COVID-19 Symptoms To Look Out For in Children?

The first wave of the COVID-19 pandemic in India affected senior citizens the most. During the second wave, a high number of coronavirus cases are being reported in the younger generation. Even children, as small as a few days old are getting infected from COVID-19. According to Virologist Dr. V Ravi, the third wave of COVID-19 in India will hit children in a big manner.

In April 2021, the health department in Maharashtra highlighted an alarming 51% rise in COVID-19 infections among children, in just 30 days. As far as the reasons behind children getting COVID-19 infected are concerned, the prime ones include relaxation in precautions, social distancing norms & protocols, exposure of children to shopping malls and other crowded places without proper protection, re-opening of educational institutions (especially for the conduct of examinations), pregnant women testing positive for coronavirus, etc.

COVID-19 Symptoms in Children 

The good thing is that only mild COVID-19 symptoms in children are being observed. Furthermore, only a few are requiring hospitalization. Having said that, we must not forget that coronavirus can infect children of all age groups, be it newborns or adolescents. As a parent, it is important for you to know that while in most cases, COVID-19 symptoms in children appear within a few days of infection, there is a very small proportion of children who were COVID-19 infected and recovered from their initial symptoms in the form of a condition called MIS-C or Multisystem Inflammatory Syndrome in Children. MIS-C occurs three to six weeks after the onset of symptoms of the infection and is more severe. Talking about long COVID, it is an extremely rare form in children. 

Most Common COVID-19 Symptoms in Children 

The most common COVID-19 symptoms in children include: 

• Fever
• Sore throat
• Cough
• Runny nose
• Vomiting
• Diarrhoea
• Abdominal pain 

It must be kept in mind that a good percentage of children may not have any significant symptoms at all. 

Moderate or Severe COVID-19 Symptoms in Children

95% COVID-19 positive children have only mild symptoms like runny nose, sore throat , etc. Moderate or severe symptoms are quite rare among affected children. 

The list of moderate symptom includes:

1. Higher Breathing Rate

Breathing rate is an important symptom to note in the child. A child having a high temperature can be expected to have fast breathing. The number of breaths per minute must be checked after giving paracetamol and confirming that the fever has settled. Please note that respiratory rates in children should be as follows:

• Below 60 - Under two months of age
• Below 50 -  Two months up to one year
• Below 40 - One up to five years of age 
• Below 30 - Above five years of age 

Higher breathing rate is considered as a symptom of moderate severity. In cases like such, the child is likely developing pneumonia. 

The list of severe symptoms includes: 

• Drowsiness

• Blue discolouration of the fingers and lips

• Complete refusal of food and water

Please note that pulse oximeter readings dropping below 95% indicate moderate to severe disease.

Here are a few things that must be kept in mind regarding the treatment of COVID positive children: 

2. Children With Mild Symptoms - Such children can be managed with home isolation and supportive care. It is advised to ensure that the child rests properly and drinks plenty of water. Child’s body temperature should be noted at every six-hour interval. 

3. Children With Diarrhoea and Vomiting - Such children should be given ORS solution, tender coconut water, salted porridge water, or other fluids regularly so as to prevent dehydration. Note that breastfeeding should be continued. 

4. Children With Moderate Symptoms - Such children should seek medical practitioner’s to determine further treatment measures, including inpatient hospital admission for further treatment.

5. Children With Severe Symptoms - Such children should be admitted to the hospital and treated immediately.

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Diagnosing COVID-19 in Children

RT-PCR is the most reliable COVID-19 testing method in children as well. PCR-based nucleic acid amplification test (NAAT) is a reliable test option as well. Note that Rapid antigen test (RAT) is the second reliable option for diagnosing COVID-19 in children. 

Even though a positive test is confirmatory, a negative test result needs confirmation by PCR testing, in case the child is exhibiting COVID-19 symptoms. 

COVID-19 Precautions for Children

Some of the key COVID-19 precautions to ensure with children include:

• Exposure to crowded places
• Postponing child-related ceremonies and functions
• Washing and sanitizing the children's hands frequently
• Promoting the use of mask
• Practicing social distancing practices

The Indian Academy of Pediatrics (IAP) advises the use of masks by all children above two years of age. Children less than two years of age need not use the mask, solely due to safety reasons. 

Parents of breastfed babies should try to stay indoors to prevent their exposure to infection. Mothers with suspected or confirmed COVID-19 are encouraged to initiate or continue breastfeeding as advised by WHO. However, mothers should take proper safety and health-related precautions before holding the baby.

COVID-19 Vaccination for Children?

While COVID-19 vaccine trials have proved to be safe and effective in children between the ages of twelve and fifteen in other countries, children have been excluded from trials in India. 

As of now, taking precautionary measures to keep children safe from COVID-19 is the ultimate need of the hour.

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Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.