How Does COVID-19 Manifest in Children?

SARS-CoV-2, the virus that causes COVID-19, is a coronavirus that is part of a larger family of enveloped, single-stranded, zoonotic RNA viruses.

Many different strains of coronaviruses have been recorded in history and the literature. A given strain can rapidly mutate and recombine to form a novel coronavirus that can spread from animals to humans.

There have been many outbreaks of coronavirus in the past, including the MERS-CoV outbreak and the SARS-CoV outbreak.

Prevalence of COVID-19 in Children

Coronaviruses can infect any age group, from infants and children to adults and the elderly. However, the presentation and severity of symptoms may be a little different in infants and children from those of the older population.

SARS-CoV and MERS-CoV both appeared in children, but the infection was much milder and slightly different in the presentation when compared with that of the adult population.

Epidemiologic studies suggest that children under 18 years of age make up about 22% of the total COVID-19 population in the United States, with similar percentages in China and Europe. (1)

COVID-19 Symptoms in Adults and Children

COVID-19 in adult groups typically produce the following symptoms.

Respiratory symptoms:

• Fever
• Sore throat
• Cough
• Body aches (similar to the common cold), which may progress to bronchitis, pneumonia, acute respiratory distress syndrome, and in severe cases multi-organ failure

Gastrointestinal symptoms:

In rare cases, the patient may suffer from:

The studies suggest that children are as likely to become infected with COVID-19 as adults but are less likely to become symptomatic or develop much milder symptoms. (2)(3)

Children are more prone to the gastrointestinal symptoms of COVID-19 than adults. The majority of children with COVID-19 are asymptomatic or only have mild symptoms of fever, sore throat, and nausea and therefore typically will go unnoticed and undiagnosed.

A recent paper by the CDC stated that 73% of children develop symptoms of fever, cough, and shortness of breath, as compared with 93% in adults. The hospitalization rate in children was about 5.7% as compared with 10% in the adult population. (4)

ALSO READ: How Does COVID-19 Affect Children?

Difference Between Pediatric and Adult Cases of COVID-19

The transmissibility of COVID-19 is similar among children and adults, which means the virus can infect an equal number of both. However, the symptoms of the infection tend to be much milder in children than in adults.

In children, the fevers are lower in grade but the incidence of gastrointestinal symptoms is higher when compared with those in adults.

Many children with COVID-19 may also be asymptomatic, and the percentage of infected individuals requiring hospitalization is much lower in children than in adults.

Treating COVID-19 in Children

There is currently no treatment for COVID-19. Treatment is mainly supportive, through hydration, medication for fever, and oxygen for those with hypoxia and shortness of breath.

Many trials are looking at experimental drugs, including antiviral and antimalarial drugs. However, none have been found to be that effective, and therefore these drugs are only given in certain severe circumstances.

For mild symptoms and disease, the treatment is going to be mainly supportive. (5)

Diagnosing COVID-19 in Children

The diagnosis of COVID-19 in children is similar to that of adults. A nasopharyngeal swab is done on the posterior oropharynx area and is sent to the lab for identification of the virus.

Diagnosis can also be made via a lower respiratory sample obtained via deep suctioning or coughing or through a bronchoscope. Currently, no blood tests can detect COVID-19, but they are being worked upon and may become available in the coming weeks.

When Should Medical Attention Be Sought for Children?

Consult with a medical professional if you believe your child may have been exposed to COVID-19 and develops:

COVID Transmission Through Breastfeeding

There is limited information in this arena. However, it does not look like breastfeeding will transmit COVID-19 to the baby. (6)

In babies, breast milk is protective and gives the baby the immunity that the baby needs, and therefore breastfeeding is encouraged.

If you think you may be sick with COVID-19, it is recommended that you take maximum precaution to wear a mask and clean your hands and the surrounding area to prevent transmission of the virus to the baby.

COVID-19 Recurrence After Treatment

Both children and adults can develop immunity to coronaviruses after treatment. However, there have been few studies that have shown individuals can get infected twice. (7) There has also been a second milder strain that can infect individuals.

Even if you are immune to the recent strain of coronavirus, there may be new mutated strains that can emerge in the future, which can end up infecting you just the same. Therefore, standard precautions should still be taken in public and around sick individuals.

Improve Your Child’s Immunity Against COVID-19

Nutrition is key to boosting immunity in children, and therefore eating a healthy balanced diet is important.

For infants, the mother’s milk is the only source of immunity, and therefore it is important to continue breastfeeding unless your doctor advises against it. Always follow the standard precautions recommended by the CDC to protect yourself and your children from this pandemic. (8)

Severity of COVID-19 in Children

According to currently available data, the mortality and severity of COVID-19 are much lower in children than those in the adult population.

There have been a few small reports of children dying with COVID-19. However, the overall percentage is less than 1%. Thus, only a small percentage of children are likely to develop severe disease, although more data is needed in this arena. (9)(10)

But even the slightest possibility that COVID-19 may endanger your child’s life warrants that it should be regarded as a serious illness. You must adhere to all the precautionary guidelines regarding social distancing, hand hygiene, and protective masks to prevent disease transmission.

Final Word

Even the slightest possibility that COVID-19 may endanger your child’s life warrants that it should be regarded as a serious illness. You must adhere to all the precautionary guidelines regarding social distancing, hand hygiene, and protective masks to prevent disease transmission.