Search Menu Globe Arrow Right Close
Cedars-Sinai Blog

COVID and Kids: What You Need to Know

How to diagnosis kids with COVID, a cold or the flu.

With flu season arriving and some children heading back to school, parents are rightfully concerned about viral illnesses.

While COVID-19 continues to make headlines, it's important to remember that the seasonal flu is also a dangerous illness—one that disproportionately affects children.

"The most common symptoms in children are fever and cough, but COVID-19 can hit kids so many different ways. It's like a wild card."

Sharon L. Wirawan, MD

"Unlike COVID-19, there's an approved vaccine to protect children against the flu," explains Dr. Sharon Wirawan, a pediatrician in Pediatric Primary Care. "Every child 6 months of age and older should get vaccinated."

The silver lining: Because people are taking COVID-19 precautions—practicing physical distancing, wearing masks and paying extra attention to hand hygiene—children may suffer from fewer colds and flu this year.

Still, if your child is suffering from a scratchy throat and stuffy nose, particularly if they spike a fever, it's natural for parents to worry and wonder: Is it COVID-19? The flu? Or just a common cold?

The reality is, you may not get a clear-cut answer. Here's how these viruses affect children.

The flu in kids

The flu can be a dangerous illness for kids, especially children who are under 2 years old. Each year, millions of children develop the flu and some become so ill they die from flu-related complications.

During the 2017-2018 flu season, an estimated 600 children died from the flu in the U.S., according to the Centers for Disease Control and Prevention (188 deaths were reported). About 80% of those children were not fully vaccinated. 

Seasonal flu outbreaks can happen as early as October, but flu activity tends to peak between December and February, so it's best to vaccinate early.

"Children who are under age 9, and who are getting vaccinated for the first time, require a booster vaccine 28 days after their first flu shot," Dr. Wirawan says. 

If your child does come down with the flu, it's important to get them tested.

It's not uncommon for children who have the flu to require medical care for complications ranging from dehydration to pneumonia. Plus, if a child tests positive for the flu, a doctor may prescribe medication to help prevent these complications and shorten the duration of symptoms.

COVID-19 in kids

While fewer children than adults get sick from COVID-19, they can become infected and spread the disease to other people—even if they show no signs of illness. Most children with COVID-19 do not suffer from severe illness, but in rare cases they may require hospitalization and intensive care. 

"The most common symptoms in children are fever and cough, but COVID-19 can hit kids so many different ways. It's like a wild card," Dr. Wirawan says.

Kids can have nasal congestion, loss of taste and smell, or even skin reactions and something called "COVID toes," a condition characterized by swollen and discolored toes. 

Researchers are also investigating a rare, but serious medical condition associated with COVID-19 called multisystem inflammatory syndrome in children (MIS-C). With MIS-C, body parts—such as the heart, lungs, kidneys, brain, skin, eyes and gastrointestinal organs—can become inflamed. While MIS-C can be deadly, most children who have MIS-C improve with medical treatment. 

The common cold in kids

The common cold is one of the most frequent illnesses among children. Most kids have between six and eight colds each year—and possibly more if they attend school or daycare. 

Unlike the flu, which primarily affects the lungs, the common cold is an upper respiratory illness that irritates the lining of the nose and throat. 

"Kids who develop the common cold often have a gradual onset of symptoms—they may be a little sniffly or they might have a scratchy throat," Dr. Wirawan says.

They're easy to catch, too, because the virus can spread through respiratory droplets (from a cough or sneeze) or direct contact with someone who is infected. 

Children contract more colds than adults because they tend to touch their nose, mouth and face more often. Symptoms typically begin one to three days after a child is exposed to the virus and may include: 

  • Stuffy or runny nose
  • Scratchy, tickly throat
  • Watery eyes
  • Sneezing
  • Mild hacking cough
  • Congestion
  • Sore throat
  • Headaches
  • Low-grade fever

The symptoms of cold and flu are similar. While most kids can play through a cold, the flu usually grounds them. 

Not sure which virus your child is suffering from? See a pediatrician for an official diagnosis. 

What to do if your child is sick

The challenge during this year's cold and flu season is trying to determine which virus your child is experiencing. Fortunately, the treatment for all three—the flu, COVID-19 and the common cold—is largely the same: rest, drink plenty of fluids (electrolyte solutions such as Pedialyte are a good choice) and treat symptoms such as fever and aches and pains with acetaminophen. 

"Then, just keep a watchful eye," Dr. Wirawan suggests. "Children can develop ear infections and secondary bacterial infections from a viral illness, so it's important to see a physician if symptoms don't improve over time." 

Kids who have only mild cold or flu-like symptoms should still be quarantined for at least 10 days after the onset of symptoms—even if they tested negative for COVID-19.

"It could be a false negative," Dr. Wirawan says. "So for this season, in particular, keep the child home." 

Want to protect your child from getting sick in the first place? The basic tenets recommended to protect against COVID-19 apply to all viral illnesses: 

  • Make sure children over age 2 wear a mask
  • Teach your child to practice good hand hygiene
  • Encourage your child to cough or sneeze into their elbow ("Tell them to pretend they're Dracula," Dr. Wirawan suggests)
  • Ensure there's a safe distance between your child and other individuals
  • Help your child maintain a solid sleep schedule
  • Provide your child a healthful diet boasting plenty of fruits, vegetables and whole grains