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Coronavirus symptoms in children: What to watch out for as kids go back to school

KIDS in England are set to go back to school from 1 September, with some parents worrying about the effect of coronavirus on their children.

Children in reception, year one and year six  have been back in classrooms for at least a month – but how can parents tell the differences between Covid-19 and other winter bugs?

Read our coronavirus live blog for the latest news & updates

Ministers in England said it will be safe for their children to return to the classroom in September
PA

With children back at school they will once again be mixing with their school friends.

Many children returned to school on June 1 and others have been gradually walking back through the school gates.

It’s important parents remain vigilant and look out for the key symptoms of Covid-19.

Scientists are still trying to understand the new illness, but research so far suggests that there are fewer cases of the virus reported in children.

study in the New England Journal of Medicine also said that “children might be less likely to become infected or, if infected, may show milder symptoms” than adults.

Many children had still been attending school during the pandemic but in much smaller numbers (stock image above)
Getty Images - Getty

Symptoms may appear similar to other respiratory illnesses, such as the flu and the common cold, but this new strain is said to be more likely to trigger cough and fever, researchers said.

The main symptoms of coronavirus to look out for in your child are:

  1. A high temperature – this means they feel hot to touch on their chest or back.
  2. A new, continuous cough – this means coughing a lot, for more than an hour, or three or more coughing episodes in 24 hours.
  3. A loss or change to sense of smell or taste – this means they cannot smell or taste anything, or things smell or taste different to normal.
  4. Shortness of breath – this means their chest may begin to feel tight or they begin to feel as though they cannot breathe deeply enough to get a good breath.
  5. Muscle pain – they may experience body aches or joint pain.
  6. Fatigue – this means a feeling of tiredness and an overall lack of energy.
  7. Stomach ache/diarrhoea – they may notice general stomach pain, constipation, diarrhoea, or other kinds of GI distress.

The most common signs of coronavirus in confirmed cases of Covid-19 from China up to February 22, 2020

Symptom checker

COVID-19

Fatigue: None to severeFever: Moderate to high
Chills, shaking: Possible
Aching muscles, joints: Unlikely
Runny, stuffy nose: Possible
Facial pain, headache: Yes
Sore throat: Possible
Cough: Severe, persistent
Nausea, vomiting, diarrhoea: More likely in children
Loss of taste or smell: Often
Neck stiffness: No
Shortness of breath: Severe
Wheezing: Unusual
But Covid-19 can be symptomless.

COMMON COLD

Fatigue: Slight
Fever: No
Chills, shaking: No
Aching muscles, joints: No
Runny, stuffy nose: Yes
Facial pain, headache: Yes
Sore throat: Yes
Cough: Yes
Nausea, vomiting, diarrhoea: No
Loss of taste or smell: Possible
Neck stiffness: No
Shortness of breath: No
Wheezing: No

FLU

Fatigue: Severe
Fever: Moderate to high
Chills, shaking: Yes
Aching muscles, joints: Severe
Runny, stuffy nose: Yes
Facial pain, headache: Yes
Sore throat: Yes
Cough: Dry, hacking
Nausea, vomiting, diarrhoea: No
Loss of taste or smell: Possible
Neck stiffness: No
Shortness of breath: Possible
Wheezing: Possible

SINUSITIS

Fatigue: None
Fever: Unusual
Chills, shaking: No
Aching muscles, joints: No
Runny, stuffy nose: Yes
Facial pain, headache: Yes
Sore throat: No
Cough: No
Nausea, vomiting, diarrhoea: No
Loss of taste or smell: Possible
Neck stiffness: No
Shortness of breath: No
Wheezing: No


BRONCHITIS/PNEUMONIA

Fatigue: Yes
Fever: Yes
Chills, shaking: Yes
Aching muscles and joints: No
Runny, stuffy nose: Unusual
Facial pain, headache: Yes
Sore throat: No
Cough: Yes
Nausea, vomiting, diarrhoea: Unusual
Loss of taste or smell: Possible
Neck stiffness: No
Shortness of breath: Yes
Wheezing: Possible

MENINGITIS

Fatigue: Yesever: Yes
Chills: Yes
Aching muscles and joints: Yes
Runny, stuffy nose: No
Facial pain, headache: Yes
Sore throat: No
Cough: No
Nausea, vomiting, diarrhoea: Possible
Loss of taste or smell: No
Neck stiffness: Yes
Shortness of breath: No
Wheezing: No

NOROVIRUS

Fatigue: Yes
Fever: Mild
Chills: No
Aching muscles and joints: Sometimes
Runny, stuffy nose: No
Facial pain, headache: Yes
Sore throat: No
Cough: No
Nausea, vomiting, diarrhoea: Severe
Loss of taste or smell: No
Neck stiffness: No
Shortness of breath: No
Wheezing: No

ASTHMA

Fatigue: No
Fever: No
Chills: No
Aching muscles and joints: No
Runny, stuffy nose: Possible
Facial pain, headache: No
Sore throat: Possible
Cough: Dry cough
Nausea, vomiting, diarrhoea: No
Loss of taste or smell: No
Neck stiffness: No
Shortness of breath: Yes
Wheezing: Yes

If your child shows any of the above symptoms or you’re concerned they may have coronavirus make sure you keep them off school to stop the bug from spreading and follow NHS guidelines by calling NHS 111.

Experts say it’s unclear why coronavirus isn’t impacting on children as much as adults – especially because children’s immune systems aren’t as robust as adults and they tend to overreact.

Dr Nathalie MacDermott, from King’s College London, told the BBC: “You’d expect it to go haywire and it’s not doing that.

“There must be something this virus does that is not as readily stimulating the immune system in children, but what that is is unclear.

“They don’t seem to be mounting a disproportionate immune response and some seem to be asymptomatic.”

Kids’ Kawasaki disease-like illness

The NHS has recently warned GPs to be on the lookout for a new “inflammatory syndrome” in kids that could be linked to coronavirus.

There has been a rise in children with the mystery illness needing intensive care in recent times.

Some of those children struck by the mysterious condition have tested positive for Covid-19, while others have not.

Doctors have been told the children displayed signs similar to toxic shock syndrome (TSS) and Kawasaki disease, a condition that causes inflammation to the heart.

Hospitals say they have been treating youngsters “of all ages” with the syndrome.

Health chiefs said in an alert to GPs the signs include:

  • Stomach pain
  • Gastrointestinal symptoms – like vomiting and diarrhoea

The mysterious condition has been compared to toxic shock syndrome (TSS) and Kawasaki disease.

The signs of TSS are:

  • High temperature
  • Flu-like symptoms, like headache, feeling cold, aches, sore throat and cough
  • Feeling and being sick
  • Diarrhoea
  • Widespread burn-like rash
  • Lips, tongue, and whites of the eyes turning bright red
  • Dizziness or fainting
  • Difficulty breathing
  • Confusion

Signs of Kawasaki disease include:

  • A rash
  • Swollen glands in the neck
  • Dry, cracked lips
  • Red fingers or toes
  • Red eyes

The effects of the illness had been seen in children both with and without coronavirus

When you should call an ambulance

If you are worried your child could be suffering from the symptoms, it is important to seek medical advice, as soon as possible.

Contact your GP or call NHS 111.

Dr Sarah Jarvis, GP and clinical director of Patientaccess.com, told The Sun: “The NHS is very much open for business.

“If you have a child who is seriously unwell, you should call an ambulance – your child is much better off in hospital if they’re seriously unwell.”

She said you should always call an ambulance if your child:

  • Is unwell with the symptoms above (tummy pain, diarrhoea and vomiting)
  • Becomes pale, mottled and feels abnormally cold to the touch or has blue lips
  • Has pauses in their breathing or severe problems breathing
  • Has a fit/seizure
  • Becomes extremely distressed (crying inconsolably despite distraction)
  • Becomes confused, very lethargic (difficult to wake) or unresponsive
  • Has a rash that does not disappear with pressure (the ‘Glass test’)

Prof Russell Viner, president of the Royal College of Paediatrics and Child Health (RCPCH), said parents should be reassured children with Covid-19 are unlikely to be seriously ill.

He added: “We already know that a very small number of children can become severely ill with Covid-19 but this is very rare.

“Evidence from throughout the world shows us that children appear to be the part of the population least affected by this infection.

“New diseases may present in ways that surprise us, and clinicians need to be made aware of any emerging evidence of particular symptoms or of underlying conditions which could make a patient more vulnerable to the virus.

“However our advice remains the same: parents should be reassured that children are unlikely to be seriously ill with Covid-19 but if they are concerned about their children’s health for any reason, they should seek help from a health professional.”

To stop the spread of coronavirus, health bosses say that parents should encourage thorough handwashing, throwing tissues straight in the bin and avoiding people who are ill.

The best way to protect yourself is to wash your hands with soap and water for the time it takes to sing Happy Birthday twice.

Happy Birthday takes about 20 seconds to sing twice and is said to be the perfect number to clean your hands to thoroughly

Is skipping meals a sign of coronavirus in children?

Skipping meals could be a new coronavirus warning sign to look out for in children, experts have warned.
experts have warned that the main symptoms in children could differ from adults – including a loss of appetite.
Tim Spector, professor of genetic epidemiology at King’s College London said children are suffering from around five symptoms that are not consistent with those adults are experiencing.
Speaking on BBC Inside Science, Prof Spector said that data from the Covid Symptom Tracker App has revealed that the top five symptoms in children aged under 18 who tested positive for Covid are headaches, fatigue, fever, sore throat and skipping meals.
He said: “These are different from the top five we see in adults which includes generally the cough and the shortness of breath and the loss of smell.
“That’s really important to realise – skipping meals and fatigue are really important, as are headaches.”
Prof Spector said there are currently no clear differences between children in primary school and high school, adding: “We did also pick up skin rashes as quite a common feature in children and they can be as young as babies as well.
“And these rashes can come before any other symptoms, or they can come after other symptoms and that’s increasingly a sign in kids that can’t tell their parents what’s going on.”

Look out for lice

While parents also need to remain vigilant for the virus and other illnesses, experts have also reminded many not to forget the usual issues school children might face, such as contracting head lice.

Many kids would have managed to avoid catching lice while being at home, but this doesn’t mean the pests are gone for good.

Headlice expert, Ian Burgess, working on behalf of Hedrin, says: “Those who may usually be at risk but without a current outbreak of lice were protected during lockdown, but for those who struggle with regular infestations and find it hard to eradicate the problem, it is likely that those children will continue in the same way and may exacerbate outbreaks.

“The back to school season is always a common time for parents to worry about head lice as regular head-to-head contact makes them easy to pass on when children meet their friends again. I know parents will likely have so many things on their minds at the moment, perhaps more than the usual back to school period, but I would recommend being prepared before school starts so at the first sign of lice, it can be nipped in the bud with effective treatment”.

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