Coronavirus disease 2019 (COVID-19) seems to be impacting children at lower rates than adults, and those who contract the virus typically have mild illness.
While information is limited, experts discussed what they know about the impact of the SARS-CoV-2 virus on children and pregnant women during a Centers for Disease Control and Prevention (CDC) webinar Thursday that can be viewed at http://bit.ly/39LFtIl .
Children
Symptoms of COVID-19 in children include fever, cough, congestion, rhinorrhea and sore throat, according to Kate Woodworth, M.D., M.P.H., from the CDC's COVID-19 Response Maternal Child Health Team. Some have reported vomiting and diarrhea.
Testing criteria for children are the same as adults. Clinicians should consider the presence of symptoms, travel history, contact with a confirmed COVID-19 patient and local epidemiology, and should rule out other potential causes of illness.
Dr. Woodworth said the low infection rates among children may be due to having more mild cases that aren't reported. Children also don't have some of the exposures from work, travel and caregiving that adults experience. They typically are exposed by someone in their home.
Transmission is primarily by respiratory droplets. To avoid becoming infected and infecting others, children should wash their hands regularly, cover coughs and sneezes, stay home if they are sick, avoid people who are sick and avoid touching their faces.
Children with mild illness still can transmit the virus to others, and there also have been reports of asymptomatic transmission, according to Dr. Woodworth.
"It's not clear to what extent these cases impact spread, but we don't consider this a significant means of transmission," she said.
Clinicians should provide supportive care to children with COVID-19. No antiviral drugs have been approved for treatment. There are no data on which underlying conditions put children at higher risk of severe disease.
Dr. Woodworth acknowledged children may have anxiety about catching the virus, and the CDC has provided resources on resilience.
"We encourage parents to provide simple information and reassurance, consider monitoring or limiting media exposure, correcting misinformation, trying to keep routines as much as possible and reminding children of the actions they can take to keep themselves and their community safe like handwashing and covering coughs," she said.
For frequently asked questions on children and COVID-19, visit http://bit.ly/2TKcLlg. For information from the AAP about coding for COVID-19 patients, visit http://bit.ly/38MPDaj.
Pregnant women and infants
In general, pregnant women are at increased risk for infection and serious illness due to physiological and immunologic changes in their bodies. While data on COVID-19 are limited, Denise Jamieson, M.D., M.P.H., chair of the Department of Gynecology and Obstetrics at Emory University School of Medicine, said pregnant women should be considered an at-risk group.
Likewise, pregnancy losses have been reported after pregnant women were infected with other coronaviruses, but experts can't say for sure if the same will be true for COVID-19.
Infants born to mothers with COVID-19 should be considered under investigation, and clinicians should consider temporarily separating the mother and infant at birth to avoid transmission, according to Romeo Galang, M.D., M.P.H., from the CDC's COVID-19 Response Clinical Team.
The CDC has posted guidance on infection prevention and control in inpatient obstetric settings at http://bit.ly/2Ih4M8I and also has frequently asked questions about COVID-19 and pregnancy at http://bit.ly/2U4nOF5.
Breastfeeding
COVID-19 has not been detected in breastmilk, according to Dr. Galang. If mothers with COVID-19 are separated from their infants, they should express breastmilk but should wash their hands thoroughly and disinfect the pump and bottles. Someone who is healthy should feed the child.
If an infected mother decides to breastfeed, she should wear a face mask and wash her hands.
For more information about COVID-19 and breastfeeding, visit http://bit.ly/38KvGRr.
AAP president offers advice to pediatricians, parents on COVID-19
Copyright © 2020 American Academy of Pediatrics
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