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What Does COVID-19 (Coronavirus) Mean for Children with Cancer or Other Illnesses?

What Is COVID-19?

COVID-19 stands for coronavirus disease 2019. It is a respiratory infection that is passed from person to person. A respiratory infection is an illness that affects the nose, throat, airways, or lungs. Most people with COVID-19 have mild symptoms, similar to a cold or the flu, but some people can develop more serious problems like pneumonia.

Coronaviruses are a large family of viruses that are common throughout the world. The virus that causes COVID-19 is a new type of coronavirus. The official name of the virus is SARS-CoV-2.

When person who has the virus coughs or sneezes, respiratory droplets can land in the mouths or noses of people who are nearby. Droplets from a sneeze can travel up to 6 feet.

When person who has the virus coughs or sneezes, respiratory droplets can land in the mouths or noses of people who are nearby. Droplets from a sneeze can travel up to 6 feet.

How Does COVID-19 Spread?

COVID-19 can spread from close contact with an infected person. When an infected person coughs or sneezes, respiratory droplets can land in the mouths or noses of people who are nearby or may possibly be inhaled into the lungs.

The virus may also be spread when a person touches a surface with the virus and then touches their eyes, nose, or mouth. The virus may live on surfaces for a few days.

Who Can Get COVID-19?

Anyone can get COVID-19. The illness is spread person-to-person. In other words, anyone can develop COVID-19 after coming in close contact with someone infected with the virus. The virus may also be spread when a person touches a surface with the virus and then touches their eyes, nose, or mouth.

Primary symptoms of COVID-19 include fever, cough, runny nose, shortness of breath, and sore throat.

Primary symptoms of COVID-19 include fever, cough, runny nose, shortness of breath, and sore throat.

What Are the Symptoms of COVID-19?

COVID-19 is a respiratory illness (like a cold or the flu) caused by a virus. Symptoms of COVID-19 include fever, cough, chills, shortness of breath, body aches, runny nose, and loss of the sense of smell or taste. Symptoms usually develop 2-12 days after exposure to the virus.

Most people with COVID-19 have mild symptoms. Some people may have the virus and not show any symptoms at all.

In some cases, people with COVID-19 become very ill. COVID-19 can cause pneumonia, severe breathing problems, and even death. Warning signs of severe illness are:

  • Shortness of breath or problems breathing
  • Chest pain or pressure
  • Blue color of lips or face
  • Confusion
  • Decreased alertness or loss of consciousness

Are Children at Higher Risk for COVID-19?

No. Overall, children seem to be at lower risk for serious illness due to COVID-19. This does not mean that children don’t get COVID-19. But the risk of severe illness in children is generally lower.

In most cases, the highest risk for complications with COVID-19 is seen in older adults and patients with chronic health problems such as heart disease, diabetes, lung problems, or people with weak immune systems.

Families with children who have weakened immune systems due to an illness or medical condition should take extra care to prevent exposure to the virus. If symptoms develop, contact your doctor right away.

Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19

In very rare cases, children may develop a serious inflammatory syndrome associated with COVID-19. This condition is known as multisystem inflammatory syndrome in children (MIS-C). MIS-C is similar to Kawasaki disease. This syndrome occurs in some children who had a previous coronavirus infection. Children may develop the syndrome even if they did not have noticeable symptoms of COVID-19.

Signs and Symptoms of Multisystem Inflammatory Syndrome in Children

Signs and symptoms of pediatric multisystem inflammatory syndrome include:

  • fever lasting at least 24 hours
  • abdominal pain, diarrhea, or vomiting
  • irritability, sluggishness
  • swollen lymph nodes
  • skin rash, eye redness, red color of the lips or tongue
  • swollen hands and feet

Inflammation is a part of the normal immune response. In this syndrome, it appears that there is an overactivation of the immune system. It is not known exactly why this occurs. However, children’s immune systems are naturally on alert and ready to fight new infections. If the immune response continues too long, it can cause inflammation and affect the blood vessels in many organs including the heart and kidneys.

Although the syndrome is very rare, MIS-C can damage the heart, kidneys, and other organs. The condition can be life-threatening, and prompt medical care is needed. Call your pediatrician immediately if you suspect MIS-C or observe any of its features, which develop weeks after the infection.

 

Are Cancer Patients at Higher Risk for Serious Illness?

Cancer and cancer treatments can weaken the immune system. This means that a child with cancer is often at higher risk for infection and illness.

In general, cancer can lower immunity and make it harder to fight infection in different ways:

  • The cancer or cancer treatment can lower the number of immune cells that attack germs.
  • Cancer treatments, including radiation and certain medicines, may weaken the skin or membranes lining the mouth and digestive tract. This can allow some kinds of germs to enter the body more easily. We don’t yet know if this affects risk in COVID-19.

Pediatric cancer patients with COVID-19 continue to do relatively well. But it’s possible that more severe illness could occur, so close observation is needed.

COVID-19 and Delayed Medical Care

A new and important concern, raised in the last few weeks by the American Academy of Pediatrics and World Health Organization, is that families may be reluctant to take their child to the doctor because of COVID-19. Parents may wait to see the doctor until symptoms worsen and health problems are more serious.

In the case of children with cancer, case reports from Europe and now recently in the US suggest that this may be leading to a delay in cancer diagnoses. A delay in diagnosis could result in more advanced cancer that is harder to treat.

It is important to have regular check-ups and vaccinations and seek medical care as needed. Always talk to your health care provider about any signs and symptoms that worry you.

 

What Should I Do if My Child Is Immunocompromised?

If your child has a weak immune system or chronic health condition, it is important to plan ahead and take steps to prevent illness.

  • Talk to your doctor about the risk of COVID-19 and your child’s individual health needs.
  • Know what to do if symptoms develop. Call ahead before going to the doctor except in an emergency.
  • Make sure you have extra medicines and medical supplies on hand in case you must stay home due to an outbreak or quarantine. Talk to your doctor about options to get medicines such as shipping to your home.
  • Ask your doctor about any upcoming medical visits and if they should be postponed. Your doctor may recommend waiting on some types of appointments if they can be delayed.
  • Limit exposure by avoiding travel, crowds, public places, and contact with people, especially those who may be sick. This is called social distancing or physical distancing.
  • Watch for symptoms.
  • Know warning signs that require emergency care.
Wear a mask or face covering as your doctor recommends. If your child is immunocompromised, ask your care team about the type of mask needed and instructions for use.

Wear a mask or face covering as your doctor recommends. If your child is immunocompromised, ask your care team about the type of mask needed and instructions for use.

Simple Ways to Help Prevent COVID-19

Other ways to protect yourself and others from illness include:

  • Wash your hands often, especially after being in public places. Wash your hands after every time you cough, sneeze or blow your nose. Use soap and water, and scrub for at least 20 seconds.
  • If you don’t have access to soap and water, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry.
  • Avoid touching your face, mouth, nose, and eyes.
  • Avoid close contact (within about 6 feet) with people as much as possible. COVID-19 is spread through droplets from a person’s sneeze or cough.
  • Cover coughs and sneezes and then wash your hands right away.
  • Wear a mask or face covering as your doctor recommends. If your child is immunocompromised, ask your care team about the type of mask needed and instructions for use.
  • Clean and disinfect surfaces that are touched often.
  • Don't spray household disinfectants on people or pets. Know what to do if a family member has symptoms and how to care for someone with COVID-19 at home.
Handwashing: Protect yourself and others from getting sick. Wash for 20 seconds. 1) Water and Soap. 2) Palm to palm. 3) Between fingers. 4) Thumbs 5) Back of hands 6) Wrists.
To prevent the spread of COVID-19, cleaning Hands with Alcohol-Based Hand Sanitizer. Steps include: 1) Choose a hand sanitizer that contains at least 60% alcohol. 2) Apply hand sanitizer to the palm of one hand. Use enough to cover all surfaces of hands and fingers. 3) Rub hands together covering all surfaces, until hands are dry. Note: If hands are visibly dirty, wash them with soap and water.
Simple ways to stay health include: Washing your hands with soap and water for at least 20 seconds. Avoid touching your eyes, nose, and mouth. Cover your cough or sneeze with a tissue, then throw the tissue in the trash. Avoid close contact with large crowds of people and people who are sick. Clean and disinfect frequently touched objects and surfaces. Call your primary care team when you are sick.

More Information about Coronavirus and COVID-19

"Learn about the Coronavirus" Coloring Book

Download and print this coloring book for children. They can read about the coronavirus and COVID-19 and color the pages.

"Learn about the Coronavirus" Coloring Book
Download the Coronavirus Coloring Book

“Learn about the Coronavirus” Activity Book

Download and print this coloring book for older children. They can read about the coronavirus and COVID-19, color some pages, and work word puzzles.

“Learn about the Coronavirus” Activity Book
Download the Coronavirus Activity Book


Reviewed: June 2020