COVID-19 in Children: Current Data
Coronavirus variants continue to spread rapidly, among adults and children alike, particularly in areas with low rates of COVID-19 vaccination. Although children typically have a lower risk of exposure and are tested less frequently than adults, the incidence of COVID-19 in children is similar to that in adults 2. To date, children represent nearly 20% of all COVID-19 cases in the U.S., and over 5.6 million child cases have been reported since early September 2021, resulting in a growing number of data points for determining severity and trends.
The symptomatology of COVID-19 in children is highly variable. Up to half of children and adolescents can have COVID-19 with no symptoms. Among symptomatic children, according to published data, the most common symptoms are fever and cough. Other symptoms include shortness of breath, myalgia, headache, nausea, gastrointestinal issues, a sore throat, a loss of taste or smell, and general fatigue. Overall, children remain very unlikely to die of COVID-19 3.
Current data show that most children with COVID-19 recover within four weeks. It is uncommon for symptoms to persist beyond eight weeks. A small number of children, however, may experience long-term effects of COVID-19, as in adults, including in the form of fatigue, headaches, trouble sleeping and concentrating, and a persistent cough.
While children usually experience only mild responses to COVID-19 infections, certain are at a higher risk for a serious case of COVID-19 and may need to be hospitalized, receive intensive care, and/or be placed on a ventilator. Those at high risk include children under the age of 2, children of a black or Latina background, children who were born prematurely, and children with obesity, asthma, or chronic lung disease. To minimize the risk of severe COVID-19, children with asthma should continue to take their medications, be closely monitored, and avoid elements that could trigger an asthma attack. For children with diabetes, that condition should ideally be well-controlled, and they should be closely assessed for signs and symptoms that could require further clinical care.
Clinicians have identified that some children may develop a condition termed multisystem inflammatory syndrome in children (MIS-C) following a COVID-19 infection. Symptoms of MIS-C include unusual weakness or fatigue, a red rash, abdominal pain, and vomiting and diarrhea, among others. Further research remains to be carried out as regards predisposing risk factors for this syndrome.
In an effort to keep curbing the COVID-19 pandemic, the U.S. Food and Drug Administration (FDA) has provided an emergency use authorization to a Pfizer-BioNTech COVID-19 vaccine for children ages 5 and up. This vaccine was between 91 and 100% effective in preventing COVID-19 across different age brackets in clinical trials 4. Critically, the vaccine helps minimize the spread of the virus and protects recipients from severe COVID-19 infection. Despite its highly variable symptomatology, a COVID-19 infection has the potential to have devastating effects on both children and adults. To prevent its spread, among all ages, it is critical for individuals to get vaccinated, keep hands clean, and wear a mask when in public, indoor places 5.
References
1. COVID-19: Clinical manifestations and diagnosis in children – UpToDate. Available at: https://www.uptodate.com/contents/covid-19-clinical-manifestations-and-diagnosis-in-children.
2. Dawood, F. S. et al. Incidence Rates, Household Infection Risk, and Clinical Characteristics of SARS-CoV-2 Infection among Children and Adults in Utah and New York City, New York. JAMA Pediatr. (2022). doi:10.1001/jamapediatrics.2021.4217
3. Bhopal, S. S., Bagaria, J., Olabi, B. & Bhopal, R. Children and young people remain at low risk of COVID-19 mortality. Lancet Child Adolesc. Heal. 5, e12–e13 (2021). doi:10.1016/S2352-4642(21)00066-3.
4. COVID-19 in babies and children – Mayo Clinic. Available at: https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-in-babies-and-children/art-20484405.
5. Coronavirus in Babies & Kids | Johns Hopkins Medicine. Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-in-babies-and-children.