The symptoms of COVID-19 in children can vary quite widely. Most of the children
we're seeing with COVID-19 will have fevers as one of their primary considerations.
They'll also be quite tired and fatigued. Often they'll have gastrointestinal
symptoms and by that I mean they'll have either runny poos or vomiting.
As well as sometimes tummy pain, that can be very non-specific and can mimic other conditions,
so it can be quite challenging for parents to know whether their child does or doesn't have COVID.
The other thing we're seeing in the emergency department in the middle of the night is some
children presenting with croupy coughs which can also be a symptom of COVID-19.
In terms of the duration of symptoms that parents can expect, COVID is
like any other virus and that we tend to see people being unwell for about a week to 10 days.
The majority of children presenting to emergency departments are doing
so usually around day two or three of the illness when they're feeling at their worst.
That's often the time when they've got lots of fevers and are feeling particularly
down and tired. One of the things we are seeing however is some of the tiredness can
last a bit longer and that's probably the long effects of COVID that we're seeing.
In terms of looking after your child at home, the symptoms you can expect
they'll often be hot and feverish and they might need some Panadol and Nurofen particularly if
they're miserable with a fever. They may not be eating and drinking as much as usual. That's
OK provided they keep up their fluids. How do you best do that? Small amounts of
fluids frequently, particularly fluids that contain some salts and sugars.
These can be special things like Gastrolyte or Gluco-Lyte but even flat lemonade, icy poles and
things like that just to make sure that they're staying hydrated can be very useful thing to do.
If you can, weighing your child, particularly weighing them naked at
the very beginning of the illness, can give us a really good idea about how much fluid
they've lost over the course of their illness. If you can get access to something that may help
with nausea and vomiting even before they've got sick as that can be helpful rather than
having to try and find some at the time. If you've got access to testing equipment
at home feel free to use that to try and confirm your diagnosis.
Most of all though, treat them like a kid that you would normally see with a virus. If you're
worried, we should be worried but otherwise just give them lots of tender loving care.
In terms of when you should bring your child to hospital, fundamentally, if you're very worried,
we should be worried, too, and that's the moment. But there are some signs and symptoms that can be
a concern to us as emergency physicians. If your child is confused, combative, is not
making sense or is very difficult to rouse, then we want to see them in the emergency department.
If your child has persistent and consistent difficulty breathing, breathing fast, rapid all
the time, as if they've just run 100-metre race and they've just been sitting there,
then we need to see them. If they collapse,
have a fit, then we need to see them. If they have severe and unremitting
tummy pain that can't be treated at home with Panadol or Nurofen, then we need to see them.
If you're genuinely worried that they're getting very dehydrated and not taking fluids,
say, for example, they're not passing urine at least once or twice in a 24-hour period,
then we probably need to see them. Thankfully, most children with COVID
are not getting that sick. However, we also have to remember there's lots of other diseases
out there as well, and it's important that if you're worried, and your child
is genuinely as sick as you've ever seen them, then we will be happy to see them at any time.
Most kids will get through COVID without any significant problems but
there are a few groups of kids that we get slightly more worried about.
Those, for example, that have underlying severe lung disease such as those with cystic fibrosis
or those that are immunocompromised, for example, children undergoing care
for cancer and so forth, or on immunosuppressive drugs.
The other group that often gets parents worried are the newborn babies, particularly those in
the first month of life, and while most of them that get COVID will still do fine, we
know that they can also get other conditions that concern us, particularly, if they've got a fever.
If your child is less than a month of age and has a fever we really should see them in the
emergency department and unfortunately that will mean we need to do some investigations,
however, that's the best thing that we can do to keep them safe at this time.
If you've got a child with complex care conditions and you're worried about caring for them at home
with COVID, it's going to be important to have a chat to their usual caregiver.
It's going to be important to have an adequate supply of their medications
and it's going to be important to understand whether they'll fit into a group that may
need treatment early in the course of illness should they get COVID.
The best people to give them that advice will be the people to look after them normally.
In terms of how you look after the emergency department, we'll do our
best to keep vulnerable children as safe as possible while they're here with us so you
shouldn't be scared of coming to the emergency department if you need that level of care.
While most children with COVID-19 will make a full and complete recovery,
here in the emergency department we're on the lookout for a rare complication that
occurs in a small number of children which is an inflammatory syndrome that can show signs
and symptoms about four to six weeks after the child has had their COVID infection.
What we're on the lookout for is a child that has new fevers - high, hard-to-treat - who
often looks incredibly sick, who may have an altered color, peeling, irritable, grisly.
It'll be very important for us to know that they may have had COVID
four to six weeks earlier in this situation and we would definitely want to see them.
So if you see those sort of symptoms and signs,
four to six weeks after your child's had COVID then seek help.