This document provides information on considerations for COVID-19 in children. It discusses COVID-19 facts such as transmission and signs/symptoms. Children of all ages can be infected, though cases are usually less severe than adults. Hospitalization is most common for those under 1 year old or with underlying conditions. Risk factors, diagnosis, management for outpatient and inpatient cases, prevention methods, and psychological support are also outlined.

1. Prepared By: Lizza M. Llaguno, RN
Reviewed By: Dr. David Hali De Jesus,
RN,PGDIP, FISQUA
UNITE AGAINST
COVID-19
Considerations in Children

2. DISCLOSURE
I have no relevant conflict of interest to
disclose

3. LEARNING OBJECTIVES
To give awareness about:
• COVID-19 Facts
• Signs and Symptoms
• COVID-19 in Children
• Risk Factors
• Approach to Diagnosis
• Management
• Prevention
• Psychological Support

4. COVID-19 FACTS
• Coronavirus Disease
2019 is an infectious
disease caused by
severe acute
respiratory syndrome
coronavirus 2 (SARS-
CoV 2).
• First identified last
December 2019 in
Wuhan China and
spread globally
resulting in an ongoing
pandemic.

5. COVID-19 FACTS
• The virus is mainly
transmitted through
droplets generated
when an infected
person coughs, sneezes
or exhales.
• A person can be infected
through breathing of the
virus if within close
proximity with a COVID-
19 person, touching a
contaminated surface
and then to the mouth,
eyes and nose.

6. SIGNS & SYMPTOMS

7. • Children of all ages can get COVID-19, though cases
may be less severe compared to adults.
• Almost 1-5% of COVID-19 patients accounted for
children between 0-14 age group.
COVID-19 in CHILDREN

8. • Few pediatric
COVID-19 cases
were hospitalized.
• Hospitalization
was most common
to pediatric
patients aged <1
year and those
with underlying
conditions.
COVID-19 in CHILDREN

9. COVID-19 in CHILDREN
• It is unknown whether the
SARS-CoV-2 can be
transmitted through breast
milk.
• Droplet transmission could
occur through close contact
during breast feeding.
• No cases of intrauterine
transmission of the virus were
documented.

10. COVID-19 in CHILDREN
• A new emerging pediatric
multisystem inflammatory
syndrome that is
potentially associated with
COVID-19 was reported.
• With same clinical
features to those with
toxic shock syndrome,
kawasaki disease
(persistent fever,
abdominal pain,
gastrointestinal symptoms
and cardiac inflammation.

11. Most commonly reported in children with
underlying conditions:
• Chronic pulmonary disease
(moderate to severe asthma)
• Cardiovascular Disease
• Immunosuppression (cancer,
chemotherapy, hematopoietic cell or
organ transplant, high doses of
glucocorticoids)
RISK FACTORS

12. • Chronic Kidney Disease undergoing
dialysis
• Chronic liver disease (chronic
hepatitis)
• Endocrine disorders (Diabetes
Mellitus
• Severe obesity
RISK FACTORS

13. • Certain criteria and
guidance for testing COVID-
19 in children varies among
countries.
• For laboratory tests, CDC
recommends collecting one
specimen samples each
through nasopharyngeal
and oropharyngeal swab, to
be collected by a health
professional.
APPROACH TO DIAGNOSIS

14. MANAGEMENT
OUTPATIENT
Children with
mild
symptoms
Focus on
prevention of
transmission to
others
Can be manage at
home unless when
they have other
chronic conditions
that risk of severe
diseases
Monitoring of
clinical
deterioration and
supportive care

15. Monitoring for clinical deterioration
OBSERVE FOR:
MANAGEMENT
Difficulty of
Breathing
Chest pain or
pressure
Blue lips or
face
Cold,
clammy,
mottled skin
Confusion or
difficulty
arousing
Decreased
urine output

16. SUPPORTIVE CARE:
MANAGEMENT
FEVER
• Paracetamol
• Ibuprofen
NASAL
SYMPTOMS
• Nasal suction
• Saline nasal
drops, spray
or irrigation
• Adequate
hydration
• Cool mist
humidifier
COUGH
• Oral
hydration
• Warm fluids
(tea or soup)
• Honey
• Cough
lozenges

17. MANAGEMENT
INPATIENT
Children
with severe
or critical
cases
Supportive
care (oxygen
or ventilator
support)
Require
hospital
admission
Fluid and
electrolyte
support

18. PREVENTION
HYGIENE
• Frequent hand washing with soap, hand rub using
alcohol-based sanitizers and virucidal hand
treatments .
• Avoid touching MOUTH, EYES and NOSE (MEN)
DISINFECTANTS
• Use phenol or alcohol (lysol) to decontaminate
environmental surfaces.
SOCIAL DISTANCING
• Avoid going outside if not necessary and crowded
places
• If going outside be sure to wear mask properly and
observe distant meter to other people

19. PSYCHOLOGICAL SUPPORT
• Respond to children’s
reaction in a supportive way
and explain to them
appropriately.
• Listen to their concerns and
take time to comfort them
and give them affection
• Reassure them that they
are safe and praise them
frequently.
• Create opportunities for
children to play and relax.

20. PSYCHOLOGICAL SUPPORT
• Keep regular routines and
schedules as much as
possible, especially before they
go to sleep.
• Provide age appropriate facts
about what is happening,
explain to them what is going
on and give them clear
examples on what they can do
to protect themselves and
others from infection.
• Share information about what
could happen in a reassuring
way.

21. REFERENCES
• www.cdc.gov.ph.com
• www.who.int.com
• www.uptodate.com
• www.healthychildren.org