COVID19 infection in children generally occurs 2-5 days after being exposed to the virus . Children can be symptom free or experience a range of symptoms (most children experience the equivalent of a mild to moderate cold). Most common symptoms are sore throat, fever/chills, headache, fatigue, congestion/runny nose cough, muscle aches and gastrointestinal problems like bellyache, nausea, vomiting, and diarrhea. Other less common complaints include trouble breathing, chest pain, and loss of taste and smell. Most children experience a relatively mild course of illness that can be managed at home with over the counter treatments and home therapies described below.
Watch for signs that your child might need more medical help. Go to the ER if your child:
Call 911 if your child is struggling to breathe, is too out of breath to talk or walk, or turns blue or has fainted.
Basic care for COVID19 is going to be the same as that of any viral illness.
Fever, sore throat, aches/pains can be managed with ibuprofen or acetaminophen, dosed by weight not age. Remember that the height of the fever is not as worrisome as what is causing the fever (in this case, we know it is COVID19), and what other symptoms are present (a child with a high fever who is breathing easily and well hydrated is less concerning than a child who appears otherwise very ill.). Children with fever will breathe faster and have a higher heart rate, which should improve once their fever comes down.
Not all fevers need to be treated! There is some evidence that allowing a child to maintain a modest fever can help fight off illness faster. If your child has a temperature of 101 or less, and your child does not appear uncomfortable, consider watchful waiting. If the fever is higher, your child is particularly uncomfortable, or it is bedtime and the fever appears to be rising go ahead and treat.
Nasal congestion and cough can be treated with humidification (use a cool mist humidifier right next to your child’s bed/crib), steamy bathroom play and nasal saline spray (avoid using nasal aspirators too frequently or they may cause more inflammation of the nasal membranes.). Children over age 1 can take straight honey for coughs, and children over age 3 can use pectin lollipops for sore throats and coughs. Delsym, an over the counter cough medicine, can be helpful for children over age 5 with persistent coughing (as long as they are not having trouble breathing between coughs). If your child has a history of asthma with viral infections, they should use their Asthma Action Plan medications for the yellow zone (mild to moderate illness) or we will discuss what preventative medications are appropriate if you are unsure.
Nausea/Vomiting/Diarrhea are best managed with frequent small sips of an electrolyte containing beverage such as Pedialyte for children under age 1, or in older children Pedialyte, diluted juice, Gatorade, flat ginger ale, chicken broth, ice pops and jello. As they are able to keep down solids, stick with bland foods such as crackers, toast, rice, noodles, bananas, applesauce, yogurt and progress to foods they may prefer avoiding fatty/fried foods and dairy (milk/cheeses) until their diarrhea abates. For big milk drinkers with bad diarrhea, try lactaid milk. If your child has persistent vomiting, cannot keep down fluids, has a dry mouth and/or Is not urinating every 3-4 hours they likely need ER treatment for IV hydration.
We do not recommend any homeopathic remedies, and there is no indication for any prescription medications for children with COVID19 at this point in time. Home remedies you may hear about on social media, such as the lice and animal de-worming product ivermectin, are NOT proven effective against COVID-19. Worse, they can be toxic if used not as directed.
Multisystem Inflammatory Syndrome in Children (MIS-C)
RARELY, some kids get symptoms caused by inflammation throughout the body, usually several weeks after they were infected with the virus. The child may have been infected from an asymptomatic contact and, in some cases, the child and their caregivers may not even know they had been infected. It can affect many different body systems, including the lungs, heart, brain, kidneys, blood vessels, skin, eyes, and gastrointestinal system.
Patients with MIS-C usually present with persistent fever, abdominal pain, vomiting, diarrhea, skin rash, mucocutaneous lesions and, in severe cases, with hypotension and shock. These children generally LOOK VERY SICK. They have elevated laboratory markers of inflammation. Most kids with MIS-C get better after they get special care in the hospital, sometimes in the intensive care unit.
How Can I Keep My Family Safe if My Child Has COVID19?
AFTER COVID19, if your child is a competitive athlete they will need to have a clearance visit in our in our office prior to resuming their sport. This clearance exam cannot take place until your child is at least 10 days symptoms free. If they have had fever or prolonged symptoms they may need an EKG for clearance.
If You Test Positive for COVID-19 (Isolate)
Everyone, regardless of vaccination status.
If you have a fever, continue to stay home until your fever resolves.
If you develop symptoms get a test and stay home!
Unless you are masking/distancing from the infected family member, your isolation period would begin after the LAST day of the infected member’s isolation period.