COVID-19 in Children

As a parent, you naturally worry about the health of your child. The coronavirus pandemic has added a new concern. What are the chances your child will get sick, and if they do, how sick will they get? We asked San Juan Health Partners Pediatrician Dr. Brad Scoggins your top questions about COVID-19 in kids to find out the answers and help put your mind at ease. 

Q: How does COVID-19 present in children?

Dr. Scoggins: In general we’ve been very fortunate. Despite recent increases in cases in children we have not seen kids be all that ill with it. In fact, the vast majority of patients that we’re seeing in our practice are asymptomatic. They are being tested because they have upcoming surgeries or because they have a family member who has been ill. We are finding cases in children but they don’t really seem to be sick from it. Those that have been ill, it has been a nearly sub-clinical illness. Maybe a mild sore throat, nasal congestion, slight cough at the most. 

Q: What symptoms should parents look for?

  • Fever
  • Fatigue
  • Headache
  • Cough
  • Nasal congestion 
  • New loss of taste or smell
  • Sore throat
  • Shortness of breath or difficulty breathing
  • Abdominal pain
  • Diarrhea
  • Nausea or vomiting
  • Poor appetite or poor feeding

According to the CDC, children infected with COVID-19 may have many of these symptoms, or they may only have a few, or they may be asymptomatic. The most common symptoms in children are cough and/or fever.

Q: Should I seek medical care if my child displays symptoms?

Dr. Scoggins: That is an ongoing question even in pre-COVID times. Many illnesses, I’d even add COVID to the list, don’t require any intervention from a doctor. There’s not really any specific treatment for it. Nor would I recommend getting tested for minor symptoms with a few exceptions: if you have a sick, chronically ill relative at home, someone on chemotherapy, someone on immune system suppressing medications, in those cases we would pursue a test to limit exposure. Otherwise, in mild cases, children should be distanced from relatives as much as possible. 

Q: When should we test kids for coronavirus?

Dr. Scoggins: If you have significant worry about this child passing coronavirus to a chronically ill relative, that could be a case where testing would be indicated. Also if a child is sick and comes into the hospital with viral respiratory symptoms. Otherwise, like seasonal influenza, the utility of a test particularly in the absence of a good treatment is always something we should have a discussion about. If you are not going to make changes to the treatment based on the results of the test, we should question whether or not the test is necessary. In the case of mild viral symptoms, it is likely the test results will not be back from the lab in a timely enough fashion to make decisions based upon that test. So in general I would not recommend routine testing, especially in children with mild viral symptoms.

Q: How should we talk to kids about coronavirus?

Dr. Scoggins: Kids, regardless of how sheltered we try to keep them, they are hearing about it. They hear it in casual adult conversation, in the news, or the radio in the car. They understandably have lots of questions. We are seeing a big rise in anxiety right now because of the heightened awareness of the outbreak. So what I tell kids and their parents, there are things that we should be doing even in pre-COVID and God willing post-COVID times. I encourage parents to talk to your kids about making these things part of your normal routine to prevent infection. Places where there’s lots of people gathered together, things like wiping down shopping cart handles, washing your hands before you eat and after you use the restroom, using a mask to help slow the spread of the virus. If you are going to venture out to a playground or a public place, washing hands, maybe a change of clothes when you are finished. The good news is if kids are playing outside the UV light from the sun does seem to have an effect on killing the virus. When kids are in outdoor spaces wind will carry away aerosolized particles. So outdoors is actually a very safe place to be. The beneficial effects of sunlight include raising vitamin D levels, which may be somewhat protective against most viral illnesses, and giving your immune system a boost.

Q: Do parents need to be worried about the multi-inflammatory syndrome in kids?

Dr. Scoggins: The multi-inflammatory syndrome is a lot like a previously known entity called Kawasaki’s Disease. With both of these there is pretty significant widespread inflammation so it does affect multiple organ systems including the heart; it can affect the liver, certainly the blood vessels. After some initial outbreaks of this, I haven’t heard of a lot more cases. We have not had a case admitted to our hospital here that I am aware of. So this is a syndrome that follows an infection of coronavirus. It involves inflammation in multiple body systems and can be quite significant. Things to look for:

  • A fever lasting longer than 5 days
  • Bright red, inflamed eyes under the lower eyelid
  • Swollen tongues 
  • Large lymph node on one side of their neck 
  • A fairly significant rash that causes peeling to the hands and feet

If you have any one of those symptoms and a known COVID exposure, that could be a good idea to be seen by a doctor and possibly the Emergency Department. We have treatments for Kawasaki’s disease that can be effective. 

Q: Should I be concerned about sending my kids back to school? 

Dr. Scoggins: In the eventual likely reopening of in person school, should parents be really worried with coronavirus? The short answer is no, I don’t think they should. All regular precautions should be taken. Teachers do a good job of keeping the classroom clean, hand washing, use of alcohol-based hand sanitizer. I would not have a big worry about kids going back to school. For the most part kids seem to be getting the infection at very low rates and they seem to have less viral carriage than adults do, if they do cough or sneeze the likelihood that it will be transmitted to their classmates is very small. Last but not least, kids seem to get less ill with it. Some caveats to that would be based on individual family considerations, so if you have a chronically ill family member that might be something to consider. If you are going to be sending kids back to school, even if they don’t get sick there is a small chance of transmitting that vaccine to a family member. One thing that assures me is that even in the lockdown time we have had children of essential workers in daycare, and as far as I’m aware I have not heard of any major case outbreaks in daycare centers within our state.

Dr. Scoggins’ final takeaways on coronavirus in kids:

  1. Kids don’t seem to be getting sick with the virus and the number of hospitalizations has been very small. In fact, no children have been hospitalized with COVID-19 at San Juan Regional Medical Center.
  2. Going back to school is probably safe and kids and families and teachers should work together where they prevent the spread as much as possible.
  3. Let’s get outside. Make sure we are getting outside, getting sunlight. Don’t forget to let kids be kids.

San Juan Health Partners Pediatrics is open and seeing patients both in clinic and via telemedicine visits, depending on your child's needs. We’re taking extra precautions to keep you and your child safe when you come to visit us. For in clinic visits, we'll check you in by phone and call you when we're ready to see you, eliminating the need to wait in our lobby. Join Jonathan Palmer, Nurse Practitioner as he discusses the importance of vaccinations and scheduling your child well-check visit. We are welcoming new patients. Visit us online or call us at 505.609.6700.

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