What if I test positive for COVID?

COVID-19 Illness in Children

Before we discuss the questions that come with learning your child tested positive for COVID-19, we want to offer some reassurance.    Time and again we have seen children with COVID-19 illness presenting with mild symptoms, not causing complications, severe illness, or long-term effects.  This does not mean we take the illness lightly, as we know that severe cases can and do exist.  Though this is the case, the grand majority of children seen in our office with COVID-19 illness have had mild illness and will do well.  We will now discuss quarantine, symptomatic care, and future sports participation.

Quarantine:

The CDC recommends quarantining from those outside the household for at least 10 days.  Additional quarantine guidelines are based on whether your child had symptoms of illness or tested positive for COVID without having any symptoms.  If your child:

• had any symptoms of illness: He/she should quarantine until 24 hours without fever, respiratory symptoms are improved, AND it has been 10 days since symptoms first began.
• had NO SYMPTOMS of illness: He/she should quarantine until 10 days since testing positive

To return to school, repeat testing to prove a negative test, is not recommended.  Positive test results can be present for 3 months after infection.  This does not mean that the individual is still contagious.  He/she can leave quarantine as described in the appropriate scenarios above.  

Symptoms and symptomatic care

Symptoms of COVID-19 illness in children can vary greatly and can include no symptoms or symptoms of any or all of the following:  fever, runny nose, nasal congestion, cough, diarrhea, headache, sore throat, fatigue, vomiting, muscle aches, and/or loss of taste and smell.  Symptoms vary greatly from child to child. 

Symptomatic care and what to watch for:

Unfortunately, there are currently no FDA approved treatment options for COVID-19 in children.  That being said, children typically recover well, without complications, with the supportive care measures we recommend with any viral illness.    Supportive measures include increased rest, adequate hydration, and good nutrition with lots of fruits and vegetables.  Additionally, there are medication suggestions found on our blog  www.pediatricassociates.net/blog/caring-for-your-childs-cold.

Please call our office if you are not seeing slow, steady improvement. Cold symptoms can last for 2 weeks and then a cough can last for 2 additional weeks, but we don’t expect there to be a worsening in these symptoms causing shortness of breath, wheezing, or trouble breathing.  If you are seeing these things, please call.  Also, with COVID we often see fever lasting as long as 5 days.  If your child continues to have good energy and is in good spirits despite temperature up to 102°F, not treating the fever with Ibuprofen or Acetaminophen is a good thing, as it allows their body to fight the virus.  If fever resolves for a full 24 hours without medication and then returns to a number over 100.4°F, please let us know.  This could simply be the sign of another virus sneaking in while fighting COVID but could also indicate a secondary bacterial infection such as an ear infection. 

Return to sports participation

As you have likely read online or heard in the news, COVID-19 illness can be associated with a heart condition called myocarditis.  Though myocarditis is much less commonly observed in children than it is in adults, its consequences can be devastating.  For this reason, we follow  guidelines from the American College of Cardiology and the American Academy of Pediatrics to help us determine when and if a child needs screening for this condition before being cleared to return to contact sports participation. 

Here’s what you need to know:

• All children/teens should be asymptomatic for at least 2 weeks before returning to exercise or sports participation
• After this 2 week period, we’d like to see your child to discuss sports participation. The exception to this rule is if the child/teen has had a well-child exam in our office since they were diagnosed with and recovered from COVID-19 illness, and their COVID-19 illness was classified as mild (A mild case of COVID-19 illness is one where either there were no symptoms or symptoms were mild, including fever for 3 days or less, muscle aches for less than 1 week, and chills and decreased energy for less than 1 week).
• When returning to exercise, we recommend a gradual return to exercise progression. If your child reports any shortness of breath that is out of proportion from his/her baseline, chest pain, the feeling of abnormal heart beats, or passing out, they should stop exercise immediately and call our office

Additional information about returning to sports after COVID-19 illness can be found on our blog: www.pediatricassociates.net/blog/returning-to-sports-after-covid-19-illness