It can be hard to identify COVID-19 in children as their symptoms are often mild. They may have no symptoms at all. It is a good idea to do a test if a child shows any symptoms of illness, especially if they’ve been exposed.

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For the past few years, COVID-19 has dominated public discourse. At first, countless conflicting reports led to confusion that it was just like the flu, and that it didn’t have the same impact on children as it did on adolescents and adults.

As we head into our third year of research on COVID-19, more is known about how the novel coronavirus and COVID-19 affect various people in our communities. We now know that pediatric infection rates are similar to that of adults, though many children may not have any symptoms.

In fact, researchers in one 2022 pediatric study examined antibody tests. They found evidence that up to 77% of children have already had COVID-19. We now know that children can, in fact, contract the coronavirus that causes COVID-19.

For parents and caregivers, this can cause anxiety — is that cough and runny nose just a cold that’s circulating through day care, or something more serious?

This article sheds light on the most common symptoms of COVID-19 in children, and what to do if you suspect your child has it.

Experts note that COVID-19 symptoms in children are similar to those documented in adults. However, the symptoms in children are usually not as severe.

In many cases, children may be asymptomatic. This means that no symptoms may be present even though they test positive.

Common symptoms of COVID-19 include:

  • fever
  • headache
  • fatigue
  • body aches or muscle pain
  • sore throat
  • cough
  • shortness of breath
  • nausea or vomiting
  • diarrhea
  • loss of taste or smell
  • rash, often on toes, lower extremities, or hands

It’s important to keep in mind that as new coronavirus variants emerge, new symptoms may arise. Others can shift in severity.

For example, when COVID-19 first appeared globally in 2019, a loss of smell and taste was one of the hallmark signs that a person might have contracted the virus.

But with later variants, such as many of the Omicron variants, a loss of taste and smell is less frequently reported as a primary symptom, whereas a sore throat is often more common.

When in doubt, it’s always best to reference the latest information shared by reliable health organizations, such as the Centers for Disease Control and Prevention (CDC) or the National Institutes of Health (NIH).

Also note that many common COVID-19 symptoms are similar to those of the common cold, flu, stomach flu, and other upper respiratory infections.

Before jumping to conclusions, get your child tested to confirm they have COVID-19.

Even though children tend to have a less severe reaction to COVID-19 than older populations, one serious risk COVID-19 poses to children is the potential to develop multisystem inflammatory syndrome in children (MIS-C).

Researchers still don’t fully understand the link between MIS-C and COVID-19. But they do know that since the appearance of the novel coronavirus, many children with MIS-C had either an earlier coronavirus infection or were exposed to someone who had COVID-19.

MIS-C can affect multiple organ systems across the body, including the heart, lungs, kidneys, gastrointestinal system, and brain. If left untreated, MIS-C can be deadly. In most cases, it’s easily treated.

If your child has symptoms of MIS-C, get them evaluated by a doctor immediately. Symptoms associated with MIS-C include:

  • fever
  • bloodshot eyes
  • dizziness or lightheadedness
  • abdominal pain
  • diarrhea
  • skin rash
  • vomiting

Another potential symptom of COVID-19 in young children is croup. Croup is the inflammation of the airways that causes:

  • a barking cough
  • stridor (high pitched, coarse sound when breathing)
  • distressed breathing

If your child has symptoms of croup, it’s worth getting evaluated and tested for COVID-19 or other possible causes.

Studies are still being conducted to determine how COVID-19 specifically affects babies.

One 2022 study from Poland looked at infections in infant populations (newborns up to 12 months old) during the first year of the COVID-19 pandemic (March through December 2020). Researchers noted the majority of cases in this group were mild.

Of the infant cases reviewed — even though 94% were hospitalized — 276 cases were mild, six were moderate, 32 were asymptomatic, and none were reported as severe cases.

Similar to adults, the most common symptoms were low and high grade fevers. However, other reported symptoms included:

  • cough
  • diarrhea
  • loss of appetite
  • vomiting
  • rash
  • abdominal pain

Researchers noted that one of the most common secondary diagnoses that followed COVID-19 in infants was pneumonia. It was found in 70 of the 300 cases reviewed.

On the whole, the Polish study noted that infant cases of COVID-19 tend to represent only 1% to 2% of all cases, even when looking at general case counts in other countries. But, in countries with more prevalent testing, this percentage could increase to a range of 5% to 13%.

Still, infant cases were generally mild compared with adult cases, which were often more severe.

A 2022 study from Germany suggests that at-home rapid antigen tests tend to be less precise or accurate than the RT-PCR test, which healthcare professionals perform.

Experts have consistently questioned the effectiveness of at-home tests because of known issues regarding low sensitivity to detect the coronavirus across all age groups.

This means there’s a higher possibility of false negatives for at-home rapid tests. Coupled with a heightened chance of improper nasal swabbing in younger populations, there’s an increased risk of getting incorrect results from an at-home rapid antigen test performed on children.

Parents and caregivers should keep in mind that a rapid test only offers results for a snapshot in time. It can only provide sufficient results if there’s enough viral load for the test to pick up.

The coronavirus’s incubation period ranges from 2 to 14 days, with the average being 3 to 6 days, depending on the coronavirus variant.

So, a negative rapid test result doesn’t necessarily mean you’re in the clear if the test is taken fewer than 14 days after a known exposure. It could mean the virus is not yet detectable.

If you suspect that your child may have been exposed to COVID-19, your first step should be to get them tested.

While at-home tests might provide an initial answer, it’s always best to take your child to a physician or clinic for an RT-PCR test. This test type offers higher accuracy and has a lower false-positive rate.

Plan to keep your child at home from day care or school if COVID-19 is suspected to reduce the risk of transmitting the virus to others.

Currently, there’s only one antiviral medication for COVID-19 that’s approved by the Food and Drug Administration (FDA) for use in babies and children under the age of 12: remdesivir (Veklury).

It’s only administered intravenously at healthcare facilities and used for children with an increased risk of developing severe symptoms.

The CDC currently recommends that if your child tests positive for COVID-19, treat the day you first noticed symptoms as day 0 and the following day as day 1. The organization recommends that children be kept at home for at least 5 days. Ideally, try to isolate them from other members of the household.

Depending on the severity of the disease, isolation may end on different dates. Children with mild symptoms who show improvement with no symptoms on day 5 of isolation can end isolation.

If symptoms persist or worsen, continue isolation until your child is fever-free for 24 hours without the need for fever-reducing medication and until symptoms begin to improve.

If you’re not sure when to end isolation, talk with a healthcare professional.

When you’re caring for small children, isolating them from yourself or other family members can be a tall order — especially if they’re babies and not self-sufficient enough to manage basic tasks without adult supervision.

In this case, you’ll want to wear a mask when interacting with your child. Wash your hands frequently to avoid transmitting the coronavirus to other surfaces or family members.

Additionally, avoid sharing personal items, like cups, utensils, towels, and bedding. Likewise, be sure to regularly clean and disinfect surfaces throughout shared areas of the home, like the kitchen, living room, and bathrooms.

Anyone can contract the coronavirus and develop COVID-19. But according to health organizations around the world, babies and children consistently tend to contract the virus less frequently and in a milder form than in older populations.

According to the American Academy of Pediatrics, as of early September 2022, there have been a total of 14.7 million cases of COVID-19 reported in children in the United States since the start of the pandemic in March 2020.

That’s out of a total of 79.4 million cases across all age demographics in the country. The child case count represents 18.4% of the total U.S. case count.

With an active case of COVID-19, it’s important to talk with a doctor to determine what type of treatment is needed.

Depending on your child’s age and the severity of their illness, a doctor may recommend different treatments. A very mild case may just need home remedies and rest. Others might be better served by introducing a therapeutic or antiviral medication.

Regardless of which option a doctor recommends, keeping your little one hydrated and trying as best as possible to isolate them from other members of the household is important.

Preventive solutions are best

Preventive solutions are often best at minimizing your child’s risk of severe COVID-19. This means that if your child is of an approved age to get any of the COVID-19 vaccines, it’s recommended that they get vaccinated according to the recommended schedule and receive boosters as needed.

It’s important to note that COVID-19 vaccines prevent severe infections that could lead to serious illness, hospitalization, or death. However, they do not necessarily prevent contracting the virus itself.

To date, COVID-19 vaccines have been proven safe and effective for babies, children, and adults. Getting vaccinated is one of the best measures to prevent severe COVID-19.

The CDC offers comprehensive information regarding which vaccines are approved in which age groups, and the recommended schedules for receiving them.

COVID-19 continues to be an issue of concern. While babies and children tend to contract the coronavirus less frequently and usually develop a milder case of COVID-19, they are not immune to it.

To date, vaccination is the best preventive method to reduce the chances of hospitalization, getting very sick, or dying from COVID-19. If your baby or child contracts the coronavirus, seeking immediate medical attention can ensure that they receive treatment that can help recovery and reduce symptoms.

When in doubt, follow the guidelines as outlined by authoritative health organizations such as the CDC and NIH. If your child has any COVID-19 symptoms, get them tested.