COVID-19 in children

COVID-19 is the illness caused by the coronavirus SARS-CoV-2. In children it usually runs mildly or with no symptoms at all, but a severe course is possible in some children, and a rare but serious complication — MIS-C — can begin weeks after the infection. This page covers the symptoms, the course, the difference from flu and an ordinary cold, the risk groups, and both “delayed” conditions — MIS-C and long COVID.

Symptoms in children

The most common symptoms of COVID-19 in children are fever and cough. Many children also have a sore throat, a runny nose, a headache, fatigue, shortness of breath, or gastrointestinal signs: nausea, vomiting, loose stools. A new loss of taste or smell is possible. Croup has been reported in some children.

• fever or chills
• cough
• sore throat, a blocked or runny nose
• headache, fatigue, aching muscles
• shortness of breath or difficulty breathing
• nausea, vomiting, loose stools
• a new loss of taste or smell

Symptoms may appear anywhere from 2 to 14 days after contact with the virus — that is the overall range. In studies from the period of Omicron-variant circulation the median incubation period was 3–4 days: a different characteristic — not “the middle of the range” but the typical interval in those particular studies.

How it runs and how long it lasts

Most children get through the infection without symptoms or in a mild form. The illness can start with mild symptoms, and in some children the condition worsens over time — so the child is watched over days, not judged on a single day.

An exact duration of the illness cannot be named in advance for a particular child: the available sources describe a range of courses from mild to severe, not a number of days. The practical benchmark is different: if symptoms are growing, not passing, or the child's condition worries you — that is a reason for an examination, not for waiting out a “due term”.

How COVID-19 differs from flu and an ordinary cold

These are different viruses: COVID-19 is caused by the coronavirus SARS-CoV-2, flu by influenza viruses. Both infections are contagious and affect the airways, and they cannot be told apart by the totality of symptoms — many of the signs are identical. A laboratory test confirms the diagnosis; tests exist that distinguish flu and COVID-19 at the same time.

Incubation period

with flu, symptoms usually appear 1–4 days after infection; with COVID-19, typically 2–5 days, possibly up to 14 days. So with COVID-19 more time can pass from infection to symptoms.

Contagiousness

on current evidence, SARS-CoV-2 spreads more easily than the flu virus, and the contagious period in COVID-19 can be longer.

Individual symptoms

loss of taste or smell is more frequent in COVID-19; vomiting and loose stools are more frequent in children with flu, although they can occur with COVID-19 at any age. None of these signs makes a diagnosis.

From an “ordinary cold”

in a child with a mild course — by nothing except the name of the virus: the same fever, cough and runny nose. The difference shows not in a single symptom but in the risks: a severe course in children from risk groups, and the delayed complications — MIS-C and long COVID, covered below.

Who is at higher risk of a severe course

Most children have a mild illness, but a severe course is possible. The risk is higher in children under one year — babies make up a disproportionate share of severe cases — and in children with obesity, diabetes, heart, lung or nervous-system disease, and in children with complex accompanying conditions. Several accompanying conditions at once raise the risk more strongly than one.

MIS-C: a rare but serious complication

MIS-C (multisystem inflammatory syndrome in children) is a rare but serious complication that can begin weeks after infection with SARS-CoV-2. The infection itself may have passed unnoticed: the child may have caught it from an asymptomatic carrier, and the family sometimes does not know there was an infection at all.

MIS-C usually appears as a fever combined with some of these signs: abdominal pain, vomiting, loose stools, a skin rash, red eyes (conjunctivitis). In severe cases, low blood pressure and shock are possible.

Long COVID in children

Long COVID is a chronic condition that arises after SARS-CoV-2 infection and persists for at least three months; WHO calls it “post COVID-19 condition”. It covers a range of symptoms and conditions that may grow, ease or persist; among the common ones WHO names weakness, shortness of breath, muscle or joint pain and disturbed sleep.

Long COVID can affect anyone who has had the infection, including children. It develops more often after a severe course, but a severe course is not a requirement: it is possible after a mild illness too. No confirming laboratory test exists, and a past positive SARS-CoV-2 test is not required for the diagnosis — the doctor weighs the history and examines the child. If symptoms persist for months after the infection, that is a reason to see a doctor.

Vaccination

Vaccination against COVID-19 reduces the risk of hospitalisation in children and adolescents and reduces the risk of MIS-C. Which vaccines are available in Georgia, from what age and on what schedule — that is a question for the doctor: recommendations change, and this page deliberately carries no product names or schedules. How childhood vaccination is organised in Georgia in general is covered on a separate reference page.

What helps in a mild course

In a mild course, help consists of support: enough to drink, a calm routine, free nasal breathing, and watching the breathing, behaviour and fluid intake. An older child is told why rest is needed; a baby is watched especially closely, because their condition is judged by behaviour and feeding, not by complaints.

What the doctor does

The doctor assesses the general condition, the breathing and the skin, looks for signs of fluid shortage and searches for the source of the infection. At the appointment the blood's oxygen saturation is measured (pulse oximetry) — this is non-invasive and takes less than a minute. Laboratory confirmation of the virus is the doctor's call: with a typical mild course, management is usually determined by how the child is breathing and drinking, not by the name of a virus in a report.

If your child's condition raises questions, book an appointment or an online consultation — and for any of the signs listed in the red-flags block, seek help without delay: in Georgia the emergency number is 112.

This page is for general information only and is not a substitute for a consultation with a doctor. A child's diagnosis and treatment are determined by a doctor during an examination.