COVID-19 In Children: Your Questions Answered

Covid-19 in children

Is Today’s Childhood under the shadow of COVID-19 Pandemic? Let’s have a look.

COVID-19 has become a catastrophe in our lives, especially now when it’s targeting children on a large scale. The second wave of COVID-19 has certainly made children enjoy a little less and worry a little more. We all can hope that this time must not prove to be a “lost age” for them.

Here are some of the questions that might have crossed your mind about children and COVID-19.

COVID-19 Second Wave: Why Are More Children Getting Infected?

As compared to the first wave, more children are getting infected in the recent second wave of the pandemic. This increase can be attributed to the double mutated coronavirus variant along with other strains that are more contagious and have a higher tendency to infect children. However, fortunately, the severity of infection is mild in most children. This means they are either asymptomatic or do not have as many symptoms as adults do. Also, the recovery rate in children is highest among all age groups [1, 2, 3, 4].

What Are The Signs & Symptoms Of COVID-19 In Children?

Your child may experience [5]:

– Fever
– Cough
– Runny nose
– Vomiting
– Loose stools
– Stomach pain
– Muscle/body pain
– Redness of eyes
– Rashes over body
– Headache

It may be difficult to find out whether fever is due to COVID or normal flu. So, whenever you notice any symptom in your child, speak to a doctor immediately.

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What Should I Do If My Child Has These Symptoms?

– Do not panic and render home-based care.
– Continue to follow personal protective measures for yourself and your child.
– Give nutritious home-cooked meals to your child and keep them well hydrated.
– Encourage your child to remain active indoors to reduce psychological stress due to crises.
– Expose the child to sunlight for a minimum of 20 minutes daily [6].
– Measure their temperature every 6 hours using a thermometer. If it is more than 100°F, sponging using lukewarm tap water can be done. Avoid cold water showers [5].
– Monitor your child’s oxygen saturation levels (SPO2) using a pulse oximeter. Call the doctor right away if the levels fall below 92% [5].
– Never self-medicate. Give all medicines as prescribed by the doctor only. The dose of the medicine will depend on the child’s body weight, age, and clinical condition.
– Be watchful for danger signs in a child. If worrisome, seek medical help immediately.

When Should Your Child Be Tested For COVID-19?

– Test if your child is symptomatic [4,5].
– Test if fever continues beyond 3 days [4, 5].
– Test if family members are COVID positive only if your child is symptomatic. If not, then simply observe the child for symptoms till 14 days from contact [4, 5].

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When To Visit The Hospital If Your Child Tests COVID-19 Positive?

If the child develops:

– Fever more than 102°F (38.8°C) in babies up to 1 year of age [4, 5].
– Fever more than 100°F (37.7°C) that persists for more than 3 days [4, 5].
– Fast breathing [4, 5].

Then, visit nearby healthcare facilities at the earliest. To manage these symptoms:

– Continue to follow personal protective measures
– Observe the child for danger signs
– Give fever medicine in the dose as suggested by the doctor

If the child develops these signs & symptoms:

– The child looks pale or blue
– Indrawing of chest
– Cold arms/legs
– Sunken eyes
– Dry mouth
– No urine passed for more than 3-4 hours
– Refusing to feed
– Abnormal body movements

Then, seek urgent medical help and rush to the nearest hospital. To manage these symptoms:

– Keep your child warm.
– Turn your child to the left side in case the child exhibits abnormal body movements or is drowsy.

What Special Precautions Should Be Taken To Prevent COVID-19 In Children?

COVID-19 can impact children across all age groups, including infants and newborns. Since every child is at equal risk of developing COVID-19, you must:

– Ensure safe distancing (6 feet).
– Encourage and explain to them the importance of masks.
– Make sure they wash their hands frequently using soap and water or frequent sanitization.
– Guide children not to touch any surfaces outdoors.
– Bathe children and change their clothes when they come back home.
– Sanitize the frequently touched surfaces at home.

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How Long Do Children Take To Develop Symptoms Of COVID-19?

The time between exposure to the SARS-CoV-2 virus and when symptoms appear is the same for adults and children. It commonly takes around 5 to 6 days or up to 14 days for the symptoms to appear. However, now this duration has reduced to 2 to 3 days [4, 7, 8].

What Special Precautions Should Be Taken To Protect Children With Comorbidities From COVID-19?

Precautions remain the same. Children already having underlying medical conditions such as heart problems (congenital heart disease), respiratory illness (asthma), metabolic diseases (diabetes), or complications like cerebral palsy (brain-muscle movement coordination disorder) need more care and should follow utmost precautions as these conditions may increase the severity of illness [4, 9].

My Child Is Having A Chronic Disease. Do I Continue His Steroid Treatment/Other Treatment?

Most of the treatment of pre-existing diseases need not be altered unless your child contracts a severe disease. If your child has any chronic disease and catches COVID-19, you should consult your doctor for specific advice about ongoing medications.

What Are The Psychological Effects Of COVID-19 On Children?

The unexpected social isolation due to the pandemic has caused enormous disruption of daily routines, especially for children. To curb the spread of the virus, most schools closed, canceled classes, and moved it to home-based or online learning to encourage and adhere to social distancing guidelines. This abrupt change in the learning environment, increased screen time, and limited social interactions and activities pose an unusual situation for children’s developing brains. These also pose a potential risk to the mental well-being of children.

How Parents Can Help Children Cope-Up With The Stress During COVID-19?

– Be your child’s best friend and answer all their queries.
– Stay calm, listen and offer reassurance.
– Talk about COVID-19 and explain COVID-19 appropriate behavior (handwashing, mask donning, and social distancing) to children. Keep reinforcing it from time to time.
– Stay connected to your child along with work from home schedule.
– Be aware of your child’s mental health.

Is It Safe To Give Routine Vaccinations To Children During The COVID-19 Pandemic

Children should be vaccinated as per the Immunization schedule recommended by the Indian Academy of Pediatrics (IAP) [4]. Basic immunization is necessary as it prevents children from any other infection or disease and boosts the immune system. If need be, you may delay the booster shots of the vaccines [4].

In What Way Can Parents Help Medical Experts Treat Their Children In Stressful COVID-19 Situations?

– Take an appointment with the doctor before visiting.
– Adhere to the appointment slot timings. Make ‘Quick in’ and ‘out’ visits.
– Ask detailed questions over video consultations. This helps save time and expedite the visit.

The Bottom Line
COVID-19 vaccine is our best hope for ending the pandemic. While we await a vaccine that helps safeguard children below 18 years of age, let’s get the adults in our family vaccinated; and hope that soon children will be able to spend time with friends, travel ​with their families, and enjoy their communities safely.

With inputs from Dr. Rajiv Chhabra, Chief of Pediatrics, Artemis Hospital, Gurgaon.

(The article is written by Dr. Lipika Khurana, Medical Writer and reviewed by Dr. Sakshi Jain, Health Content Manager)

Recommended Reads: 

Covishield Vs Covaxin: Benefits, Side-effects And Efficacy

Home Care Tips For Mild Covid-19 Positive Patients

References:

1. Sarah Brookman, James Cook, Mark Zucherman, et al. Effect of the new SARS-CoV-2 variant B.1.1.7 on children and young people. Lancet Child Adolesc Health. 2021 Apr;5(4):e9-e10. https://doi.org/10.1016/S2352-4642(21)00030-4

2. Chan Liu, Yu He, Lian Liu, et al. Children with COVID-19 behaving milder may challenge the public policies: a systematic review and meta-analysis. BMC Pediatr. 2020 Sep 1;20(1):410. doi: 10.1186/s12887-020-02316-1. https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-020-02316-1

3. Hippich, M., et al. (2021) A Public Health Antibody Screening Indicates a Marked Increase of SARS-CoV-2 Exposure Rate in Children during the Second Wave. Med (New York, N.Y.), 10.1016/j.medj.2021.03.019. 3 Apr. 2021, doi:10.1016/j.medj.2021.03.019

4. Mahesh A Mohite, BakulParekh, Deepak Ugra. Coronavirus Disease-2019 in Children—Information for Parents (As on 25 April 2021). Indian Academy of Pediatrics (IAP). 2021. Available at: http://www.palliativecare.in/wp-content/uploads/2021/04/covid_19-in-Children_Guidelines-for-parents.pdf ( Last accessed on 4 May 2021)

5. AIIMS Patna COVID 19 Management protocol (Version 4.0: 21/04/2021). All India Institute of Medical Sciences. https://covidhelplinebangalore.com/wp-content/uploads/2021/04/Covid-SOP-AIIMS-P-version-4.0.pdf

6. Sunlight Exposure and Vitamin D Status in Breastfed Infants. Indian Pediatrics. http://www.indianpediatrics.net/feb2017/feb-105-111.htm

7. Information for Pediatric Healthcare Providers. Centers for Disease Control and Prevention (CDC). https://www.cdc.gov/coronavirus/2019-ncov/hcp/pediatric-hcp.html

8. Jiatong She, Lanqin Liu, and Wenjun Liu. COVID‐19 epidemic: Disease characteristics in children. J Med Virol. 2020 Apr 15 : 10.1002/jmv.25807. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7228385/

9. COVID-19 in Children and Teens. Centers for Disease Control and Prevention (CDC). https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/children/symptoms.html

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