The Novel Coronavirus Pandemic (COVID-19) and Symptoms in Children

By Inova Newsroom | April 24, 2020

Minal Amin, MD, is a pediatric emergency medicine physician at Inova Children’s Hospital. Dr. Amin is board certified in emergency medicine and pediatric emergency medicine.

Nicole Barbera, DO, is a fellow in pediatric emergency medicine at Inova Children’s Hospital. Dr. Barbera is board certified in pediatrics.

At Inova, we want to support you during the current novel coronavirus pandemic and want you to know we are here for you and the medical needs of your child.

For the safety of our community and patients we have modified our visitation policies (including special guidelines for Inova Children’s Hospital), initiated universal masking for both providers and patients/families, and divided the Emergency Department into separate sections for patients with concern for COVID-19 versus other medical conditions.

See all Inova COVID-19 community information

What is COVID-19?

COVID-19 is the name of the medical condition caused by the novel coronavirus (SARS-CoV-2), which typically causes respiratory illness with symptoms including cough, fever and difficulty breathing. Children may be more likely than adults to have non-respiratory symptoms such as headache, muscle aches or sore throat. Some people may have nausea, vomiting or diarrhea, but this is less common.

The highest-risk patients for severe infection are adults over 65 years old and those with medical problems such as diabetes, high blood pressure, asthma, COPD or weak immune systems. The good news is most children have mild illness and there have been very few deaths in children.

How do people get COVID-19 and why is it spreading so fast?

This virus mainly spreads from person to person from breathing, coughing or sneezing through little water droplets. Virus particles left on their hands can then be transferred across surfaces such as faucet handles, door knobs, shopping cart handles, but this is likely far less common than by respiratory droplets. The “6-foot rule” for social distancing (stay six feet apart from other people in public places) comes from the fact that most large respiratory droplets fall to the ground within six feet.

mother wearing face mask feeling her son's forehead

COVID-19: Exposure, symptoms and risks of being contagious

It typically takes 2 to 14 days from the time someone is exposed to the virus to when they have symptoms, with an average of 5 days in most patients.
3 out of 4 children with COVID-19 have a mild cold, cough, fever, or flu-like symptoms.
Some people may not have symptoms at all or know they are infected, but are still contagious and can still easily spread infection to others.
Individuals with COVID-19 may be contagious for 1-3 days before developing symptoms.

Diagnosis of COVID-19

The diagnosis of COVID- 19 is made by a physician, confirmed by testing with a nasal swab. However, testing availability is limited and is therefore reserved for patients who are very ill, require hospital admission or have medical conditions that put them at increased risk for severe infection. Chest X-rays are sometimes helpful in ill patients, but generally not necessary in patients well enough to stay home. Read about Inova’s Respiratory Illness Clinics

Treatment of COVID-19

Currently, there is no vaccine to prevent this illness and no specific medications to treat it other than symptomatically. If your child is otherwise healthy, most treatment can be done at home.

Manage fever with ibuprofen (e.g., Motrin) or acetaminophen (e.g., Tylenol)
Give your child plenty of fluids

Rarely, children with difficulty breathing or pneumonia may have to be admitted to the hospital for oxygen support and hydration. This is quite different than in adults, where as many as 1 in 5 adults may be admitted to the hospital.

When should I be concerned or bring my child to the Emergency Department (ER)?

Call 911:

If you think your child cannot breathe, or if their face and/or lips appear white or bluish

Bring your child to the ER now if your child has any of the following:

Trouble breathing
Shortness of breath
Chest pain
A weakened immune system such as cancer, is on steroids, or has HIV
Fever (greater than 100.4 degrees F) and is less than 3 months of age
Fever that is not improving after giving the appropriate dose of fever medication in older infants and children
Not acting normally
Has trouble tasting food with difficulty breathing

Follow up with your pediatrician (via phone; ask about video conference availability):

If your child has mild symptoms and is otherwise acting, eating and drinking normally

What can I do to protect myself and my family?

If you and your child are healthy or are managing symptoms at home, stay at home to protect yourselves and others. The elderly and people with serious health problems are extremely vulnerable to contracting the infection if exposed to you or your sick child, which could have life threatening consequences. Guidelines include:

Wash your hands frequently with warm soap and water for 20 seconds or use alcohol gel
Avoid touching your face
Stay at home with your child as much as possible to prevent infection, and if sick, stay at home until child is fully recovered
Wear a mask to prevent spreading respiratory droplets when you are out

Find a pediatric ER or urgent care center in your community