Understanding How COVID-19 Affects Kids

August 20, 2020

Clinical Contributors to this Story

Felicia J Gliksman, D.O. contributes to topics such as Pediatric Neurology.

Rachel Lewis, M.D. contributes to topics such as Pediatric Critical Care Medicine.

There exists a strange irony with the COVID-19 pandemic among kids. Typically, kids, especially very young children, can get really sick with viruses.

“During the winter, we generally see children admitted with viral respiratory infections who are very sick, requiring critical care,” says Rachel Lewis, M.D., pediatric critical care medicine specialist at Joseph M. Sanzari Children’s Hospital. “Everything else being equal, the younger ones are the sickest.”

Yet the opposite has happened with COVID-19: Adults are the ones getting so sick.

Impact of School Closures

Part of that has been a result of schools shutting down, which limited the spread of germs and all viruses. “With my own children, they haven’t even had a runny nose,” says Felicia Gliksman, D.O., pediatric neurologist. “One of the unexpected side effects is that children are not filling up the intensive care unit with COVID-19 or the other viral infections that they often would.”

That took pressure off the whole health care system, with pediatric hospitals reallocating resources, such as ventilators and other non-invasive respiratory support, to adult care sites in need. “It’s surprising, but a blessing,” Dr. Lewis says. “It’s much rarer for a child to become very sick with COVID-19.”

Who’s at Most Risk?

That doesn’t mean the virus doesn’t present real threats to children. It’s still dangerous. In particular, the most at risk are:

  • Children with chronic lung disease
  • Children with heart disease
  • Children with obesity
  • Children who are immunocompromised

What to Know About Multi-System Inflammatory Syndrome

Dr. Lewis and Dr. Gliksman are quick to point out that there are two matters of concern with this particular virus. It is true that COVID-19 is a respiratory viral illness. All those symptoms and effects have been well documented—cough, difficulty breathing and so forth.

However, there’s a secondary element to COVID-19 that parents should be aware of: Multisystem Inflammatory Syndrome in Children (MIS-C). The immune system naturally creates antibodies against a virus in order to fight the infection. That happens even with the common cold. However, while rare, doctors are seeing cases in younger children where antibodies developed in order to fight COVID-19 start attacking organs in ways they shouldn’t.

“All of this is still in the theoretical stage and being extrapolated from what we see with other viruses,” Dr. Lewis says. “It’s really only been documented in kids. It’s pretty rare, but it does at times make children critically ill.”

MIS-C is often accompanied by gastrointestinal symptoms, such as abdominal pain, vomiting, diarrhea and lack of appetite. Some even see blood pressure changes and require medicine to help their heart pump normally.

If your child develops any symptoms associated with COVID-19, consult your doctor. If your child is especially sick, consult your doctor or bring your child to an emergency department.

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The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.