Kids usually display milder symptoms of COVID-19 than adults, but severe complications are also possible—and happen more often than you think. Here's what parents need to know.

At the beginning of the coronavirus pandemic back in 2020, every parent was terrified by the prospect of their children developing COVID-19. (Raise your hand if you cleaned all your groceries with Clorox wipes and banned all playdates for, well, forever.) We didn't know anything about the virus at that time, but over the following months a bit of news filtered out: Kids were far less likely to get the coronavirus, and even if they did, it wouldn't make them as sick as it did adults. We were grateful for this miracle.

Was that news untrue? Not entirely, researchers say: Children do have a propensity to handle the virus better, and their symptoms do tend to be milder than ours. But as new variants of the coronavirus have swept the land, research suggests our kids aren't entirely off the hook. And parents who fail to get their young ones vaccinated or forget that there can be real consequences to COVID-19 exposure are doing themselves and their families a disservice. The battle is not over yet.

Here's something to mull over: Nearly 13.2 million kids have tested positive for COVID-19 since the pandemic started. Incredibly, more than 5 million of those kids were tested in the first half of 2022, proving that the journey continues. Such statistics are a chilling reminder of why we need to take the virus seriously. "While much remains unknown about COVID-19, we do know that the spread among children reflects what is happening in the broader communities," said former American Academy of Pediatrics president Sally Goza, MD, in a press brief last year. In short, if our children get it, so do we.

Back in January 2022, the number of children hitting the ER with the coronavirus hit record highs in nine states. Today, half of those who are hospitalized have no underlying health issues, according to the Centers for Disease Control and Prevention (CDC). Those who currently live with conditions such as diabetes, obesity and asthma are at even greater risk. As this article is being written (in May 2022), pediatric cases of COVID-19 have risen for five straight weeks. Omicron and its subvariant BA.2 are far more transmissible than the delta variant was in 2021, yet people have let their guards down.

Vaccines cut the risk for children who get them, but breakthrough cases do occur and kids can still get sick, or pass the virus on to a grown-up. As one Toronto woman memorably noted to National Geographic in April, the symptoms may be milder when you're vaccinated, but it's still no fun. "When people say 'mild,' they mean you're not dying, like you don't end up in the ICU," said communications strategist Melinda Maldonado, who fell ill when Omicron first hit in December 2021. "For me, this was not mild." And word is, BA.2 is stealthier and more devastating than its predecessor, BA.1.

Kids under 5 are not yet able to get vaccinated, which can be nerve-wracking for parents. Here's what you need to know about what COVID-19 symptoms look like in little ones, and how to avoid the virus.

COVID-19 Symptoms in Kids and Toddlers

The first thing to know is that COVID-19 doesn't look the same for everyone. Many kids experience no symptoms whatsoever, while others get a fleeting illness that resembles the common cold. It's scary to see hospitalization rates climb, but it still remains relatively unusual for most children to go into respiratory distress, or die. Tragically, kids who are Black and Hispanic are disproportionately more likely to contract the virus and to develop the rare, related condition MIS-C (Multisystem Inflammatory System in Children); they make up 57 percent of all MIS-C cases.

Unvaccinated children are most at risk for hospitalization (their odds tend to be at least twice that of a vaccinated child), and as variants evolve at lightning speed, they make up the bulk of those with serious complications. Despite that, many parents have not gotten their kids age 5 to 11 vaccinated; fewer than 30 percent had their shots as of May 2022, compared to around 60 percent of kids age 12 to 17. And although Pfizer just introduced a booster for the elementary school crowd, if grown-ups are anything to go by, uptake on that will be slow (50 percent of adults haven't gotten their booster shots yet).

With so many unvaccinated kids running around, it's important to know what the current symptoms of COVID-19 can look like. In general, they appear within 2 to 14 days of exposure, and may include:

  • Fever 
  • Cough
  • Runny nose or congestion
  • Sore throat
  • Gastrointestinal issues (such as nausea, vomiting, or stomachache)
  • Diarrhea
  • Fatigue
  • Headache
  • New loss of taste or smell
  • Shortness of breath 
  • Body aches
  • Poor appetite 

Kids are often asymptomatic, even if they are carrying a high viral load. Fortunately that does not typically translate to them being sicker, but there's still a downside to that: As a study in the Journal of Infectious Diseases points out, we might think they are doing fine, until they infect us.

How long does COVID-19 last in kids? Every little one is different. Most symptomatic children will recover within two weeks, but if they have complications, it could take a little longer to get better. Long-haul COVID that sticks around for weeks or months has also been reported in kids. 

little girl in her mother's arms at breakfast table
Credit: Westend61/Getty Images

How Often Do Kids Have COVID-19 Complications?

Here's some good news. Despite the recent rise in hospitalizations, state records suggest that individuals under 18 are less than 1.5 percent of those who enter the hospital with COVID-19, and comprise less than .30 percent of deaths due to the virus. Kids can and do get very sick, and some experience serious complications, but U.S. researchers believe BA.2 does not cause more severe symptoms than its predecessors, despite being infinitely more transmissible. (One thing to be aware of, however: Researchers in Hong Kong are already sounding an alarm on a new strain, BA.2.2.)

Babies under the age of 1 are typically at higher risk of developing intense symptoms when they contract the coronavirus, according to the Mayo Clinic. Parents with toddlers and young kids need to remember, though, that the virus does not discriminate, so it's impossible to tell who will become really ill, or end up on a ventilator. COVID-19 protocols should always be on your radar if your child has congenital heart disease, chronic lung disease, or any of the other health issues mentioned above.

As noted, the coronavirus can (rarely) lead to MIS-C, which resembles Kawasaki disease. Symptoms include fever, rash, abdominal pain, vomiting, diarrhea, bloodshot eyes, fatigue, and neck pain. As of May 2022, 8,210 children have developed MIS-C, and 68 have died. Beyond that, evidence that children will suffer any aftereffects of COVID-19 (what's known as long-haul COVID) is fairly limited.

Why is COVID-19 Less Likely in Children and Toddlers?

There are a few theories within the medical community.

#1: Kids have a different physical response to it. Studies show that children are far better than adults at mounting "robust, cross-reactive and sustained immune responses" to the coronavirus. This may be due to their bodies' constant exposure to viruses that give you the common cold, including milder forms of coronavirus. Their immune systems are "considerably stronger" than ours where pathogens are concerned, points out K.C. Rondello, M.D., a clinical associate professor at the College of Nursing and Public Health at Adelphi University. In his estimation, it could be "immunological cross-protection."

#2: Kids have fewer preexisting conditions than we do. "The death rate for COVID-19 is higher among individuals with certain pre-existing conditions, such as cardiovascular disease, diabetes, and cancer," says Aimee Ferraro, Ph.D., a professor of public health at Walden University. "This may help explain why many children seem to be at lower risk, since they are less likely to have these types of preexisting conditions." Few children die from COVID-19 (1,230 as of May 2022), but the majority of those who did suffer from at least one underlying health issue.

#3: Experts might not be identifying all COVID-19 cases. Robert Frenck, M.D., director of The Gamble Vaccine Research Center at Cincinnati Children's Hospital, says that a reporting bias might be to blame. It's possible that many children with mild or asymptomatic cases of the virus were never tested for coronavirus, and that it could still be happening—which means the virus might attack more kids than believed. Poor reporting could have skewed our perception of reality.

No matter what's behind this apparent trend for kids, they may actually have more protection from COVID-19 since Omicron. In an April 2022 study from CDC researchers (not yet peer-reviewed), blood samples suggested that 68 percent of kids age 1 through 4 have already caught the coronavirus, along with 77 percent of kids age 5 through 11, and 74 percent of those age 12 to 17. Omicron was so transmissible that infections doubled in that first age group from December 2021 to February 2021 alone. The antibodies it created may defend children against future variants.

How to Prevent and Treat COVID-19 in Children

Before you do anything else, check your community's transmission level here. The CDC advises parents to make sure kids over age 2 are wearing masks indoors in public settings with high transmission levels. If children are unvaccinated, it's wise to have them wear masks and socially distance in areas of moderate transmission, too, or when in a packed, poorly ventilated area.

Like the cold and flu, the coronavirus is a respiratory illness that spreads through contaminated droplets. These then enter the body through the eyes, nose, and mouth, says Miryam Wahrman, Ph.D, director of the microbiology research lab at William Paterson University and author of The Hand Book: Surviving in a Germ-Filled World. Airborne transmission is also possible. So even as the rest of the world relaxes into the idea that the pandemic is over, remember how much kids love to lick and grab everything around them, then touch their faces. They're not exactly risk-averse.

If your child begins showing symptoms of COVID-19, or you think they've been seriously exposed to someone with the coronavirus, get them tested immediately. They will need to quarantine with any unvaccinated or symptomatic members of the household until you receive the test results (which won't take long thanks to the new free self-tests). If they test positive, have them isolate at home for at least 5 days. Give them their own bedroom and bathroom, if possible, and take other measures to contain the illness. Learn more about caring for someone with the coronavirus here.

Seek medical help immediately if your child has difficulty breathing, chest pain, confusion, an inability to stay awake, changing skin color (especially if it looks pale, blue, or gray), or other worrisome symptoms. Chances are good that if your kids get COVID, they are going to be just fine.

Check the Centers for Disease Control and Prevention (CDC) website for up-to-date information on coronavirus statistics, COVID-19 news, and travel advisories.