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Covid-19 symptoms in children, based on pediatricians' advice - CNN
Aug 12, 2020 3 mins, 40 secs
Hospitalizations due to Covid-19 among children in Florida rose by 105% during the same four week time frame, from 213 to 436.

Because most children have been sheltering at home until recently, it's not surprising that the numbers of cases in children were low at the start of the pandemic.

"Kids just haven't had that many contacts," said CNN Chief Medical Correspondent Dr.

"Which is something that really worries me."

What are the symptoms?

Symptoms of Covid-19 are the same in children as they are in adults.

"If you look at the long list of potential symptoms — congestion, cough, fever, loss of sense of smell — they can all happen in both adults and children," O'Leary said.

And that's when you want to get them care," Cohen added.

That guidance applies to the emotional and psychological health of children as well, O'Leary said.

"Those are things — even though they're not directly related to Covid — that need attention."

Can you tell if your child is sick?

It's an especially scary reality for parents that many young children are asymptomatic, which means there are no signs or symptoms that their kids are carrying the virus.

That should be a relief for parents when it comes to their child's safety, because if a child with Covid-19 is weathering the virus well, pediatricians are just supporting and guiding the parents during the illness, Cohen said.

"The best way to get rid of a fire is to remove the fuel, so we keep everybody separated."

The only way a parent might suspect an asymptomatic illness is by tracking their child's exposure to others with Covid-19 and to be aware of what is happening in the school the child attends.

"Knowing their habits, knowing who they were around, knowing their exposures are key," Cohen said.

"You know, a child not wearing a mask in Georgia is different right now than a child not wearing a mask in New York, because cases are rising in Georgia."

Whether asymptomatic children should be tested for a coronavirus infection depends on "how often the kids are being exposed to other people" and the testing capacity in their communities, O'Leary said.

"The most important thing for getting kids back into school is really to get the virus under control in the surrounding community," he said.

Mitigation measures that work for decreasing transmission of the virus — wearing masks, cleaning our hands and physical distancing — are most important, O'Leary added.

Rare but severe illness linked to Covid-19

Another worry for parents is multisystem inflammatory syndrome in children (MIS-C), It's a rare and unusual presentation in children that can appear a few days to weeks after a child has been exposed to Covid-19.

Rapid breathing or other respiratory signs may also be present, but are not as common.

Beside the common fever symptoms, the gastrointestinal symptoms are most prevalent in children with MIS-C, with 80% to 90% of patients experiencing them, said Friedman, who is also an assistant professor of pediatrics at Harvard Medical School.

It is inevitable that we'll see this with the reopening of schools," Friedman said, adding that in his experience the vast majority of children with MIS-C improve and "they improve quite quickly."

Not sure your child is sick or just stressed?

Some parents may be concerned with more typical parenting issues -- like if their child is truly sick or possibly just avoiding getting up early.

They know how to differentiate organic symptoms from psychosomatic reactions."

You still could be sending a sick kid to school

Still, no matter how careful a parent is, "because so many kids with Covid-19 are asymptomatic, it's certainly still possible that you are sending a child with asymptomatic Covid-19 to school," Radesky said.

"We need more surveillance testing of asymptomatic students and teachers, otherwise we may feel false reassurance that we are sending a non-contagious child to school," Radesky said.

In a commentary published Tuesday in the journal JAMA Pediatrics, a Stanford University School of Medicine's pediatrics team recommended that schools follow a three-pronged testing approach, carried out in collaboration with local hospitals:

All students with symptoms must be tested; Schools should conduct random student and staff testing to identify asymptomatic patients (important for children especially); and students from high-risk households should be offered testing more frequently

"As many school districts face budgetary constraints, schools must evaluate their options and identify measures that are particularly important and feasible for their communities," the authors wrote.

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