COVID-19 in children: symptoms, care, and prevention

Symptoms

• Fever (the most common symptom)
• Cough
• Sore throat
• Runny or stuffy nose
• Muscle pain
• Stomach ache, vomiting, or diarrhea
• Headache
• Fatigue
• Significant loss of appetite
• Sudden loss of smell without a stuffy nose (may also be accompanied by a loss of taste)

Call Info-Santé 811 if your child:

• Is drinking less than usual and peeing less often
• Shows signs of dehydration
• Has a fever that quickly gets worse or returns after your child has been without a fever for at least 24 hours
• Doesn’t seem to be getting better after 7 days or has worsening symptoms

Go to the emergency room immediately if your child:

• Is under 3 months old and has a rectal temperature of 36°C or lower, or 38°C or higher
• Has a fever lasting more than 4 or 5 days despite fever-reducing medication
• Seems very sick, is extremely tired, or is hard to wake up
• Is pale or has an unusual skin colour
• Has trouble breathing or is breathing faster than usual
• Refuses to eat or drink
• Has a chronic illness or a weakened immune system and a fever of over 38.5°C

What is COVID-19?

COVID-19 is a respiratory tract infection. It is caused by the SARS-CoV-2 virus, which is highly contagious. This virus belongs to the coronavirus family, named for its crown-like shape.

Generally, children infected with COVID-19 show only mild symptoms, and some don’t have any symptoms at all. Hospitalizations are very rare, and serious cases are extremely uncommon.

Children seem less affected by COVID-19 than adults. Some data also suggests that children may be less contagious than adults, especially when they have few or no symptoms, which means they are less likely to spread the virus.

However, children can still develop complications after catching COVID-19, such as long COVID or multisystem inflammatory syndrome in children (MIS-C).

Children at risk of complications from COVID-19

Some children need to take extra precautions to avoid getting COVID-19 because they have a higher risk of complications. They are also more likely to be hospitalized with COVID-19 due to breathing difficulties, pneumonia requiring oxygen, and other issues.

This includes children who:

• Were born very prematurely
• Have heart problems
• Have cystic fibrosis or another chronic lung disease, including uncontrolled asthma
• Have neurological or neuromuscular disorders
• Have sickle cell anemia
• Have cancer
• Have a weakened immune system due to an organ transplant or regular use of steroids

How does COVID-19 spread?

COVID-19 mainly spreads through close contact with an infected person lasting more than 15 minutes. The virus can be transmitted through contact with:

• Secretions from the nose or mouth of an infected person
• Tiny droplets the infected person releases into the air when breathing, talking, singing, coughing, sneezing, etc.
• Touching a contaminated surface and then touching the eyes, nose, or mouth

People who have COVID without symptoms can spread the illness, even if they have been vaccinated.

Treating COVID-19 in children

Make sure your child is comfortable

• Dress them in light clothing, especially if they have a fever, and keep the room temperature around 20°C.
• Make sure they get plenty of rest. You don’t have to keep your child in bed all day, but they do need rest.
• Clear your child’s nose with saline solution if they’re congested. To learn how, see our article on cleaning and blowing a stuffy nose.
• Make sure your child is getting enough fluids and has no signs of dehydration, especially if they’re vomiting or have diarrhea. If they have signs of dehydration, you can give them a rehydration solution from a pharmacy (for example, Pedialyte^®). Ask your pharmacist for advice.
• If your child is over 4 years old, soothe their sore throat by giving them ice chips or lozenges containing honey, medicinal herbs (e.g., peppermint, lemon balm, thyme, sage, linden, hyssop), or pectin.
• If your child is coughing a lot at night, raise the head of their bed to at least a 30-degree angle (semi-upright position). You can do this by placing cushions or pillows under the mattress. If your child is older and uses a pillow, elevate their head with an extra pillow.
• Watch for worsening symptoms like difficulty breathing, rapid breathing, confusion, or bluish lips. If these signs appear, your child should see a doctor.
• If your child has one or more risk factors for severe COVID-19, inform their doctor about the infection. In some cases, the doctor may prescribe targeted antiviral therapies.

Appropriate medication

If your child is over 3 months old and has a rectal temperature above 38°C (100.4°F), you can give them acetaminophen (such as Tylenol^® or Tempra^®), following the product instructions and based on your child’s weight.

If your child is over 6 months old and acetaminophen does not reduce their fever, you can give them ibuprofen (such as Advil^® or Motrin^®), but discuss it first with a healthcare professional (pharmacist or physician).

Precautions to avoid spreading the infection at home

• Wash your hands often.
• Clean and disinfect toys and frequently touched surfaces, such as door handles and faucets.
• Make sure your child does not share personal items (cups, utensils, etc.), food, or drinks with other family members.
• Open a window regularly to air out your home and your child’s room, if possible.

How to prevent COVID-19

There are measures that can reduce the spread of the coronavirus. Teach them to your child, if they’re old enough.

• Wash your hands frequently with soap.
• Sneeze and cough into a tissue or the crook of your elbow, not your hand.
• Avoid touching your eyes, nose, and mouth.
• Clean toys and frequently touched surfaces like doorknobs and taps.
• Avoid contact with people who have a cold or are coughing.
• Open doors and windows regularly to air out the house during gatherings. A few minutes at a time is enough if it’s cold.
• For children 6 months or older, have them vaccinated against COVID-19.

Scientific review: Dr. Isabelle Viel-Thériault, pediatrician and infectious disease specialist at CHU de Québec – Université Laval Research and copywriting:The Naître et grandir team January 2025

Photo: GettyImage/Igor Bostanika