Children & COVID-19


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By Dr. Sunil A. Kapoor, Pediatric Lung & Allergy Center

The COVID-19 (Severe Acute Respiratory Syndrome Coronavirus 2) pandemic was identified earlier this year, and there have now been over 14 million cases worldwide, with approximately 25% of them in the United States.

Although the medical community has learned a great deal about it, there are still many unanswered questions, including the impact on children.

What we DO know is:

It has become clear that children do not face the same risk from COVID-19 as adults.
While individuals under the age of 19 represent approximately 10% of the cases in the state of Virginia, they only represent <2% of the individuals requiring hospitalization. As a respiratory specialist, it has been very reassuring to see that children with asthma have not demonstrated any greater likelihood of severe COVID infection. The most common presenting symptoms in children are fever, cough, and runny nose, although many children have been asymptomatic.

The virus is spread primarily via respiratory droplets, and to a likely lesser degree, contact with infected surfaces.
Hand hygiene (frequent hand washing/sanitization), physical distancing, and wearing a mask have been proven to be effective in decreasing the risk of transmission between individuals and within communities. Most documented infections in children have come from infected older family members.

Multisystem Inflammatory Syndrome in Children (MIS-C) is a very rare, but serious complication of COVID in children.
It typically impacts children after an initial COVID infection and can lead to life-threatening complications involving the cardiovascular and other organ systems. While MIS-C is very uncommon, much more needs to be learned about its risk factors and mechanisms.

Children’s mental health has been significantly impacted by COVID.
Anxiety, stress, and depression indices have all increased. Children are navigating new learning models, new rules about interactions with friends and loved ones, and having to adjust to physical isolation. While the presentation of this can be subtle, it is an important consequence of the pandemic.

What we DON’T know is:

• Are there other routes of transmission (airborne) of the virus?
• What is the timeline of a vaccine?
• What degree of protection do you have if you have already been infected with COVID-19?
• Is there a difference between the likelihood of child-to-adult transmission vs. adult-to-child transmission?

What you can do as a parent:

• Encourage and model good handwashing, mask-wearing, and physical distancing practices.
• Discuss the importance of protecting more vulnerable members of your family and community.
• Have age-appropriate discussions with your child about COVID.
• Acknowledge the difficulties and challenges of all the changes we are going through; children are typically more perceptive than we adults give them credit for, and not acknowledging the challenges or our current situation can worsen feelings of stress or anxiety.
• Look closely for signs of COVID in your child — both from physical and mental health standpoints and seek guidance from your health care provider if any are developing.


Fairfax Neonatal Associates’ Pediatric Lung & Allergy Center (PLAC) provides comprehensive care for respiratory, allergic, and immune disorders in children of all ages. The PLAC pediatric specialists partner with patients, families, primary care providers, and other subspecialists to accurately diagnose and develop an individual treatment plan to meet the needs of every child.

Learn more about Dr. Sunil A. Kapoor, this post’s author here, and all of Fairfax Neonatal Associates’ providers here. Connect with Fairfax Neonatal Associates’ Pediatric Lung & Allergy Center online, or by calling your preferred location, including Leesburg, VA (703-289-1410) and Fairfax, VA (703-289-1410).


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