What to Know About Children and Coronavirus

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Key Takeaways

  • COVID-19 seems to generally produce less severe symptoms in children than adults, although we're learning new information about the virus every day.
  • Children with compromised immune systems or underlying health conditions have a higher risk of severe COVID-19 symptoms than their peers.
  • Parents should still be taking common-sense precautions to keep their kids and family safe and to prevent the spread of the virus.

If you are a parent, hearing about a frightening disease like the novel coronavirus (COVID-19) making its way across the globe is bound to set your nerves on edge. We know that children are basically germ factories—they seem to catch everything going around in the community. And we also know that children can get sicker than most grown-ups (for example, with the seasonal flu). After all, their immune system is still developing.

The good news is that while there is reason to be concerned, and certainly every reason to take smart precautions, COVID-19 seems to generally produce less severe symptoms in children than the older portion of the population.

The American Academy of Pediatrics (AAP) notes that while COVID-19 is contagious, it does not seem that children are at higher risk. However, while children are not typically manifesting severe symptoms from COVID-19, they are still contagious and able to spread the disease to others. (Some research in progress has found that about 25% of infections are caused when people are pre-symptomatic.)

Still, because there is still so much we don’t know—and the situation on the ground with COVID-19 is constantly evolving—parents need to be sure to take necessary precautions, listen to their doctors and local health departments, and stay up to date on the latest CDC recommendations for children and families.

How Susceptible Are Children to COVID-19?

COVID-19 is a new virus in the coronavirus family. SARS and MERS are also coronaviruses. COVID-19 was first reported in December 2019 in Wuhan, China, and has since made its way across the world. Since the virus has only been around for a few months, it isn’t possible to get a complete picture of how the virus behaves and how susceptible individual population groups are to it so far. But there are a few things we know about children and COVID-19—much of which will come as a relief to worried parents.

Centers For Disease Control and Prevention

[T]here is no evidence that children are more susceptible. In fact, most confirmed cases of COVID-19 reported from China have occurred in adults.

— Centers For Disease Control and Prevention

The CDC reports that COVID-19 seems to act similarly in children to both Severe Acute Respiratory Syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), where infections among children were relatively uncommon. Although infections of COVID-19 have occurred, children for the most part have been spared, or at least have experienced less severe symptoms.

What the Data Says

Again, because COVID-19 is a new virus, the data and research we have on it is limited. But when looking at the way the virus affected the people of China during the first wave of the outbreak, there is reason to believe that children became ill less frequently, or at least presented less severe symptoms.

As the World Health Organization reports, regarding the initial outbreak in China:

  • Only 2.4% of people under the age of 19 became ill with COVID-19
  • 2.5% developed severe disease
  • 0.2% developed critical disease

The CDC reports similar outcomes, with the virus affecting older adults more severely than children. The CDC reports that, of the 44,000+ cases reported in China up to February 11, 2020:

  • The majority of infections (77.8%) occurred in adults aged 30-69 years old
  • 2.1% of children under the age of 20 tested positive for the virus
  • No deaths were reported among children under the age of 10

As more data has been analyzed since the initial outbreak, our understanding of how COVID-19 can affect children is growing. A study of over 2000 children with the disease in China revealed the following:

  • About 4% had no symptoms
  • About half of the children in the study had mild symptoms (fever, cough, fatigue)
  • About 40% became moderately ill, including symptoms like pneumonia or lung problems in addition to the more common symptoms
  • About 6% developed serious illness, with the majority of those cases being children aged 5 or younger

While, overall, it still appears that symptoms may generally be less severe for children, there is still risk of serious illness, and all necessary precautions should be taken to decrease the risk of infection for you and your loved ones.

Why Fewer Kids Are Getting Sick

What’s the reason for these encouraging statistics, you might be wondering?

Dr. Chad R. Sanborn, a pediatric infectious diseases doctor at KIDZ Medical Services in Florida, explained a few theories in an interview.

“The first theory would be that kids aren't getting the virus very much at all,” Dr. Sanborn said, referencing the studies from the WHO, which found that only 2.4% of initial COVID-19 cases have been in children.

“The other theory would be that many kids are getting the virus, the same as with every other virus, just not getting sick from it and therefore may not be tested as much,” explained Dr. Sanborn.

Dr. Sanborn said that while it’s true that kids seem to get sick with everything (any parent can attest to this!), the fact that children are constantly fighting infections—some of which are similar to COVID-19, may offer them an added layer of protection.

“This lack of ‘sickness’ could be because their immune systems are dealing with viruses similar to coronavirus all the time and therefore may have some protection, or that their immune system doesn't go bananas when it fights infection, as adults' immune systems sometimes do,” Dr. Sanborn added. However, other doctors note that adults are exposed to these same coronaviruses, so they would also have protection. Instead, they suggest, perhaps there is a mechanical explanation.

How Does COVID-19 Affect Children?

Just because most healthy children aren’t likely to deal with severe symptoms of COVID-19 doesn’t mean that they won’t contract it. If you suspect your child has symptoms of COVID-19, you should be diligent about keeping them safe and notifying their healthcare providers about any concerns.

Symptoms of COVID-19 in Children

Symptoms of COVID-19 in children resemble symptoms found in the general population, though they are often less severe. Some children only present with a mild cold or cough. Some children may be asymptomatic and still test positive for the virus.

Here are some of the most common symptoms found in children:

Cold symptoms such as a runny nose

  • Fever
  • Cough
  • Shortness of breath
  • Fatigue
  • Sore throat
  • Headache
  • Gastrointestinal symptoms such as vomiting or diarrhea (less common; one child with COVID-19 has had these symptoms, according to the CDC)

Less common, but extremely serious symptoms, warranting an immediate medical attention:

  • Acute respiratory distress syndrome
  • Septic shock

Children With Underlying Health Conditions

Children who have chronic medical conditions or who experience immunosuppression are at higher risk of experiencing more severe symptoms of COVID-19. Parents of these children should be in close contact with their doctors to discuss what symptoms to watch out for and what precautions to take.

Chad R. Sanborn, MD

Even though kids might do better with this virus, kids with weaker immune systems or underlying health conditions may still be at higher risk for getting sick with this than their peers.

— Chad R. Sanborn, MD

Are There Special Precautions to Take?

At this time, the CDC still lists the risk of COVID-19 for most of the U.S. population as “low.” However, there are certain communities that are experiencing outbreaks, and it’s important to stay updated with information from your state and local health departments about what you need to do to keep your family safe.

“Working parents can be prepared by having alternative childcare plans or talking with their employers about work from home options during school closings,” explains the AAP. “If your child attends a college or university, encourage them to learn about the school's plan for a COVID-19 outbreak.”

For the most part, though, taking common sense precautions to protect your family from COVID-19 is your best bet right now. Precautions can include:

  • Wash your hands frequently, with soap and water, for at least 20 seconds.
  • When soap and water are not available, a hand sanitizer (60% higher alcohol based) will work—unless the hands are grimy with mucus, food grease or other dirt. In those cases, if running water is not available, wipe hands with a wet wipe, and then follow with hand sanitizer.
  • Keep your kids home from school and out of public if they are sick.
  • Teach your children to cough into their elbow, not directly into their hands.
  • Teach children not to touch their face and urge them not to put their fingers in their mouth (very hard with little ones, of course!).
  • Regularly disinfect your home, especially doorknobs, light switches, and other frequently touched surfaces.
  • Keep up to date on your child’s vaccines, including their flu shot.

Why Flu Shots Matter

Kids and younger adults are much more likely to require hospitalization or die from seasonal flu than COVID-19, and the flu vaccine prevents about 50% of flu cases this year. It is not too late to get a flu vaccine. There simply aren't enough ICU beds, ventilators, and hospital staff to handle a large influx of patients with COVID-19. So getting a flu shot (and practicing good hand hygiene) are the best ways to keep ourselves from taxing our healthcare system.

Help Flatten the Curve

In addition to good hand hygiene, we all need to take additional measures to flatten the curve (have fewer people sick at any one time, so the healthcare system can handle it). Everyone should practice social distancing, self-quarantine if you have any symptoms, and avoid crowded places. This is why many schools are closing, as children spread disease among themselves, bring it home, and infect others.

This is why Broadway shows, major sporting events, and many other large gatherings are canceled. When you leave your home, don't go to crowded places. Take your kids outside in your backyard (if you have one) or visit a local park and take a hike, activities where you are far from others. Consider video chatting with grandparents instead of having them visit to lower the risk to them if they are in a high-risk group.

Special Precautions for High-Risk Children

If your child is in a high-risk group, such as someone who has a chronic medical condition or is immune suppressed, Dr. Sanborn recommends “carrying a list of medications they might be on, phone numbers of their specialists from their home cities, and possibly an immunization record (especially if traveling internationally).”

He also urges parents of vulnerable children to make sure their vaccines are up-to-date and that they make sure they have at least two weeks of medications stocked up in case they become quarantined.

Dr. Sanborn recommends caution in terms of traveling with a medically at-risk child.

“For someone who is immune-compromised, it may not be a bad idea to not get on a plane/go to an airport unless it's truly necessary,” says Dr. Sanborn. “Young children who may be immune-suppressed or with chronic illness, in particular, may not be good travel candidates because they don't wash their hands as well, touch their face more often, not cover their cough and sneezes as well and pick their noses/wipe their nasal secretions more often.”

Older at-risk children may be better equipped to handle travel, says Dr. Sanborn. “But I'd still be cautious if they have weakened immune systems,” he adds. In general, it's best to avoid non-essential travel, even if everyone in your family has a healthy immune system, as this will help flatten the curve.

What Should You Do If You Suspect Your Child Has COVID-19?

During a time like this, it can be easy to become panicked at the first sign of any type of illness. However, don’t be quick to assume your child has COVID-19 just because they have the sniffles.

Chad R. Sanborn, MD

When your child gets sick it's probably from one of the hundred other viruses they get sick from and NOT coronavirus. So you don't have to rush to the ER at the first sign of sniffles if they otherwise look OK.

— Chad R. Sanborn, MD

At the same time, if your child has more concerning symptoms, such as a severe cough or high fever—or if you have reason to believe that your child has been exposed to COVID-19—you should call your pediatrician right away for guidance.

Since spreading the virus is a concern right now, your doctor may or may not want you to come into the office. You can discuss the best option here with your doctor. Your local board of health may also give you advice about the best place to go for the diagnosis and treatment of a suspected COVID-19 infection.

However, if your child is experiencing severe symptoms, such as shortness of breath, rapid heart rate, extremely high or low temperature, confusion, or severe dehydration, your should visit your local emergency room right away. If possible, call ahead to the ER to tell them you are coming, so that they can prepare.

What This Means For You

It's understandable that parents would feel especially anxious about a virus like COVID-19. Even if you are assured that your child will likely be fine, it’s common for parents to slip into a “worst cases scenario” type of thinking here. After all, our children are our hearts and souls and the idea of anything scary happening to them can feel terrifying.

Besides taking a few deep breaths and contacting a mental health professional if your anxiety feels out of control, it’s important that you get good, reliable information about COVID-19 as it pertains to your children.

Make sure that whatever sources you are reading include information from trusted medical and health organizations such as the Center for Disease Control, The World Health Organization, and the Academy of American Pediatrics. Unfortunately, there is a fair amount of incorrect information floating around, so you want to be sure you are reading sources you can trust.

And it goes without saying that if you have any concerns about your child’s specific needs, or their current state of health, you should never hesitate to reach out to their pediatrician. That’s what they’re there for.

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Article Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Dong Y, Mo X, Hu Y, et al. Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China. Pediatrics. 2020; doi:10.1542/peds.2020-0702

Additional Reading
  • Academy of American Pediatrics website. 2019 Novel Coronavirus (COVID-19). Updated March 2020.

  • Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19) Frequently Asked Questions and Answers: Coronavirus Disease-2019 (COVID-19) and Children. Updated March 2020.

  • Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19) Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19). Updated March 2020.

  • Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19) Situation Summary. Updated March 2020.

  • Harvard Health Publishing. As coronavirus spreads, many questions and some answers. Updated March 2020.

  • World Health Organization. Report of the WHO-China joint mission on coronavirus disease 2019 (COVID-19). Published February 2020.