who are at higher risk. Nuvaxovid, made by Novavax, is approved for people 12 years and older who are at higher risk.
Vaccination can help reduce the risk of severe COVID-19. Parents and caregivers should ask their child's pediatrician which vaccine is appropriate based on age and health.
When to see a doctor
According to the American Academy of Pediatrics (AAP), children should be evaluated by a pediatrician if they have:
- A fever of 100.4°F (38°C) or higher and are younger than 3 months
- A fever of 101°F (38.3°C) or higher and are between 3 and 6 months old
- A fever that lasts more than 24 hours in a child younger than 2
- A fever that lasts more than 3 days in a child age 2 or older
- A significant loss of appetite or difficulty drinking fluids
- Changes in their usual behavior
- Symptoms that are getting worse or are not improving
Seek emergency medical care if a child has difficulty breathing, blue or gray lips or face, persistent or severe chest pain or pressure, new confusion, or difficulty waking up or staying awake.
Children can also become dehydrated when they are sick, especially with fever, sweating, vomiting, or diarrhea. Contact a pediatrician if signs of dehydration develop, such as a dry mouth, sunken eyes, reduced urination, crying without tears, or unusual irritability.
Although COVID-19 in children is usually less severe than in adults, medical evaluation may be needed when symptoms are severe, persistent, or getting worse.
