Children of all ages can become ill with coronavirus disease 2019 (COVID-19). But most kids who are infected typically don't become as sick as adults and some might not show any symptoms at all. Know the symptoms of COVID-19 in babies and children, why children might be affected differently by COVID-19 and what you can do to prevent the spread of the virus.
How likely is it for a child to become sick with coronavirus disease 2019 (COVID-19)?
While all children are capable of getting the virus that causes COVID-19, they don't become sick as often as adults. Most children have mild symptoms or no symptoms.
According to the American Academy of Pediatrics and the Children's Hospital Association, in the United States children represent about 9% of all COVID-19 cases. Hospitalization rates for children are much lower than for adults. However, if children are hospitalized, they need to be treated in the intensive care unit as often as hospitalized adults, according to research from the Centers for Disease Control and Prevention (CDC).
In addition, people of any age with certain underlying conditions, such as obesity, are at higher risk of serious illness with COVID-19. Children who have congenital heart disease, genetic conditions or conditions affecting the nervous system or metabolism are also at higher risk of serious illness with COVID-19.
Research also suggests disproportionately higher rates of COVID-19 in Hispanic and non-Hispanic Black children than in non-Hispanic white children. Hispanic and non-Hispanic Black children also have had higher rates of hospitalization.
Rarely, some children might also develop a serious condition that appears to be linked to COVID-19.
Why do children react differently to COVID-19?
The answer isn't clear yet. Some experts suggest that children might not be as severely affected by COVID-19 because there are other coronaviruses that spread in the community and cause diseases such as the common cold. Since children often get colds, their immune systems might be primed to provide them with some protection against COVID-19. It's also possible that children's immune systems interact with the virus differently than do adults' immune systems. Some adults are getting sick because their immune systems seem to overreact to the virus, causing more damage to their bodies. This may be less likely to happen in children.
How are babies affected by COVID-19?
Although rare, children under age 2 appear to be at higher risk of severe illness with COVID-19 than older children. This is likely due to their immature immune systems and smaller airways, which make them more likely to develop breathing issues with respiratory virus infections.
Newborns can become infected with the virus that causes COVID-19 during childbirth or by exposure to sick caregivers after delivery. If you have COVID-19 or are waiting for test results due to symptoms, it's recommended during hospitalization after childbirth that you wear a cloth face mask and have clean hands when caring for your newborn. Keeping your newborn's crib by your bed while you are in the hospital is OK, but it's also recommended that you maintain a reasonable distance from your baby when possible. When these steps are taken, the risk of a newborn becoming infected with the COVID-19 virus is low. Research suggests that only about 2% to 5% of infants born to women with COVID-19 near the time of delivery test positive for the virus in the days after birth. However, if you are severely ill with COVID-19, you might need to be temporarily separated from your newborn.
Infants who have COVID-19 or who can't be tested due to a lack of availability and have no symptoms might be discharged from the hospital, depending on the circumstances. It's recommended that the baby's caregivers wear face masks and wash their hands to protect themselves. Frequent follow-up with the baby's health care provider is needed _ by phone, virtual visits or in-office visits _ for 14 days. Infants who test negative for COVID-19 can be sent home from the hospital.
Children's COVID-19 symptoms
While children and adults experience similar symptoms of COVID-19, children's symptoms tend to be mild and cold-like. Most children recover within one to two weeks. Their symptoms can include:
Fever
Nasal congestion or runny nose
Cough
Sore throat
Shortness of breath
Fatigue
Headache
Muscle aches
Nausea or vomiting
Diarrhea
Poor feeding or poor appetite
If your child has symptoms of COVID-19 and you think he or she might have COVID-19, call your child's health care provider. Keep your child at home and away from others as much as possible, except to get medical care. If possible, have your child use a separate bedroom and bathroom from family members. Follow recommendations from the CDC, the World Health Organization (WHO) and your government regarding quarantine and isolation measures as appropriate.
Factors used to decide whether to test your child for COVID-19 may differ depending on where you live. In the U.S., the health care provider will determine whether to conduct tests for COVID-19 based on your child's signs and symptoms, as well as whether your child has had close contact with someone diagnosed with COVID-19. The doctor may also consider testing if your child is at higher risk of serious illness.
To test for COVID-19, a health care provider uses a long swab to take a sample from the back of the nose. The sample is then sent to a lab for testing. If your child is coughing up phlegm (sputum), that may be sent for testing.
