Children are susceptible to COVID-19. Understanding how the virus affects them, along with prevention strategies and potential long-term effects, can help parents navigate this evolving health landscape.
How COVID-19 Affects Children
Children often experience milder symptoms from COVID-19, and many cases are often asymptomatic. Common symptoms include fever and cough, but other signs like sore throat, runny nose, headache, fatigue, muscle pain, and congestion can also include gastrointestinal issues like nausea, vomiting, and diarrhea. Symptoms may appear 2 to 14 days after exposure to the virus.
While most children recover within one to two weeks with home care, some may develop more severe illness requiring hospitalization. Children with underlying health conditions, such as obesity, diabetes, or cardiac and lung disorders, face a higher risk of serious outcomes. Severe illness can also occur in children without pre-existing conditions, particularly if they are unvaccinated.
A serious, albeit rare, complication after COVID-19 infection is Multisystem Inflammatory Syndrome in Children (MIS-C). This condition usually develops two to six weeks following infection and involves inflammation in multiple organ systems, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal tract. Symptoms of MIS-C often include a persistent fever lasting several days, accompanied by abdominal pain, vomiting, diarrhea, skin rash, red eyes, and dizziness or lightheadedness. Children with MIS-C often require admission to an intensive care unit.
Protecting Children from COVID-19
Vaccination is a primary strategy for protecting children from COVID-19, significantly reducing the risk of severe illness and complications. The effectiveness of mRNA vaccines against infection has been observed across different pediatric age groups, though it can vary and wane over time. For instance, effectiveness against the Omicron variant was found to decline over several months.
Beyond vaccination, general public health measures play a role in limiting the spread of the virus among children. Frequent hand hygiene, using soap and water or an alcohol-based hand rub, helps remove germs. Covering coughs and sneezes with a bent elbow or tissue also prevents the spread of respiratory droplets.
Face masks can also contribute to prevention by containing respiratory droplets and filtering airborne particles. Masks are safe for children over two years of age and do not block oxygen or affect learning. When selecting a mask, those with multiple layers, such as surgical masks or respirators like KN95 or KF94, offer better filtration than single-layer cloth masks.
Understanding Long COVID in Kids
“Long COVID,” also known as Post-COVID Conditions or Post-acute sequelae of SARS-CoV-2 (PASC), refers to symptoms that persist for weeks or months after the initial COVID-19 infection. While more commonly discussed in adults, children can also experience long COVID, though its prevalence in the pediatric population varies widely across studies.
Common lingering symptoms reported in pediatric cases include fatigue, headaches, and sleep disturbances, which can impact daily life and school attendance. Other symptoms may include shortness of breath, muscle and joint pain, and neurocognitive issues like difficulty concentrating or “brain fog.” For adolescents, loss of smell or taste can also be a persistent symptom. The likelihood of developing long COVID symptoms may increase after a severe acute COVID-19 infection, but it can also occur in those with mild or asymptomatic initial illness.
When to Seek Medical Care and Support
Parents should seek immediate medical attention if their child exhibits certain warning signs related to COVID-19:
Persistent pain or pressure in the chest.
New confusion or inability to wake or stay awake.
Pale, gray, or blue-colored skin, lips, or nail beds.
Severe abdominal pain.
Difficulty breathing.
Signs of dehydration, such as dry mouth, no tears, or decreased urination.
For infants younger than three months, a fever higher than 100.4 degrees Fahrenheit (38 degrees Celsius).
For common, milder symptoms such as a cough, body aches, or a sore throat, contacting a child’s primary care physician for guidance is appropriate. The pandemic has highlighted the importance of mental health support for children and adolescents, who may experience increased stress, anxiety, and depression. Parents can support their children by limiting media exposure, validating their feelings, and maintaining routines. If children or teens show signs like persistent anxiety, mood changes, withdrawal, disordered eating, or sleep disturbances, consulting a behavioral health specialist is advisable.