If your child is showing symptoms of COVID-19, the most important first steps are to test them, keep them home, manage their comfort, and watch for any signs that need medical attention. Most children with COVID-19 recover at home within a week or two with basic supportive care. Here’s exactly what to do and what to watch for.
Test Right Away
If your child has symptoms like fever, cough, sore throat, runny nose, body aches, or fatigue, use an at-home rapid antigen test immediately. A positive result is reliable, but a negative result isn’t always accurate, especially early in the illness. If that first test comes back negative and your child still has symptoms, test again 48 hours later. This second test catches infections that hadn’t built up enough virus to detect on the first try.
Knowing whether it’s COVID-19 versus another respiratory virus helps you make informed decisions, especially if anyone in your household is at higher risk for complications. It also helps your child’s school or daycare track what’s circulating.
Keep Them Home and Comfortable
Your child should stay home from school, daycare, and activities while they’re symptomatic. The CDC recommends children remain home until they’ve been fever-free for at least 24 hours without using fever-reducing medication. Once that threshold is met and symptoms are improving, they can typically return to school.
While they’re sick, focus on three things: fever management, hydration, and rest.
For fever and pain, acetaminophen (Tylenol) can be given every 4 to 6 hours as needed, up to 5 times in 24 hours. Ibuprofen (Advil, Motrin) can be given every 6 to 8 hours, up to 4 times daily. Always dose by your child’s weight, not their age. Acetaminophen should not be given to infants under 8 weeks old, and ibuprofen should not be given to infants under 6 months old. If you’re unsure about the right dose, your pharmacist or pediatrician’s office can walk you through it quickly.
Watch for Dehydration
Sick children often don’t feel like eating or drinking, and fever increases fluid loss. Dehydration can sneak up fast, especially in younger kids. Offer small, frequent sips of water, an electrolyte drink, or even popsicles if they’re refusing liquids.
Mild dehydration looks like increased thirst and slightly less urination than normal. If your child progresses to having a dry mouth, sunken eyes, little or no urine output, or noticeable lethargy, that’s moderate dehydration and worth a call to your pediatrician. In infants, a sunken soft spot on the head is another sign to take seriously. Severe dehydration causes rapid breathing, cool or mottled skin, and extreme drowsiness or unresponsiveness. That’s an emergency.
Know the Emergency Warning Signs
Most children handle COVID-19 well, but certain symptoms require immediate emergency care. Take your child to the ER or call 911 if they:
- Have trouble breathing or are breathing unusually fast
- Have persistent pain or pressure in their chest
- Seem suddenly confused
- Can’t stay awake or won’t wake up from sleep
- Develop a bluish color to their lips or face
These signs can indicate that the infection is affecting their lungs or oxygen levels in a way that needs professional intervention right away.
Children With Underlying Health Conditions
Some children are at higher risk for severe COVID-19 outcomes. Conditions that increase risk include obesity, diabetes, heart conditions, lung diseases like asthma, neurologic disorders, and complex medical conditions requiring multiple specialists. If your child falls into any of these categories and starts showing COVID symptoms, contact their doctor early rather than waiting to see how things develop. They may qualify for treatments that work best when started soon after symptoms begin.
Protecting the Rest of Your Household
If possible, have your sick child stay in one room as much as they can, using a separate bathroom if one is available. Everyone in the house should wash hands frequently, especially before eating and after any contact with the sick child. Hand sanitizer works well between washes.
If someone in your household is especially vulnerable (elderly, immunocompromised, or pregnant), consider having them stay with a friend or family member until the illness passes. That’s the single most effective measure. If that’s not possible, masking helps. Everyone should wear a mask when in shared spaces, including the sick child if they’re old enough. Even with masks, limit shared time: no eating meals together in the same room, and minimize face-to-face conversations. Keeping windows open or running a fan to improve airflow makes a meaningful difference in reducing how much virus lingers in the air.
Watch for Complications in the Weeks After
A rare but serious condition called Multisystem Inflammatory Syndrome in Children (MIS-C) can develop weeks after a COVID-19 infection, even if the initial illness was mild. MIS-C causes widespread inflammation throughout the body and tends to show up as a combination of symptoms that look different from the original infection.
The hallmark signs are a persistent fever along with some combination of abdominal pain, vomiting, diarrhea, skin rash, and red eyes. Some children develop neck pain or headaches. In more severe cases, children can become lightheaded or lethargic, which may signal low blood pressure. The abdominal symptoms can be intense enough to mimic appendicitis.
MIS-C is uncommon, but it requires hospital treatment. If your child develops a new fever with any of these symptoms in the two to six weeks following a COVID infection, contact your pediatrician promptly. With timely treatment, most children with MIS-C recover fully.
When to Call Your Pediatrician
You don’t need to rush to the doctor for every COVID case, but certain situations warrant a call. Reach out if your child’s fever lasts more than a few days, if they’re refusing fluids, if symptoms seem to be getting worse rather than better after the first several days, or if you’re simply unsure whether what you’re seeing is normal. A quick phone or telehealth visit can give you peace of mind and catch anything that needs closer attention before it becomes urgent.