Coronavirus Pediatric Care Plan

By Chesney Fowler, MD
Medically reviewed checkmarkMedically reviewed
August 16, 2022

What is COVID-19?

Coronaviruses are a group of highly contagious viruses that cause respiratory infections that can range from mild (e.g. cold) to severe (e.g. pneumonia). In December 2019, a new human coronavirus (SARS-CoV-2) began causing a respiratory illness called Coronavirus Disease 2019 (COVID-19). 

Common COVID-19 symptoms in children include:

  • Fever & chills
  • Dry cough 
  • Headache
  • Diarrhea
  • Sore throat
  • Muscle aches
  • Runny nose

How Does COVID-19 Affect Children?

Children under 18 tend to get similar symptoms to adults, but in the majority of cases, they are milder and resolve on their own. Abdominal symptoms like vomiting and diarrhea without any respiratory symptoms are more common in children, as well as different types of rashes that don’t commonly occur in adults.

Risk factors that increase the possibility of severe disease include:

  • Asthma or chronic lung disease
  • Diabetes
  • Genetic, neurologic, or metabolic conditions
  • Heart disease since birth
  • Weakened immune system
  • Obesity

In very rare cases, complications that require medical intervention can occur either during or after a COVID-19 infection.

This can include an extremely rare condition known as Multisystem inflammatory syndrome (MIS-C), which typically develops several weeks after COVID-19 infection (regardless of whether the child had symptoms).

*MIS-C* affects different systems in the body and may include a persistent fever accompanied by abdominal pain, nausea, vomiting, diarrhea, rash, eye redness, lip redness or swelling, headache, confusion and decreased responsiveness, trouble breathing, dizziness/lightheadedness, or swollen hands or feet. These symptoms require immediate medical evaluation. 

How is COVID-19-diagnosed?

The are a few basic mechanisms for testing COVID-19 

  • A diagnostic (viral) test: a nasal swab, saliva test, or oral swab that determines if you have an active COVID-19 infection. Diagnostic tests cannot detect past infections. There are two types of viral tests: 
  • COVID-19 PCR test, with results that may take up to a few days but are considered very accurate.
  • Rapid Antigen (Ag) test, with results that are obtained quickly but are considered less accurate. 

(Note that different countries require different testing, so be sure you’re updated on local guidelines and travel requirements.)

  • An antibody (serology) test: this is a blood test purposed to detect past COVID-19 infections. The medical community, however, is still learning about what having antibodies against COVID-19 means. We don’t know, for instance, if having antibodies against COVID-19 provides immunity against the virus in the future, so booster vaccines are essential to maintaining immunity.

How is COVID-19 treated?

Most cases in children can be treated at home with supportive care. Supportive care is everything you do to keep your child comfortable and hydrated while they are sick – without medical intervention. Supportive care doesn’t cure a disease but makes the symptoms more tolerable.

Over-the-counter medications

Pain and fever

  • Acetaminophen (Tylenol)  – at the recommended dose for age and weight 
  • Ibuprofen (Motrin or Advil) – at the recommended dose for age and weight

Research indicates that ibuprofen is not associated with worse outcomes and can be used alongside acetaminophen for COVID-19 symptoms. 

If these medications are used regularly for chronic conditions such as juvenile idiopathic arthritis, they should not be stopped 

Other supportive measures (non-medicated remedies)

Hydration 

Keep your child hydrated as hydration thins mucus, helps your child stay alert, and keeps organs like the kidneys healthy.

Sore throat

  • Warm chicken broth 
  • Cold foods (e.g. popsicles, ice cream)
  • Saltwater gargles (if age appropriate)
  • Hard candy (if age appropriate)

Cough

  •  One teaspoon of honey (for children over the age of one year)

Go to the emergency room if your child…

  • Is having any trouble breathing
  • Is not drinking enough fluids or showing signs of dehydration
  • Seems weak, pale, confused, or less responsive than usual

Check in with K if…

  • You’d like advice on how to manage your child’s symptoms
  • Your child’s symptoms do not improve within a 3-4 days
  • Your child’s symptoms improve and then worsen

Frequently Asked Questions

When can my child return to school, sports, and other activities after COVID-19 exposure or illness?

Here are the most up-to-date CDC guidelines on when to stay at home, when to quarantine, and when to isolate your child – as well as instructions on when to end isolation in each case. You should also consult your local authority’s guidelines.

What if a parent or caregiver has COVID-19?

If possible, it’s best to have another family member or caregiver take care of the children to allow the sick parent or caregiver to quarantine and self-care. If an ill parent leaves the quarantine room of the house, wearing a mask and limiting time in shared household areas is recommended. Good handwashing and frequent disinfection of communal surfaces can also help prevent transmission. See CDC for caregivers.

When should I get my child tested for COVID?

  • If your child has any COVID-19 symptoms.
  • If your child was exposed to a COVID-19 positive person. If your child has no symptoms, wait five days before testing to ensure an accurate test result.
  • If clearance to return to school or sports is required
  • If clearance for a medical procedure is required 

Should my child and I get the COVID vaccine?

COVID vaccines are considered safe and highly effective in preventing severe illness in both children and adults. See more information on vaccines for children and teens from the CDC here .

Who is eligible for a vaccine?

Children age 6 months and older are eligible to be vaccinated.

How many doses will my child need? 

Most COVID vaccines require a minimum of two shots to be effective: a priming dose, followed by a second dose a few weeks later. The interval between Moderna doses is 28 days, and the Pfizer interval is 21 days. Your child may need booster doses in the future to remain immune to COVID-19. 

What are the possible side effects?

The most common short-term side effects are injection site pain, injection site swelling and/or injection site redness, fatigue, headache, muscle pain, joint pain, fever, and swollen lymph nodes. Young children may also become more irritable, sleepy, or temporarily lose their appetite.

Mild side effects are no cause for alarm – they’re a sign of an immune system kicking into gear – it means the vaccine is working!

What if my child is allergic to one of the vaccine ingredients?

If your child ever had a severe allergic reaction to any ingredient in a COVID-19 vaccine, the CDC recommends that they should not get that specific vaccine. If they had an allergic reaction to other vaccines or injectable therapies, you should ask their doctor if they should get a COVID-19 vaccine. 

The CDC recommends that people with a history of severe allergic reactions not related to vaccines or injectable medications – such as allergies to food, pet, venom, environmental, or latex – still receive all of their vaccines. Allergies to antibiotics, latex, or nuts do not make a person allergic to the COVID-19 vaccine.

If you have a severe allergic reaction after getting the first shot, you should not get the second shot. Fatigue and muscle pain are not considered a severe allergic reaction.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Chesney Fowler, MD

Dr. Fowler is an emergency medicine physician and received her MD from George Washington University. She completed her residency in emergency medicine at Christiana Care Health System. In addition to her work at K Health, Dr. Fowler is a practicing emergency medicine physician in Washington, DC.

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