What Are Coronaviruses?
Coronaviruses are a large group of viruses. They cause diseases in animals. They often move among camels, cats and bats. Then the viruses may evolve and begin to infect people. Coronaviruses didn’t just start with COVID-19. Human coronaviruses were first identified sometime in the 1960s. Usually coronaviruses present as a common cold but some strains can cause serious infections in humans.
Coronaviruses can spread when people:
- Cough, sneeze or talk
- Have close personal contact, such as hugging or shaking hands
- Touch a surface or object with the virus on it, then touch their mouth, nose or eyes
When Was COVID-19 First Recognized?
COVID-19 was first recognized in December 2019 in China − mainly in the city of Wuhan. It is important to understand that we don’t know exactly when and where it started in the world. What’s clear is that something happened, probably sometime in 2019, that made the coronavirus able to find a large group of people who were vulnerable to the disease. Those people just happened to live in China.
Wuhan is a large city with many people coming and going from all over the world: Europe, North America, South America and Africa. Very quickly − within a few months − COVID-19 was on every continent. At that time it was spreading from person to person.
COVID-19 Signs and Symptoms
COVID-19 symptoms can range from mild (or no symptoms) to severe illness. The symptoms of COVID-19 are similar in children and adults and include:
- Shortness of breath or trouble breathing
- Muscle or body aches
- New loss of taste or smell
- Sore throat
- Congestion or runny nose
- Nausea or vomiting
Keep these things in mind as you watch for signs of the virus in your child.
- The incubation period (time from when exposure to the virus happened to when symptoms develop) is two to 14 days. If a child is infected, the virus usually appears in five to six days.
- COVID-19 symptoms are thought of as “nonspecific.” That means a symptom may not be caused by one specific illness. For instance, if your child has allergies, she may have a sore throat or lose her sense of smell. But those may also be signs of COVID-19. This makes it hard to know if your child has COVID-19 or something common like a cold.
- The best way to deal with symptoms is to watch out for any that aren’t going away. If you see that the problem doesn’t seem to be getting any better, call your child’s doctor.
- Know what symptoms to look for, when you should call and when you should take action. Talk about that ahead of time with your child’s doctor. This is always helpful, but it’s especially important if your child has underlying health issues such as asthma or allergies. These problems might make it harder to identify COVID-19.
- Don’t worry about calling and then it turns out to be a false alarm. It’s better to call and be relieved if you find out it’s not COVID-19.
- Most kids are not going to have major problems with COVID-19. They won't end up in the hospital or even be sick very long.
Other Conditions Related to COVID-19
Multisystem inflammatory syndrome in children (MIS-C) is a newly recognized illness. For many children, it seems to be a complication of COVID-19. It appears after the child has already been infected with the virus. However, not all children with symptoms of MIS-C will test positive for the virus.
Doctors believe that because COVID-19 is a new virus and a child’s immune system has not been exposed to it, the child has a delayed immune response to the coronavirus. The immune system goes into overdrive and causes inflammation. MIS-C appears to be a late effect after the virus is gone.
The inflammation causes blood vessels to become leaky. When the vessels become leaky, blood can't get to the organs. When oxygen can't get to the organs, the organs get damaged.
Clinically, MIS-C can mimic Kawasaki disease, which is an inflammation of blood vessels. Kawasaki disease has not been associated with a specific virus. In Kawasaki disease, blood vessels may increase in size or form aneurysms. This has not been reported for MIS-C. MIS-C has a range of symptoms that may include:
- Bloodshot eyes
- Rash or peeling skin
- Swollen tongue
- Swollen hands and feet
- Cracked lips
- Enlarged lymph node in the neck
Other symptoms may include:
- Stomach pain
- Swollen stomach
Call a doctor if your child has any of these symptoms. Call even if the child has not been infected with COVID-19.
Keep in mind that a pretty small number of children have developed signs and symptoms of MIS-C. Most children have also recovered quickly. While MIS-C may seem like a mysterious illness, most pediatricians are familiar with this condition. It’s a form of autoinflammatory disease. At this time, researchers aren’t sure why or how this condition appears in some children. They aren’t sure how it’s related to COVID-19.
COVID-19 Diagnosis and Treatment
At this time, COVID-19 is diagnosed using a viral test. This test checks samples from your child’s respiratory system. The most reliable test is the swab that’s inserted through your child’s nasal passage to the back of the throat.
Children who are diagnosed with COVID-19 usually get better with rest and fluids. If your child becomes very ill, they will go to a hospital for care that may include breathing help, IV fluids and other treatments.
It’s important to make sure a child with COVID-19 stays away from others who may have a harder time with the virus. These people include adults 65 years old and over or adults and children with underlying health problems.
How to Protect Your Child from COVID-19
- Wash hands following guidance from the Centers for Disease Control and Prevention.
- Using soap and water, lather for 20 seconds (the time it takes to sing “Happy Birthday”) before rinsing.
- Using hand sanitizer, be sure to rub it in well, and that it has at least 60% alcohol.
- Avoid places where there's illness.
- Stay away from people who have, or may have, COVID-19.
- Wear a face mask any time a child leaves home or will be around others. Remember that children who are less than 2 years old or have developmental delays or serious breathing problems should not wear masks because it can be a suffocation risk.
- Kids who are nervous about wearing masks can practice wearing them at home or putting a mask on a favorite toy to make it less scary.
- Parents should practice good behavior by wearing a mask too.
- Socially distance as much as possible. This means staying home as often as you can. When your child goes out, stay at least 6 feet away from others.
- Show your child how to cough and sneeze into a tissue and then throw the dirty tissue into the trash. Show them how to cough or sneeze into their arm or elbow, not their hands.
- Teach your child to avoid touching their eyes, nose and mouth.
When it comes to protection, it’s best to think of it this way: You can't have one form of protection without the other. When your child wears a mask, make sure to maintain social distancing, and wash your hands frequently. Data show that if we all mask, the risk of COVID-19 infection is much lower. But it doesn’t work as well without other “parts of the package,” too.
Another way to protect your child is to ask yourself these questions before you head out to places such as playgrounds, swimming pools or recreation centers:
- Do I feel comfortable about my child going to this place?
- Will the people at this place respect the principles of social distancing and good hygiene?
- Does my child understand how to socially distance and follow the guidelines in this situation?
- Are there places we can wash our hands and/or do I have hand sanitizer so we can wash our hands often?
If you can’t answer yes to those questions, you may want to decide not to take your child to that place.
Research on COVID-19 Vaccines and Treatments
The Pfizer vaccine is approved for ages 5 and older, and the Moderna and Johnson & Johnson vaccines are approved for ages 18 and up.
Many organizations are studying new drugs, including those that are approved for other conditions, as possible ways to treat COVID-19. At Cincinnati Children’s, we offer some of the available treatments to our patients based on clinical criteria and risk factors.
Cincinnati Children’s is one of the sites in the U.S. that has been participating in clinical trials for multiple vaccine candidates for COVID-19 prevention. The Pfizer trial is part of a global development, which began in Germany, and is currently recruiting adolescents. We are also conducting clinical trials in adults for the AstraZeneca vaccine candidate.
> Read our FAQs about vaccines.
What Is the Long-Term Outlook for COVID-19?
Because COVID-19 is still such a new virus, there are questions about it that haven’t been answered. Researchers around the world are working day and night to develop treatments and vaccines. There are ways to focus now on how to help our children cope with this “new normal.” Communities that are social distancing and using other preventive measures have helped stop the spread of COVID-19.