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COVID-19 and Children: What We Know So Far

Author: Children's Specialty Group, Dr. Laura Sass
Published Date: Friday, May 22, 2020

By Dr. Laura Sass, Pediatric Infectious Disease Specialist at CHKD

Dr. Laura Sass, medical director of infection prevention and control at CHKD has been tracking COVID-19 cases throughout the Health System. She answers some of the most common questions about kids and COVID-19 below.  

How many COVID-19 cases have CHKD healthcare providers seen?

As of May 19, we’ve had 20 CHKD patients test positive for COVID-19, ranging from ages 2 weeks to 21 years. Of those, four patients needed to be admitted to the hospital, two of whom had underlying health conditions. None of the patients have required respiratory support.

What are doctors seeing nationally?

According to a CDC study released in early April, about 2 percent of cases have been in children 18 and under. That’s a small percentage overall when you consider children make up 22 percent of the overall U.S. population.

About 5.7 percent of those pediatric patients were hospitalized, lower than the percentage hospitalized among all adults aged 18 to 64 years, which was 10 percent.

A more recent study published in May by JAMA Pediatrics Journal looked at 48 pediatric cases in the United States and Canada from 14 hospitals, infants up to age 21, during late March and early April. The vast majority of the patients — 40 children — had pre-existing medical conditions. Nearly half of those patients had complex developmental disorders like cerebral palsy or lifelong technology-dependent treatments like tracheostomies or feeding tubes. Other pre-existing health issues included cancer and suppressed immune systems from organ transplants.

What symptoms do children show?

Some infected children don’t show any symptoms at all.

Others have mild symptoms of fever, fatigue, muscle pain, runny nose, sore throat, and cough. Some have fast breathing and chills. Vomiting and diarrhea have also been reported. Some have reported a loss of taste and smell. Although rare, hospitalization rates appear to be highest among those with underlying conditions, such as chronic lung or heart disease, and suppressed immune systems.

What is multisystem inflammatory syndrome in children?

In rare cases, kids are experiencing what’s being called “multisystem inflammatory syndrome in children associated with COVID-19” in which there is inflammation throughout the body several weeks after the infection. Experts say the new inflammatory syndrome appears to be a delayed reaction driven by a child’s immune system response to the infection, in contrast to the usual way that the virus affects patients by attacking the cells in their lungs. It was first described in Europe in April, and now has been seen in the U.S. in May, especially in areas of higher COVID-19 infections. Two cases have been reported in Fairfax, Va., in May. These cases have been primarily in children 5 to 19 years of age.

These cases have been small in number, and CHKD has not seen any patients with this condition. Some people have compared it to other rare childhood conditions such as Kawasaki disease or toxic shock syndrome, but at this time, it is thought to be a separate condition.

Symptoms that have been seen in these kids:

  • a persistent fever that lasts several days
  • belly pain
  • vomiting or diarrhea
  • a rash
  • red, cracked lips
  • red eyes
  • swelling of the hands or feet
  • joint pain
  • dizziness
  • vision problems
  • a headache
  • looking pale

How is COVID-19 treated?

Most children with COVID-19 get better with rest, fluids, and fever-reducing medicine. Children with more severe symptoms may need to be hospitalized. The goal is to reduce respiratory problems and inflammation to avoid long-term damage to arteries in the child’s body and heart.

What should I watch out for?

If you notice any of the following symptoms, call your pediatrician:

  • a fever that won't go away
  • abdominal pain, diarrhea or vomiting
  • rash or changes in skin color
  • trouble breathing
  • your child seems confused or overly sleepy

Your pediatrician will let you know if your child needs to be seen in the office or if you need to go to the emergency department.

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About Children's Specialty Group

About Children's  Specialty Group Children's Specialty Group is the only pediatric multi-specialty practice serving southeastern Virginia and northeastern North Carolina. The physicians of Children's Specialty Group base their practices at Children's Hospital of The King's Daughters and serve as faculty in the Department of Pediatrics at Eastern Virginia Medical School. Learn more about our specialists here.