COVID-19 and children: Answers from a Boston Children’s Hospital expert

Child's hand drawing question marks on a chalkboard
Many parents have questions about how COVID-19 could affect their kids. (Adobe Stock)

Parents around the world have been glued to news outlets for the past few weeks, looking for information about COVID-19 and how it might affect their kids. Although early reports from China indicated that most children and teens infected with COVID-19 only had mild to moderate symptoms, many parents are still understandably nervous about how COVID-19 might affect their families — especially those who have kids with underlying health conditions.

Now that there have been several published studies and reports about how kids and teens have responded to COVID-19 infection, we sat down with Dr. Kristin Moffitt, an infectious disease specialist at Boston Children’s to talk about what the literature has shown so far.

Where are these studies and observations coming from?

Most of the data are coming from Wuhan, China, where the outbreak originated, but we also now have some data from Italy and Seattle and other areas in the U.S. with high rates of transmission.

Are these sources reliable?

Yes. The reports have been published in several reputable medical journals, and have been peer-reviewed. This means they were carefully vetted by other experts in the field.

What’s the overall outlook for kids in these reports?

So far, across all settings, the majority of cases of COVID-19 infections in kids under 18 have been mild. And the number of kids needs needing hospitalization has been much lower than in adults. Of course, those numbers are changing all the time, but the fact that kids seem to have milder cases of the disease seem to be fairly consistent.

Dr. Moffitt answers more questions about coronavirus and kids, and explains how to talk with your kids about the outbreak.

Are there any groups of children who seem to be more affected by the virus?

In the report from Wuhan, children under age 1 had higher rates of more moderate to severe illness, and were more likely to need hospitalization. This isn’t really that surprising, because it’s not unusual for infants to get sicker from other types of viral infections than school age children and teens. However, the rates of hospitalization even in these very young children were still much lower than for adults.

Did the reports find that children with underlying conditions were at higher risk?

There’s really not enough data yet to say for sure. But as health care providers, we are still operating under the assumption that children with certain types of conditions, such as pulmonary disorders or compromised immune systems, may be at higher risk for severe illness. There’s not enough data to substantiate that yet, but because it’s the case for other types of respiratory viral infections, it may well be true for coronavirus.

What can parents of high-risk kids do to protect them?

We’re still largely referring to recommendations to prevent the spread of illness from the Centers for Disease Control and Prevention (CDC) for guidance. This includes recommendations for careful hand hygiene and staying home as much as possible to avoid contact with people who may be infected. Families should also communicate any concerns about their children with that child’s medical providers.

Do you have any other advice for parents?

I think it’s important to remember that no one is invulnerable to infection. Even though the data we have so far indicate that most children have mild symptoms, it’s still important to protect them from infection, and help limit the rates of illness in everyone.

This can be hard for kids to grasp, especially if they’re too young to understand how badly this infection can affect other people, or for older kids who may think that because it doesn’t affect them so much, why bother doing all this. So I think it’s important to explain that we’re trying to reduce the global incidence and flatten the curve for everyone.

Read about current research and learn more about COVID-19.

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