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Infectious Diseases

COVID in kids: symptoms, warning signs, treatment and MIS-C

COVID is a respiratory virus that most children get over at home in several days. A few, mostly those with certain health conditions, need medicine or hospital care, and a rare inflammatory illness called MIS-C can follow weeks later.

Does my child with COVID need a doctor now? →Study the COVID-19 in children flashcards →
COVID-19 in children — trackerFlu, COVID-19 & RSVMIS-CFever: When to Call the DoctorBack to School or Child Care?

At a glance

  • Symptoms start 2 to 14 days after contact and look much like flu, RSV or a cold.
  • A new loss of taste or smell points to COVID, but only a test can confirm it.
  • Call 911 for trouble breathing, chest pain that will not go away, new confusion or gray or blue lips.
  • Higher-risk children may get medicine; Paxlovid (age 12 and up) must start within 5 days.
  • Back to school after 24 hours without fever (no fever medicine) and with symptoms improving.
  • MIS-C is rare: lasting fever plus belly pain, rash or red eyes 2 to 6 weeks after COVID.
  • The AAP recommends the COVID vaccine for all children 6 to 23 months old and for higher-risk older children.

COVID symptoms in children

Children with COVID may have a fever, cough, stuffy or runny nose, sore throat, body aches, headache or tiredness.

Some have nausea, vomiting or diarrhea, and some feel short of breath.

  • Flu, RSV, COVID and colds look alike, and a child can have two of these viruses at once.
  • A home test helps, but an early negative result can miss COVID, so follow the kit's instructions on testing again.

COVID, flu or RSV?

COVID
  • Starts 2 to 14 days after contact
  • May bring loss of taste or smell
Flu
  • Starts 1 to 4 days after contact
  • Sudden fever, chills and body aches
RSV
  • Most likely to cause labored breathing
  • Wheeze and hard breathing, worst on days 3 to 5
Clues from the AAP. Symptoms overlap a lot, so a test is the only way to know.

COVID warning signs: when to get help

  • Call 911 or your local emergency number for trouble breathing, chest pain or pressure that does not go away, new confusion, trouble staying awake, or pale, gray or blue lips, skin or nail beds.
  • Call the doctor now for fast breathing, flaring nostrils, grunting or the chest caving in with each breath.
  • Call the same day for poor drinking, signs of dehydration, vomiting for more than 24 hours or bloody diarrhea.
  • Call for a fever above 104°F (40°C) at any age, or 100.4°F (38°C) or higher in a baby under 3 months.
  • Call if your child seems very ill or drowsy, or is getting worse after starting to recover.

COVID in a child: when to get help

  1. Call 911 nowTrouble breathing, chest pain that stays, new confusion, hard to wake, gray or blue lips.
  2. Call the doctor nowFast or hard breathing, a baby under 3 months with 100.4°F (38°C), or MIS-C signs.
  3. Call todayHigher-risk child with symptoms, poor drinking, vomiting over 24 hours, fever above 104°F (40°C).
  4. Care at homeDrinking well, breathing easily, alert: rest, fluids, stay home until fever-free.

Treatment: who needs COVID medicine

  • Most children need only rest, fluids and fever medicine; antibiotics do not treat COVID.
  • Antiviral medicine is for children at higher risk of severe illness, such as those with a weak immune system or certain long-term conditions.
  • Paxlovid is taken by mouth at home by children 12 and older and must start within 5 days of the first symptom.
  • Remdesivir can be used in younger children; it is given into a vein for 3 days in a row, starting within 7 days of symptoms.
  • If your child is higher risk, call at the first symptoms; the doctor can start treatment without waiting for a positive test.

Home care, staying home and going back

  • Offer plenty of fluids and rest, and use acetaminophen or ibuprofen at the right dose for fever or aches.
  • While sick, keep your child home and away from others, including family members who are well.
  • Return to school or child care once 24 hours have passed with no fever, without fever medicine, and symptoms are getting better.
  • For the next 5 days, take extra care: wash hands, cover coughs, consider a mask and keep distance from high-risk people.
  • Never give aspirin to children with a viral illness.

COVID in a child: key time points

  1. 2–14 days after contactSymptoms begin; test and keep your child home.
  2. First 5 daysWindow for medicine in higher-risk children; call early.
  3. Fever gone 24 hoursBack to school if symptoms are improving; extra care for the next 5 days.
  4. 2–6 weeks laterWatch for lasting fever with belly pain, rash or red eyes (MIS-C).
Time points from CDC and the AAP. Warning signs need action on any day.

MIS-C: a rare problem weeks after COVID

MIS-C (multisystem inflammatory syndrome in children) causes swelling and irritation in organs such as the heart, gut, skin and eyes.

It usually shows up 2 to 6 weeks after a COVID infection, even a mild one or one nobody noticed.

  • Call the doctor right away for a fever lasting 24 hours or more plus two or more of: belly pain, vomiting, diarrhea, rash, red eyes, or dizziness.
  • MIS-C is treated in the hospital, sometimes in intensive care, with medicines that calm the inflammation.

COVID vaccine for children

  • The AAP recommends the COVID vaccine for every child 6 through 23 months old unless there is a medical reason not to.
  • It is also recommended for children 2 to 18 years with conditions that raise their risk, a weak immune system, a high-risk household member, or no past COVID vaccine.
  • Healthy children 2 to 18 years can get a single dose if their family wants it.
  • The vaccine is updated for the strains going around, and it can be given with the flu vaccine. Ask your child's doctor about this season's vaccine.

Common questions

How can I tell if my child has COVID or the flu?

You usually cannot by symptoms alone. A test tells them apart, and the doctor can order one when it changes treatment.

When can my child go back to school after COVID?

When a full day has passed without fever or fever medicine and your child is feeling better. Some schools have their own rules, so check with yours.

Can children take Paxlovid?

Yes, from age 12, when the child is at higher risk of severe illness. Younger high-risk children may be offered remdesivir instead.

What are the signs of MIS-C after COVID?

A fever that will not quit, together with stomach trouble, rash, bloodshot eyes or lightheadedness, some weeks after infection. It is rare but needs a doctor quickly.

Should my baby get the COVID vaccine?

The AAP advises it for babies and toddlers aged 6 to 23 months, because this age group gets sicker from COVID. Your child's doctor can tell you how many doses are needed.

Sources

Written for Pedemy in our own words from the sources above; checked October 2026. For education only, not medical advice. Pedemy is independent and not affiliated with or endorsed by the organizations cited.

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