Should Kids and Babies Get Tested for Coronavirus?
We asked infectious disease and pediatric experts what parents need to know about coronavirus testing for children, including what tests are available right now for kids, who should get tested, and where testing is available.
The coronavirus has taken a massive toll on citizens around the world. And children, like adults, have been infected with COVID-19. As scary as the facts can be, babies and kids that have been diagnosed with the virus often recover well. "Children with COVID-19 have generally presented mild symptoms and have improved quickly," says Bessey Geevarghese, D.O., pediatric infectious disease expert at Ann & Robert H Lurie Children's Hospital of Chicago.
But as we all know now, even if symptoms are mild for some, COVID-19 can be easily spread and symptoms could be far more serious for others. So as social distancing rules begin to change and the country heads toward reopening, should your child be tested for the coronavirus?
"It is recommended that only symptomatic patients be tested. This includes any pediatric patient with COVID-19 consistent symptoms—fever, shortness of breath, cough," says Dr. Geevarghese. But ultimately, it's a decision that parents will make with the guidance of their pediatrician, and even if your child is symptomatic, he or she still may not require an official test. "Parents should talk to their pediatricians to decide if and where testing should happen," says Dr. Geevarghese. "You and your provider should partner on this decision."
With that said, recommendations for testing babies, children, and adults are changing every month, and there may be a time where testing of kids will be more available and standards will change. Here's everything parents should know right now when it comes to keeping your loved ones—and other families—safe.
Should Kids With No Symptoms Ever Be Tested for COVID-19?
If your child has symptoms and also has other underlying medical conditions, you should also consider testing. "Children that are immunocompromised or have underlying medical conditions (asthma, heart conditions) may need to get tested as they are at risk for more severe illness," says Dr. Geevarghese.
However, there are times when a test may be necessary without symptoms. "There are some exceptions wherein patients without the characteristic signs and symptoms of COVID-19 may be tested, such as prior to surgery or prior to hospital admission," says Gary Procop, M.D., director of Molecular Microbiology, Mycology, Parasitology, and Virology Laboratories at Cleveland Clinic.
Mike Patrick, M.D., emergency medicine physician and general pediatrician at Nationwide Children's Hospital in Columbus, Ohio adds, "Recommendations for COVID-19 testing depend on the unique circumstances of a particular child and family. Symptoms, medical history, sick contacts, and close proximity to high-risk individuals all play a role in making these decisions."
Should Babies Get Tested for COVID-19?
According to the Centers for Disease Control and Prevention (CDC), testing is recommended for all babies born to mothers with suspected or confirmed cases of COVID-19. The testing should happen at about 24 hours of age, even if the baby doesn't show any symptoms of the virus. Otherwise, COVID-19 testing for babies should happen on a case-by-case basis—the same way it happens with older children.
How Do They Test for Coronavirus in Kids and Babies?
Currently there are no children-specific coronavirus tests being administered; rather there are two testing options available for both kids and adults. "The most common test that is available for pediatric patients is a nasopharyngeal swab (long Q-tip)," says Dr. Geevarghese. "This swab is placed deeply into both nostrils to allow the swab to collect secretions." The nasal swab test is called polymerase chain reaction (PCR) diagnostic testing for COVID-19.
The second test option available right now looks for antibodies against the virus, and depending on the types of antibodies found, they could indicate a current or past infection. But since it's still unknown if the presence of antibodies gives a person immunity against future infection, children and adults may still be at risk for future COVID-19 infection even if antibodies are present, explains Dr. Patrick. Antibody testing also isn't recommended for babies with suspected COVID cases after birth.
And keep in mind: Getting tested doesn't necessarily guarantee a definite answer if your child has the coronavirus. "COVID-19 tests can have false-positive or false-negative results, so these tests are only one piece of data available to your doctor. Exposure history and the timing and character of symptoms are also important in making a clinical diagnosis and coming up with a treatment plan," says Dr. Patrick." Therefore, it is important for parents to partner with their child's doctor as together they look at the big picture and decide what is going on."
Where to Get Children Tested for Coronavirus
While the decision to get tested is usually made with your child's pediatrician, the test itself will likely not happen in their office. "At this time, testing of children is quite dependent on your area's capacity to perform a test and the amount of infection in the region. If testing supplies are limited, then most testing is reserved for people who are at risk for severe disease or people who are having severe symptoms," says Frank Esper, M.D., pediatric infectious disease expert at Cleveland Clinic Children's. "However, children who are being admitted to the hospital are generally being screened if they have symptoms concerning coronavirus."
This is because most pediatric offices are currently not equipped to do testing. "Currently, most pediatric offices do not have the available resources to run tests for COVID-19. However, many can obtain swabs and send them to an appropriate lab," says Dr. Patrick. "Other offices may refer families to local facilities that can obtain and run the various tests."
The Bottom Line
"Testing for COVID-19 is not necessary for children who have no symptoms and no known contact with someone who has tested positive," says Dr. Patrick. And most children who get COVID-19 will be able to recover at home and will not need any testing, adds Dr. Geevarghese. "Oftentimes, your pediatrician may be able to have a telemedicine visit with you and your child and can help decide."