Coronavirus Symptoms in Kids: What is PMIS?

young girl looking out the window; Coronavirus Symptoms in Kids: What is PMIS?

For most children, COVID-19 symptoms are mild. Children are far less likely to be hospitalized with the coronavirus than adults. Sachin Nunnewar, MD, UnityPoint Health, explains the symptoms in children, the science behind them and the latest regarding a new syndrome called Pediatric Multisystem Inflammatory Syndrome, or PMIS.

What Are Coronavirus Symptoms in Kids?

Children who contract COVID-19 usually develop flu-like symptoms such as fever, cough, runny nose, muscle pain, fatigue, sore throat or headache. 

“Many children have mild or undetected cases of the disease and could be spreading the virus to others in their families and communities, Dr. Nunnewar says. “However, serious illness from COVID-19 is possible, and parents should stay alert if their child is diagnosed with, or shows signs of, the disease.”

It is especially important to keep an eye on young children less than one-year old, and children with underlying medical conditions such as cancer, congenital heart disease, asthma and those with weakened immune systems. 

Why are Children Less Impacted by COVID-19 Than Adults?

Can children get coronavirus? Dr. Nunnewar says, “Scientists are exploring several theories about why children seem relatively protected from severe coronavirus disease. Many researchers think it might have to do with a receptor in human cells that viral particles bind to, called the ACE-2 receptor. Coronavirus attaches to this receptor and enters the cell, then replicates and spreads in the body. In kids, this ACE-2 receptor is not expressed as prominently as adults, so the virus might have more difficulty attaching to and entering cells.”

What is Pediatric Multisystem Inflammatory Syndrome?

Since the coronavirus pandemic began, most infected children haven’t developed serious respiratory failure symptoms, like adults. But in recent weeks, a mysterious new syndrome started showing up in connection to children who’ve contracted COVID-19 in the New York City area and other parts of the world – like the United Kingdom and Spain. Dr. Nunnewar says it might be an indication that the risk to children is greater than once thought.

“This new inflammatory syndrome has symptoms which overlap with Kawasaki disease and Toxic Shock Syndrome. This syndrome may occur a few days to weeks after acute COVID-19 illness. It can include persistent high fever of over 102 degrees, conjunctivitis (pink eye), lymph node swelling, abdominal pain, vomiting, diarrhea, rash on palms and hands (symptoms like Kawasaki Disease) and very low blood pressure (symptom of Toxic Shock Syndrome) requiring admission to intensive care. These kids are tested for COVID-19 and some test positive. In kids who tested negative, a few of them show presence of the antibody to COVID-19. Again, the new information around this syndrome is evolving every day, so it’s best for all parents to stay up to date,” Dr. Nunnewar says.

What Are Ways to Talk to Your Child About Coronavirus?

It’s always best to remain calm and manage your anxiety first. 

“Our children look up to us in order to learn how they should be handling moments of stress and uncertainty. Managing adaptive coping strategies during these times helps children see firsthand how to manage anxiety and fear. Take the time to check in with yourself before doing so with your children,” Dr. Nunnewar says.

Make sure to arm yourself with reliable resources to answer their questions – such as the Centers for Disease Control and Prevention (CDC), World Health Organization (WHO) and state health departments. It is important to note the developmental age of your children. Instead of giving out too much information at once, ask them open questions such as:

  • What do you know about the virus?
  • What are you afraid of?
  • What can I do to help?

Focus on being reassuring and let them know there are scientists fighting this virus. Keep the conversation on a positive note and focus on telling your children what they can do to help – like washing their hands. It is OK to admit when you don’t know an answer to their question.  

Overall, don’t be afraid to seek advice. If you notice any regressions, including persistent problems with sleep, changes in eating habits or difficulty concentrating on typical tasks, or if your kids have a persistent sense of hopelessness, excessive sadness or overwhelming worry, contact your child’s doctor or a mental health professional for advice.

Find seven additional strategies to help reduce anxiety and stress in children.

What Are Ways to Protect Kids from Coronavirus?

Children, like all people, are exposed to COVID-19 when the virus comes into contact with their eyes, nose, mouth or lungs. This usually occurs when a nearby infected person talks, coughs or sneezes, which releases respiratory droplets into the air and onto the child’s face or nearby surfaces such as tables, food or hands.

The best way to prevent children from becoming sick with COVID-19 is to avoid the virus. 

  • Stay Away From Crowds. Keep kids away from crowded areas when possible.
  • Avoid Sick People. Keeping kids at least six feet from anyone with a cough or fever, including family members.
  • Keep Things Clean. Wipe down toys and surfaces your child touches regularly.
  • Teach Handwashing Skills. Focus on handwashing after using the bathroom, before eating and after sneezing or coughing.
  • Talk About Face Touching. Ask children to avoid touching their face. Carrying a toy can help keep their hands busy. Just remember to wash the toy regularly.
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