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COVID-19 and kids: What can happen when children get the coronavirus

A rare but sometimes deadly syndrome poses extra risk for COVID's youngest victims.

A boy wears a handmade mask to try to reduce transmission of COVID-19, the disease caused by the coronavirus.

A boy wears a handmade mask to try to reduce transmission of COVID-19, the disease caused by the coronavirus.

Stephen Shankland/CNET
For the most up-to-date news and information about the coronavirus pandemic, visit the WHO and CDC websites.

With school reopenings across the country scheduled to begin, pressing questions still surround the novel coronavirus, including its effects on children. Can kids get sick with COVID-19 or are they "almost immune?" Can they transmit the disease to others? Do some kids get Kawasaki's disease or toxic shock from coronavirus?

Some of the confusion stems from doctors' initial belief that COVID-19 doesn't always affect kids as severely as it strikes adults. But that view was upended by the discovery of an inflammatory condition related to COVID-19 in children that mirrored autoimmune disease symptoms and, in rare cases, could be deadly. The consensus remains that children are less likely to die from the coronavirus than adults are, but that doesn't mean they're in any way immune.

"The idea that COVID-19 is sparing of young people is just false," said Dr. Lawrence C. Kleinman, a medical school professor at Rutgers who coauthored a study on coronavirus in children, speaking to Science Daily. "Parents need to continue to take the virus seriously."

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This article is not intended to serve as medical advice. By drawing on available information from sources such as the US Centers for Disease Control and Prevention and World Health Organization, it examines what experts say about COVID-19 in children, including how sick they can become and how contagious they might be to the adults in their lives. If you're seeking more information about coronavirus testing, here's how to find a testing site near you (you can also use Apple Maps). Here's how to know if you qualify for a test and how to get hold of an at-home test kit

Can children spread coronavirus, even if they're asymptomatic?

July CDC report that examines a coronavirus outbreak at one Georgia summer camp suggests that the coronavirus was able to spread quickly and easily among the nearly 600 children, teens and adults who attended the camp. Of those tested, 76% were positive for the coronavirus. Notably, about 26% of those with coronavirus were asymptomatic.

However, a commentary in the Journal of the American Academy of Pediatrics published in August claims children are far more likely to contract the coronavirus from adults than adults are from children. The authors conclude that children are not significant drivers of coronavirus community spread. "Therefore," the authors write, "consideration should be paid toward strategies that allow schools to remain open, even during periods of COVID-19 spread."

Closed Parks due to Coronavirus

Playgrounds across the country closed in an effort to cut down on transmission of the coronavirus.

Jessica Dolcourt/CNET

Just as there are still many unknowns when it comes to COVID-19, no one can say for sure to what extent children can spread the coronavirus. However, one thing is certain -- they do spread it.

What happens to children who get infected with coronavirus

Fortunately, in the vast majority of pediatric coronavirus cases, the prognosis appears to be very good. It's still believed that most kids don't get as sick as adults with COVID-19 -- in fact, many may show no symptoms at all.

However, a small minority of children with COVID-19 have been found to develop a potentially life-threatening condition called either multisystem inflammatory syndrome in children (aka MIS-C) or pediatric inflammatory multisystem syndrome (aka PIMS).

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What are the symptoms of this rare inflammatory syndrome?

The symptoms reported by patients and doctors vary. Doctors have observed persistent fever, red eyes and skin rash, as well as low blood pressure, inflammation, pale and sometimes blue lips and skin, trouble breathing and lethargy

The most severe reports describe blood clots, chest pain, elevated heart rate and organ failure, including, in extreme cases, cardiac arrest. Children with the illness don't always complain of respiratory problems the way doctors have come to expect from COVID-19 patients. But beyond these and a few other symptoms, doctors concede little else is known for sure about the syndrome. All they say is certain is that it requires immediate medical attention

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This is what survivors say it felt like 

Knowledge about multisystem inflammatory syndrome remains limited, but some children who have recovered have talked to the media about their experiences. 

One teenage boy, speaking to the New York Times in May, described the feeling as "like someone injected you with straight-up fire" during his hospitalization for heart failure.  

A 12-year-old girl told the Washington Post she remembered having "weird" bluish lips and feeling "super tired" before doctors say she went into cardiac arrest.  

Doctors say another 12-year-old girl developed a blood clot that stopped her heart. "It felt like someone was stabbing my leg," she told NBC, who reported that it took 45 minutes of CPR to get it started again. 

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How common is MIS-C/PIMS?

As of mid-July, the CDC reports 342 confirmed cases of MIS-C and six deaths. With total coronavirus infections nearing 20 million worldwide, experts say the illness is still quite rare and that the vast majority of patients have so far responded well to treatment, with most having fully recovered. 

How does coronavirus cause all of those symptoms?

So far no one knows for sure, but some doctors believe it may be some kind of delayed reaction of the child's immune system that's abnormal and unusually aggressive. Doctors speculate that while trying to fight off the virus, children's immune systems overreact and start damaging normal, healthy cells, like those in their organs. They suggest this also could be what leads to the dangerous drop in blood pressure often observed. 

In late May, Dr. Christopher Strother, the director of emergency medicine at Mount Sinai hospital in New York, described the syndrome to the Washington Post as the pediatric version of the cytokine storm phenomenon, an immune reaction in the body that can cause fever, swelling and even organ failure. Some doctors have reported that cytokine storms can also affect adults with COVID-19, The Lancet reported.

If you're worried about in-person classes during the pandemic, here's how to get started home-schooling your kids. School reopenings aren't the only fall tradition at risk of being disrupted by the coronavirus pandemic -- here's how to find out your options for voting in the November election. Finally, there are still some prime vacation days left in the season -- just be sure to practice a lot of caution if you do travel

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.