How To Know If Kids Have COVID-19 When They Can't Explain Their Symptoms

Young kids can't always communicate how they feel. Here's what to keep in mind if you think your child is sick with the coronavirus.

It’s often hard, as a parent, to know how sick or hurt your kid really is. Like when you think they have a mild stomach bug and it turns out to be appendicitis. Or you’re awoken by a hair-raising barking cough and rush to the ER, only to be told that your toddler has mild croup that you could have treated at home.

All of this gets even trickier during a global pandemic ― particularly when the virus in question is one that doctors and researchers still don’t understand all that well and when the range of possible outcomes is so extreme.

This coronavirus has so many possible symptoms, leaving parents to wonder: Does my kid have a cold? Allergies? Could it be COVID-19? It’s hard to tell, especially if you have a child who can’t communicate their pain precisely enough to help you with a tentative diagnosis.

So if you’re stressing over whether your young child has the coronavirus or not, here are a few things to keep in mind.

Kids might have slightly different symptoms than adults.

In general, the signs of COVID-19 in grownups and children are fairly similar: fever, chills, muscle pain, headache, sore throat, cough, shortness of breath and a new loss of taste or smell, according to the American Academy of Pediatrics. But there’s also some evidence that kids are less likely to have a fever, cough or shortness of breath, the AAP states.

Also, kids might be more likely to experience stomach troubles — although the Centers for Disease Control and Prevention now says that gastrointestinal issues are a common sign of the disease for people of all ages.

“Children may be more likely to have gastrointestinal symptoms like nausea and diarrhea or poor feeding and decreased appetite,” said Dr. Margaret Aldrich, director of pediatric infection control with Children’s Hospital at Montefiore in New York City. She cautioned, however, against overstating how different symptoms can be in adults and kids because at this point we still just don’t really know.

One other important note: Kids are continuing to develop multi-system inflammatory syndrome in children. MISC remains rare, but it’s still something parents should be aware of.

If you notice any “extreme tiredness, difficulty breathing, confusion, bluish lips, vomiting, diarrhea and/or fever lasting more than three days,” call your pediatrician right away, said Dr. Rob Darzynkiewicz, chief medical officer at telehealth provider Hazel Health.

As long as the virus is still widespread, assume it’s COVID-19.

Kids, particularly young kids, get sick a lot. Otherwise healthy babies and toddlers can get up to 10 colds a year, which means they are sniffling and coughing more often than not. And yes, a lot of cold symptoms overlap exactly with the symptoms of COVID-19.

“The challenge really is that viral illnesses are very common in children and often present with fever, cough, congestion and/or gastrointestinal symptoms,” Aldrich said.

“If you are living in a high-risk area, with lots of COVID cases, and your child develops a respiratory viral illness, I would presume that they have COVID.”

- Dr. Margaret Aldrich, Children’s Hospital at Montefiore

For now, Aldrich said, it’s a good idea to err on the side of caution.

“If you are living in a high-risk area, with lots of COVID cases, and your child develops a respiratory viral illness, I would presume that they have COVID and touch base with your pediatrician to get further guidance,” Aldrich recommended. Definitely keep them away from others, she said.

This is all especially true if you have a young baby at home.

Remind your kid that being sick isn’t their fault. And take notes.

Darzynkiewicz said that sometimes little kiddos get the idea that being sick is their fault, which can make them reluctant to talk about it because they don’t want to get in trouble.

“Kids can sometimes experience frustration or guilt when they get sick because they think it means they did something wrong,” he said. “If you explain to them that everyone gets sick and there’s no need to be upset or sad, they may be more forthcoming with their symptoms.”

Also, taking good notes about what you think you’re noticing in your child can help health care professionals make a speedy diagnosis.

“If parents can help make a list of some general symptoms their child is experiencing before seeing a doctor, this will help the doctor understand more what is going on,” Darzynkiewicz said. “Pictures and video help as well.”

Remember: When it comes to kids and COVID-19, the news is pretty good.

Although kids can certainly be affected by the coronavirus, relatively few children have been hospitalized or died because of the virus. There is also some emerging evidence that young children are less likely to spread the disease for reasons that aren’t fully understood.

Which isn’t to say that parents shouldn’t continue to take the virus very, very seriously and to be cautious about any symptoms they notice.

But as many children head back into childcare settings and schools this fall and beyond, parents shouldn’t panic.

“Don’t forget to keep checking in with your child,” Darzynkiewicz said. “Ask them how they are feeling and address their concerns. Children are resilient.”

Experts are still learning about the novel coronavirus. The information in this story is what was known or available as of press time, but it’s possible guidance around COVID-19 could change as scientists discover more about the virus. Please check the Centers for Disease Control and Prevention for the most updated recommendations.