A: The truth is we don’t know exactly how COVID-19 presents in children because there have only been rare cases reported in the literature so far.
But, here is the list of the known symptoms of COVID-19:
- Fever – frequent
- Dry Cough – frequent
- Shortness of Breath – frequent (especially adults/older patients)
- Sore throat – sometime
- Headache – sometimes
- Achiness – sometimes
- Fatigue – sometimes
- Nasal Congestion – rare (but can happen in kids)
- Stomach upset/Diarrhea – rare (but more common in kids, rare in adults but may predict worse symptoms in adults)
- Bilateral Conjunctivitis – rare
*Any patient with loss of smell or loss of taste should be tested – very specific weird presentation
The difficulty is that the symptoms of COVID-19 are very similar to the symptoms of almost all viral illnesses. At this time of year there are many viral illnesses in circulation. It is difficult to know exactly what viral syndrome a child has and in many ways it does not help our clinical management. Viral syndromes are treated with what we call supportive care – hydration, rest, fever reducers like tylenol for the patient’s comfort. At this time our recommendation is that anyone who is ill should act as if they could have COVID-19. They should stay home and avoid social contact.
In fact this is the crux of why the social distancing strategy is so important right now. STAY AWAY FROM ELDERLY AND IMMUNOCOMPROMISED RELATIVES ESPECIALLY.
Because of the lack of testing available – at this time the CDC recommends testing only if you meet the following criteria:
- You have to have symptoms including fever and:
- You have traveled outside the country to a known hot spot in the past 2 weeks
- You have a known exposure to someone who tested positive with COVID-19
- You are a health care worker who is symptomatic
- You have a pre-existing condition or are over 65 years old and are therefore high-risk
This means that most of our patients do not meet testing criteria – which can be frustrating for us and for parents. Remember that so far the evidence shows that the vast majority of younger patients with COVID-19 have mild illness. Also studies from China and Italy so far show that younger patients were less likely to be diagnosed (although it’s unclear if it was because they don’t catch the disease or just that they have such mild symptoms they don’t always get tested for the disease.)
Remember that you are watching for exactly the same red flag symptoms we always discuss: Shortness of Breath/Difficulty breathing, dehydration, altered mental status/lethargy, extremely high fever – These are reasons to go to the Emergency room for further evaluation and possible testing.
If you go to the Emergency Room you MUST call ahead to allow them to take the appropriate precautions to take care of your child
A: Yes it is. Researchers think people may be shedding the virus for a few days before showing symptoms. And some people may never develop symptoms or may only have such mild symptoms that they think nothing of it. In fact this is another reason why EVERYONE NEEDS TO PARTICIPATE IN SOCIAL DISTANCING for it to work. Just because you feel well doesn’t mean you are well – you could still be spreading the virus to those who are more vulnerable.
A. If your child is asymptomatic, continue social distancing and STAY HOME, continue frequent hand washing and avoiding touching your face. If your child becomes symptomatic within 14 days of the exposure with fever, cough, shortness of breath, you should reach out to us to discuss if testing is warranted. We will see you via telemedicine to triage the situation.
A: If you know that you have been in contact with someone with COVID-19 but you are asymptomatic you need to continue social distancing and STAY HOME. Continue frequent hand washing and avoid touching your face. Your child does not need to be tested if you are asymptomatic.
A: If you are symptomatic you need to reach out to your doctor to discuss testing for COVID-19. Your child does not need to be tested if they are asymptomatic. Your child does need to be quarantined at home for 14 days. At home continue frequent hand washing, avoid touching your face, wear a mask and gloves if you have them. Wash all frequently touched surfaces down as much as possible.
If your child develops symptoms of fever, cough, shortness of breath, you should call our office to discuss if testing is warranted. We will see you via telemedicine to triage the situation.
A: Treat your child exactly as you would for a common cold. Stay home, wash your hands frequently, and monitor for more severe symptoms that require medical attention, specifically difficulty catching your breath or labored breathing, trouble staying hydrated, or altered mental status/lethargy. Provide supportive care to your child – keep them hydrated (a change in appetite is expected) and use fever reducers like Acetaminophen to keep your child comfortable.
A: The only reason to go to the ER before contacting us is for a child with severe breathing difficulty, a child who is non responsive, or a child who is victim of a severe accident or trauma. Infants who are 6 weeks or under need to be seen in the ER for fever as well – but parents should call ahead to let the ER know that they are coming in for a workup. Otherwise call your doctor first to discuss the situation – there are many situations that can be managed by phone or Telemedicine appointments.
A. Getting fresh air is important and healthy. Taking a walk several times a day in areas that are not crowded and avoiding common meeting areas like playgrounds is healthy and fine- provided you or your child is not sick. If you need to go to a store to pick something essential up, then that too is OK provided anyone who is ill stays home
A: Until a vaccine is available. The only way to prevent this illness is to avoid exposure to the virus. This is why social distancing is so important. STAY HOME, wash your hands frequently, wipe down surfaces that everyone touches. If you do need to go out, come home and change your clothes, wash your hands. Do not take your kids out to the store or to run errands.