Coronavirus Disease 2019 (COVID-19) in Kids
Urgent or Emergency Care?
If you believe your child needs immediate attention and you have concerns for a life-threatening emergency, call 911. Not sure what counts as urgent and what's an emergency when your child is sick or injured? When it can't wait, know where to take your kids.
Help Me Decide
What is COVID-19?
Coronavirus disease 2019, abbreviated as COVID-19, is the infectious illness caused by the new coronavirus that was first discovered in late 2019. Due to the wide spread of the virus, COVID-19 is now a pandemic affecting many countries across the world, including the United States. Studies show that COVID-19 is more serious for adults over age 65 and people with certain underlying medical conditions than for the average child. However, even healthy children can become sick, some seriously, and can spread COVID-19.
What causes COVID-19?
COVID-19 is caused by a coronavirus that first appeared in December 2019. The official name of this novel (new) coronavirus is severe acute respiratory syndrome coronavirus 2, abbreviated as SARS-CoV-2. The virus SARS-CoV-2 causes COVID-19.
Where did SARS-CoV-2 come from?
SARS-CoV-2 is a new virus that has not been previously identified in the human population. It was first discovered in the Wuhan province of China in late 2019. Early studies suggest that it originated from an animal source, most likely bats.
In humans, several coronaviruses are known to cause respiratory infections (lung infections) that range from the common cold to much more serious diseases like severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).
Are the coronavirus and COVID-19 the same thing?
Though you may hear these terms used interchangeably in the news, the virus and the disease caused by the virus have different names. More specifically:
- Coronaviruses are a family of viruses that can cause illness in animals or humans.
- Though “the coronavirus” commonly refers to SARS-CoV-2, technically, there are many different coronaviruses.
- SARS-CoV-2 is the name of the specific coronavirus that causes the viral respiratory illness COVID-19 and the resulting pandemic.
Learn more about the names and differences for terms that describe coronavirus disease from the World Health Organization.
COVID-19 is a new disease, and doctors and scientists are still learning about it. Though most children with COVID-19 tend to have milder forms of the disease, kids are not immune to COVID-19 and can still get sick.
Click to expand the accordions below to learn more about COVID-19 in children and teens.
COVID-19 in kids and teens
Yes. Children of all ages can get sick with COVID-19. Though fewer children overall have been sick with COVID-19 compared to adults, kids can be infected, get sick and spread the coronavirus to other people.
Yes. Just like adults, children without symptoms of COVID-19 can still spread the virus to others. This is called asymptomatic spread.
There is still a lot we do not know about COVID-19. Based on current medical research, babies under 1 year old might be more likely to have severe illness from COVID-19. Children with certain underlying medical conditions like asthma, chronic lung disease, diabetes, weakened immune systems, heart disease since birth and obesity might also be at increased risk compared to other children.
Current evidence from scientific studies shows that some people with underlying medical conditions are or could be at greater risk of severe illness from COVID-19.
Increased risk
When compared to other children, kids with the following conditions might be at an increased risk for severe illness from COVID-19:
- Multiple chronic conditions that affect several parts of the body
- Neurologic, genetic or metabolic conditions
- Congenital heart disease
People of all ages – including kids – with the following underlying medical conditions are at increased risk of severe illness from COVID-19:
- Cancer
- Chronic kidney disease
- Immunocompromised state (weakened immune system) from solid organ transplant
- Obesity
- Serious heart conditions, such as heart failure, coronary artery disease or cardiomyopathies
- Sickle cell disease
- Type 2 diabetes
Possible increased risk
People of all ages with the following conditions might be at an increased risk for severe illness from COVID-19:
- Asthma (moderate-to-severe)
- Chronic lung disease
- Cystic fibrosis
- High blood pressure
- Weakened immune system from blood or bone marrow transplant, immune deficiencies, HIV or use of immune-weakening medicines
- Neurologic conditions
- Liver disease
- Pregnancy
- Smoking
- Thalassemia (a type of blood disorder)
- Type 1 diabetes
- Vaping
Learn more about COVID-19 in children and teens from the CDC.
Scientists are learning more about how SARS-CoV-2 spreads between people. It spreads most commonly during close contact. The latest evidence shows that:
- COVID-19 can spread through respiratory droplets, such as saliva and mucus, when people cough, sneeze, breathe, talk, sing and shout. These droplets can land on others or on surfaces. The virus can infect others if it comes into contact with their eyes, nose or mouth.
- Less commonly, COVID-19 can also be spread through airborne transmission, which occurs when tiny respiratory droplets are able to linger in the air for minutes to hours due to poor ventilation. Current science shows that airborne transmission is less common than close contact, but it’s an important consideration for small or indoor public spaces with less air flow.
Learn more about how COVID-19 spreads from the CDC.
Remember, kids can spread the virus, even if they do not have symptoms. This is why it’s important for everyone – including children and teens – to follow public health guidelines like cleaning hands frequently, wearing cloth face coverings (with some exceptions like babies and toddlers), and physical distancing whenever possible. Each of these methods offers some but not complete protection. This is why it’s important for families to use these methods together to protect themselves and others from COVID-19.
There are several steps parents and families can take to help prevent children (and everyone) from getting COVID-19. Use all of the following methods to protect your family and decrease the spread of COVID-19:
- Wash your hands frequently and thoroughly, especially after interacting with others.
- Wear a cloth face covering when you are around others you don’t live with or when you’re out in public.
- Keep a minimum of 6 feet away from others you don’t live with (referred to as social distancing or physical distancing).
- Stay at home when you feel sick (and keep your kids home when they feel sick, too).
- If you or your child gets sick, get tested.
- Avoid large gatherings and, when possible, socialize outside, not inside.
Remember, there’s no way to eliminate all risk, but there are simple and effective steps we can all take to protect each other and limit the spread of COVID-19 within our neighborhoods and communities. Practicing these public health measures isn’t just about protecting yourself and your family – it’s about protecting the most vulnerable people in our community.
Of course, life doesn’t stop, even during a pandemic. Going out and socializing with others is important for our economy and mental health. When you need to (or want to) leave your home, consult this helpful risk vs. benefit guide from the Colorado Department of Public Health and Environment (CDPHE) to help you understand the level of risk presented by different social activities, from camping to concerts.
Signs and symptoms
The most common symptoms of COVID-19 in children are:
Some patients with COVID-19 also experience the following symptoms:
- New loss of smell and/or taste
- Aches and pains
- Headache
- Sore throat
- Congestion or runny nose
- Nausea or vomiting
- Diarrhea
- Rash on the skin and/or discoloration of the fingers or toes
- Shortness of breath (feeling like you can’t take a full breath)
Most children with COVID-19 have mild symptoms and some have no symptoms at all. Some children can get severely sick from COVID-19. If your child has an underlying medical condition that may put them at higher risk, call their doctor as soon as you notice symptoms.
The symptoms of COVID-19 are similar in kids and adults. However, young children may have trouble explaining their symptoms. For example, it may be hard for a child to explain that they cannot taste or smell. Instead, they may say that their food doesn’t taste good or that it tastes funny.
People develop symptoms 2 to 14 days after they are exposed to COVID-19. The average time it takes to develop symptoms is 5 days. This is called the coronavirus incubation period, or the time from when a person is exposed to when they have symptoms.
Most children who have COVID-19 will not become seriously ill. However, whether or not you think it could be COVID-19, you should call 911 or go to the emergency room if you notice any of the following serious symptoms:
- Trouble breathing
- Persistent (ongoing) pain or pressure in the chest
- New confusion
- Inability to wake up or stay awake
- Bluish lips or face
Important: Do not delay getting emergency care for your child because you are worried about possible spread of COVID-19. Emergency departments, including at Children’s Colorado, have infection prevention plans to protect you and your child from getting sick with COVID-19 if your child needs emergency care.
Tests and diagnosis
There are several types of COVID-19 tests now available. A viral test called polymerase chain reaction (PCR) is considered the best method or “gold standard” for detecting an acute (active) COVID-19 infection. If your child receives a positive PCR test, it means your child has an active COVID-19 infection and can spread the virus to others.
What parents and caregivers should know about COVID-19 testing
Though there are several types of COVID-19 tests now available, such as rapid tests or saliva tests, each varies in terms of accuracy and its ability to detect negative and positive results. Some tests are faster, but they are also more likely to miss detecting the virus. This can create a false negative, meaning the person has the virus but received an incorrect result.
Use the table below to learn about the different types of COVID-19 tests, the pros and cons and what to do based on your child’s test result. If you have questions about the accuracy of a specific test, you should ask your doctor.
Test type |
How the test is taken |
What the test looks for |
Pros |
Cons |
What a positive result means |
What a negative result means |
Polymerase chain reaction (PCR) test |
Nasopharyngeal swab (or similar swab from the nose) to collect samples from the respiratory system |
The PCR test looks for small amounts of genetic material (viral nucleic acid RNA) from SARS-CoV-2. |
More sensitive, meaning it’s less likely to miss the virus and get a false-negative result |
Slower results |
A positive PCR test means your child has an active COVID-19 infection and can spread the virus to others.
What to do: Isolate your child from others and follow isolation guidelines for 10 days after symptoms first appeared.
Keep an eye on your child’s symptoms and consult with their doctor.
Inform close contacts of your child’s positive test so they can quarantine for 14 days.
|
A negative PCR test means that it’s highly unlikely that your child currently has COVID-19.
What to do: Continue taking steps to prevent the spread of COVID-19.
|
Rapid point-of-care testing (antigen test or PCR test) |
Nasal or oral swabs or saliva to collect samples from the respiratory system |
Rapid antigen tests look for proteins from the SARS-CoV-2 virus.
Rapid PCR tests look for small amounts of genetic material (viral nucleic acid RNA) from SARS-CoV-2.
|
Quicker results
Available in “point-of-care” settings, like the doctor’s office
Rapid testing can help quickly screen a group to identify who should be isolated (though it may miss some cases of COVID-19).
|
Rapid tests are less sensitive, meaning there’s a higher chance of getting a false negative. |
A positive rapid test means that your child has an active COVID-19 infection and can spread the virus to others.
What to do: Isolate your child from others and follow isolation guidelines for 10 days after symptoms first appeared.
Keep an eye on your child’s symptoms and consult with their doctor.
Inform close contacts of your child’s positive test so they can quarantine for 14 days.
|
A negative rapid test means that it’s still possible your child has a COVID-19 infection and can spread the virus to others.
What to do: If your child has symptoms, work with your doctor to get a PCR test to be sure.
Continue taking steps to prevent the spread of COVID-19.
|
Antibody test |
Blood test |
This test looks for SARS-CoV-2 antibodies, proteins in your blood that your immune system makes when it is fighting off a COVID-19 infection. |
This test can tell doctors whether your child had COVID-19 in the past, even if they did not show symptoms. |
This test cannot determine whether your child has an active COVID-19 infection.
This test is not 100% accurate, and a negative result does not necessarily mean they have not had a COVID-19 infection.
|
A positive antibody test means your child had a COVID-19 infection in the past.
What to do: Continue taking steps to prevent the spread of COVID-19. Recent data suggest that it is possible to get a second infection; a positive antibody test does not mean your child is immune.
|
A negative antibody test could mean several things:
Your child has not been infected with COVID-19 previously.
Your child had COVID-19 in the past but did not develop or has not yet developed detectable antibodies.
The result may be wrong, known as a false negative.
What to do: Continue taking steps to prevent the spread of COVID-19.
|
Remember: We do not fully understand the new coronavirus. Having COVID-19 in the past does not mean your child is protected from another infection. Though rare, there have been several confirmed reports of reinfection. Scientists are still learning about the virus and how it affects people.
For the most accurate results, look for COVID-19 testing that meets the following criteria:
- Viral PCR testing
- Done in a hospital or public health department laboratory
- Tested on a sample collected via nasopharyngeal swab (where the nasal passages and throat meet)
Children’s Colorado performs PCR testing to diagnose COVID-19. A PCR test involves swabbing the inside of the nose where it meets the throat to determine whether the person has live virus in their body. Most coronavirus testing takes place at drive-through testing sites that allow lab workers to take samples with a swab through the car window. This helps keep everyone safe by limiting interactions between people who may be sick with the healthy workers.
In some cases, your child’s doctor may be able to take a sample in the doctor’s office. This is typically available when your child already has an appointment.
Children’s Colorado makes an extra effort to make coronavirus testing as comfortable and easy as possible for kids and families. Learn how and what to expect during coronavirus testing for kids.
If your child’s doctor suspects they may have COVID-19, they will order a viral test. Typically, this is the PCR test explained above, though rapid tests may also be available. At Children’s Colorado, our Pathology and Lab Services use the gold standard of PCR testing to diagnose an active COVID-19 infection.
We offer viral PCR testing and antibody testing for COVID-19 at multiple locations in the Denver Metro and Colorado Springs areas. Learn where and how to get a coronavirus test for your child and find more frequently asked questions about testing.
Treatment
Coronavirus treatment depends on the severity of the illness. Most children who have COVID-19 tend to have mild symptoms that can be managed at home.
Treating kids with mild symptoms of COVID-19
If you or your child tests positive for COVID-19, treatment is focused on relieving symptoms. This includes:
- Getting lots of rest
- Taking acetaminophen (Tylenol) for any fever or achiness
- For children over 4, managing any cough or runny nose with cold medication
- Staying hydrated by drinking lots of clear fluids, like water
Call your child’s doctor if they experience any shortness of breath, seem to be getting worse or are not getting better within a few days.
Be sure to follow the CDC’s guidelines for caring for someone sick at home and when your child can be around others after they have had or likely had COVID-19.
Treating kids with more severe cases of COVID-19
Some children will develop more concerning cases of COVID-19, though this is relatively rare. Current science shows that approximately 1% to 2% of children who have COVID-19 will require hospitalization. Of those cases, about 1% of hospitalized kids will need critical care in an intensive care unit (ICU).
Treatment is available for kids and teens who have more serious cases of COVID-19. Treatment options include:
- Dexamethasone (a drug called a corticosteroid that can help decrease inflammation or swelling in the body)
- Remdesivir (a new antiviral)
Though pediatric studies on these treatments are not yet available, dexamethasone and remdesivir have helped adults with COVID-19. Doctors are also studying convalescent serum, a blood product from plasma donors who have recovered from COVID-19, as a potential promising treatment for COVID-19.
Yes. Children’s Colorado is here for all kids. That was true before the COVID-19 pandemic and it’s true today. Doctors in our Infectious Disease Program are experts in treating infectious conditions in children, including COVID-19.
Non-urgent care
If you believe your child needs attention for possible COVID-19, first call their pediatrician. If you do not have a pediatrician, you can call our ParentSmart Healthline at 720-777-0123 for advice from a pediatric nurse. This service is free and available 24/7.
Urgent or emergency care
Children’s Colorado also offers pediatric urgent and emergency care at several locations. Learn more about our urgent and emergency care and how to decide when to go where. If you believe your child is experiencing a life-threatening emergency, always call 911.
If you do go to urgent care or an emergency room for possible COVID-19, remember to:
- Call ahead;
- Tell the team about your symptoms as soon as you arrive; or
- Share your test results (if known)
This will help keep all patients and health workers safe.
Getting medical care during the pandemic
At Children’s Colorado, keeping patients safe is our top priority. Learn about the many precautions we’ve put in place to keep patients and families safe during the pandemic. Or find our coronavirus resources for families, all in one place.
Additional resources
COVID-19 is a new condition, and we’re learning more about it as additional scientific evidence becomes available every day. This means that health guidance may change as we learn more about how the coronavirus spreads and how to treat it.
We will update this webpage regularly as we learn more about COVID-19 and its impact on children and teens. We also recommend the following trusted resources for additional information on the COVID-19 pandemic.
FAQs about COVID-19 in kids
Fortunately, most kids and teens who have COVID-19 fully recover from it within 14 days of their first symptoms.
Though there have been some reports of cases where symptoms last for several weeks or months following infection, this is uncommon. Doctors and scientists are beginning to study this.
A small number of children have developed an inflammatory condition called multisystem inflammatory syndrome in children, or MIS-C for short. Though this is serious, it is rare.
There is a large international effort underway to develop vaccines against COVID-19. A governmental program called Operation Warp Speed oversees this effort in the United States. Two vaccines are close to being authorized for emergency use by the U.S. Federal Drug Administration, or FDA.
Read our COVID-19 vaccine updates to learn about the largescale effort to produce a safe and effective coronavirus vaccine.
The FDA is expected to authorize one or more vaccines for emergency use in mid- to late-December 2020. Though this is promising, it will take many more months before the general population, including kids, can be vaccinated against COVID-19. There is limited information about the safety and effectiveness of COVID-19 vaccines in children, and studies are ongoing. Preventive measures like handwashing and social distancing remain crucial for these reasons.
Vaccines have historically been remarkably safe and effective, and we expect that FDA-approved vaccines against COVID-19 will be, too. That’s because of the stringent requirements and high safety standards that must be met before any vaccine, including COVID-19 vaccine(s), can be distributed to the public. Vaccines are the single best way to prevent infectious diseases: We need them to stay safe. This is true for COVID-19 and dozens of other vaccine-preventable diseases from polio to measles to the flu.
One way to think about it is that while the business side of vaccine development and distribution was fast-tracked, the science was not. Although the process has been accelerated, no corners have been cut.
Another thing to keep in mind is that this work is building on decades of remarkable progress in the development of vaccines. When the FDA approves one or more COVID-19 vaccines, they will have gone through every single step of the vast, rigorous and complex process required to understand the safety and effectiveness of any new vaccine.
As a group, kids are at lower risk of experiencing severe COVID-19. That’s the main reason younger kids were not included in the first round of vaccine studies. However, active studies are ongoing that involve children younger than 12, and we are anticipating the results of those studies in 2021. Kids’ immune systems are different enough from adults that we need to make sure the vaccines are both safe and effective in the pediatric population.
We encourage families to be patient while waiting for a safe and effective vaccine for kids. Remember that behind the scenes there is an extensive approval process, and once a vaccine is approved and available, there’s another extensive surveillance system monitoring vaccine safety within the population.
Read more about the process to develop a safe and effective COVID-19 vaccine.
Though influenza (flu) and COVID-19 are both contagious respiratory illnesses, they are caused by different viruses. COVID-19 is caused by infection with a new coronavirus (SARS-CoV-2) and the flu is caused by infection with influenza viruses. There are several seasonal influenza viruses, and they circulate each year during what we call flu season.
Because some of the symptoms of the flu and COVID-19 are similar, it may be hard to tell the difference between them based on symptoms alone, and testing may be needed to help confirm a diagnosis. If you think your child has the flu or COVID-19, the best thing to do is call your child’s doctor to ask whether your child should be tested.
The CDC explains the key differences between COVID-19 and the flu.
If your child had a suspected or confirmed case of COVID-19, you should keep an eye on them for several weeks to make sure they are feeling better and that their symptoms improve and go away over time. Be sure to watch for any symptoms of MIS-C. Though MIS-C is rare, you should be aware of it and keep in touch with your child’s doctor if you have concerns.
In general, your child should remain in isolation until 10 days after their positive COVID-19 test.
Advice for parents of young athletes
If your child participates in competitive sports or vigorous exercise, we recommend checking in with their doctor before they return to sports and play. Their pediatrician can give them an exam to ensure that your child does not have lingering symptoms and is ready for exercise.
Generally, if your child has had confirmed or suspected COVID-19 they should wait at least 14 days after their symptoms appeared before returning to sports or vigorous exercise. This is because your child could still be contagious and may spread the coronavirus to teammates or others. It may also take up to two weeks for some symptoms to appear.
There have been reports of myocarditis (the swelling of the heart muscle) and sudden cardiac arrest in some competitive athletes who have had COVID-19. When the heart muscle is inflamed, there is a higher risk for the heart to work abnormally and to have an irregular heartbeat. Though this is unsettling, parents should not panic.
We are still learning about COVID-19 in kids and its potential effects on the heart. While there is evidence that COVID-19 impacts the heart in some adults, we need additional studies and data before we understand how the disease may affect the cardiovascular system in children and teens.
We recommend having your child checked out by their pediatrician before returning to sports if they are a competitive athlete and meet any of the following criteria:
- Over age 12
- Have a history of heart problems, including heart murmurs or high blood pressure
- Had a severe case of COVID-19 or had to be hospitalized
- Had MIS-C
- Have symptoms of pain or tightness in their chest, fainting or tiring very easily during exercise
Their pediatrician will perform a sports physical and can refer them to a pediatric cardiologist, if needed.
There is some disagreement between pediatricians about whether the return-to-play guidelines following COVID-19 infection are overly cautious. At Children’s Colorado, pediatric cardiologists in our Heart Institute recommend remaining cautious until additional scientific studies are available and we know more about the risks. Please speak with your child’s pediatrician to learn about your child’s individual risk and if they should receive a checkup.
This page was updated on Dec. 10, 2020. Due to the shifting nature of the pandemic, recommendations can change quickly. Please follow all health and safety guidelines set by your local public health authorities. Reference the CDC, CDPHE and WHO for ongoing updates on COVID-19 and the pandemic.
Keeping you safe, wherever you are
We're here when you need us with the same safe, high-quality care we've always offered, even during the pandemic. Now, in many cases, you can get that care without even leaving home because we offer virtual visits across every one of our specialties.
See if telehealth is right for your child