Author: Barton Schmitt, MD, FAAP
Copyright: Copyright 2020. Updated 7/27/2020
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
COVID-19 Infection: What You Should Know
- You or your child have been diagnosed as probably having COVID-19 OR
- You or your doctor suspect COVID-19 because it is widespread in your community and you have (or your child has) developed symptoms that match (cough, fever or others).
- You (or your child) probably did not receive a lab test for COVID-19. It doesn’t matter.
- The most common symptoms are cough, fever and trouble breathing.
- Other common symptoms are chills, shivering (shaking), sore throat, muscle pain, headache and loss of smell or taste.
- The CDC also includes the following less-common symptoms: runny nose, fatigue (tiredness), nausea, vomiting and diarrhea.
- Most infections are mild, especially in children.
Treatment of Symptoms
- The treatment is the same whether you have COVID-19, influenza or some other respiratory virus.
- The only difference for COVID-19 is you need to stay on home isolation until you recover. Reason: You want to protect other people from getting it. The elderly and people with serious health problems can die from COVID-19.
- Treat the symptoms that are bothering you or your child the most.
- There is no anti-viral medicine for treating COVID-19 at home. New antiviral treatments have been developed for patients who need to be hospitalized. Most are given by the vein (IV).
- Antibiotics are not helpful for viral infections.
- You don’t need to call or see your doctor unless you or your child develop trouble breathing or become worse in any other way.
- For fever above 102 F (39 C), you may use acetaminophen or ibuprofen if the patient is uncomfortable. There are no proven reasons to avoid ibuprofen.
- For fevers 100-102 F (37.8 to 39 C), fever medicines are not needed. Reason: fever turns on your body’s immune system. Fever helps fight the infection. Exception: if the patient also has pain, treat it.
- Fluids: offer cool fluids in unlimited amounts. Reason: prevent dehydration. Staying well hydrated helps the body sweat and give off heat.
- Age 3 Months to 1 Year:
- Give warm clear fluids (e.g., apple juice or lemonade) to thin the mucus and relax the airway. Dosage: 1-3 teaspoons (5-15 ml) four times per day.
- If nothing else helps: give a small amount of corn syrup. Dosage: ¼ teaspoon (1 ml). Can give up to 4 times a day when coughing. Caution: avoid honey until 1 year old. Reason: risk for botulism.
- Age 1 Year and Older:
- Use honey, ½ to 1 teaspoon (2 to 5 ml) as needed as a homemade cough medicine. It can thin the secretions and loosen the cough. If honey is not available, can use corn syrup.
- OTC cough syrups containing honey are also available. They are not more effective than plain honey and cost much more per dose.
- Age 6 Years and Older:
- Use cough drops (throat drops) to decrease the tickle in the throat. If not available, can use hard candy.
- Avoid cough drops before 6 years. Reason: risk of choking.
- Over the Counter (OTC) cough medicines are not recommended. Reason: no proven benefit for children. Honey has been shown to work better.
- Never use OTC cough medicines under 6 years of age. Reason: cough is a protective reflex and should not be suppressed.
- Over-the-Counter (OTC) Cough Syrups: some people find that cough syrups help decrease coughing. Dextromethorphan is the most common cough suppressant in OTC cough syrups. Often the letters ‘DM’ appear in the name.
- OTC Cough Drops: cough drops can help a lot. They work best for mild coughs. They soothe the tickling feeling in the back of the throat. Cough drops are easy to carry with you.
- Home Remedy – Hard Candy: hard candy works just as well as OTC cough drops. People who have diabetes should use sugar-free candy.
- Home Remedy – Honey: honey has been shown to help decrease coughing at night. The adult dose is 2 teaspoons (10 mL) at bedtime.
Sore Throat Treatment
- Age over 1 year: Can sip warm fluids such as chicken broth or apple juice. Some children prefer cold foods such as popsicles or ice cream.
- Age over 6 years: Can also suck on hard candy or lollipops. Butterscotch seems to help.
- Age over 8 years: Can also gargle. Use warm water with a little table salt added. A liquid antacid can be added instead of salt. Use Mylanta or the store brand. No prescription is needed.
- Pain medicine: Use if pain interferes with swallowing. Not needed for mild pain.
- Sip warm chicken broth or apple juice.
- Suck on hard candy or a throat lozenge.
- Gargle with warm salt water four times a day.
- Avoid smoking.
- Pain medicine, such as acetaminophen (Tylenol), ibuprofen (Motrin, Advil) or naproxen (Aleve): use if pain interferes with swallowing. Not needed for mild pain.
Muscle Pain Treatment
- COVID-19 can normally cause muscle pains and body aches.
- Massage: Gently massage any sore muscles.
- Stretching: Gently stretch any sore muscles.
- Apply Heat: Use a heat pack, heating pad or warm wet washcloth. Do this for 10 minutes 3 times per day.
- per day.
- Warm bath: For widespread muscle pains, consider a warm bath for 20 minutes 2 times a day. Gently exercise the sore muscles under water.
- Pain medicine: For widespread body aches, give acetaminophen every 4 hours OR ibuprofen every 6 hours as needed. (See Dosage table.) Not needed for mild aches.
- COVID-19 can cause a headache.
- Pain medicine: Give acetaminophen every 4 hours OR ibuprofen every 6 hours as needed. Not needed for mild headaches.
- Cold pack: Apply a cold wet washcloth or cold pack to the forehead for 20 minutes.
- Massage: Stretch and massage any tight neck muscles.
Loss of Smell or Taste
- Losing the sense of smell and taste can be an early symptom of COVID-19.
- Most of these patients have a mild course.
- These senses usually return within 1 to 2 weeks
Fluids – Stay Well-hydrated
- Drink lots of fluids. Water is best.
- Goal: keep the patient well hydrated.
- It loosens up any phlegm in the lungs. Then it’s easier to cough up.
- It helps the body sweat and give off heat.
- MIS-C is a very rare and severe complication associated with COVID-19.
- Symptoms: the most common symptoms are fever, a red rash, abdominal pain and diarrhea or vomiting. Half of the patients develop trouble breathing. Some children become confused or overly sleepy. All patients with this syndrome should be seen by a doctor. Most need to be admitted to the hospital. Some cases are similar to Kawasaki’s Disease (KD).
- Incidence: a very, very rare complication of COVID-19. In general, COVID-19 continues to be a mild disease in most children.
- Onset of symptoms: Usually about 4 weeks after COVID-19 infection and apparent recovery.
- Age: 6 months to 21 years. Peak age 8 years.
- Treatment: MIS-C is treatable with medications, including IV immune serum globulin (ISG). At this time, it cannot be prevented nor predicted.
- If your child gets this rare complication, see a doctor right away.
Call or Contact Your Doctor, If:
- Breathing difficulty occurs
- Symptoms of Multisystem Inflamatory Syndrome appear: fever, a red rash, abdominal pain and diarrhea or vomiting
- You or your child become worse
Home Isolation is Needed for Those who are Sick
- Isolation means separating sick people with a contagious disease from people who are not sick. That means Stay at home.
- The patient needs to stay at home but does not need to be confined to a single room. Preventing spread of respiratory infections within a home is nearly impossible. The sick person should try to avoid very close contact with other family members. That includes hugging, kissing, sitting next to or sleeping in the same bed. None of this is realistic for young children.
- Other family members should also stay at home on quarantine. Living with a suspected COVID-19 patient implies close contact has occurred. Exceptions: Essential workers who have COVID-19 exposure but do not have any symptoms. Talk to your employer.
- Do Not allow any visitors (such as friends).
- Do Not go to school or work.
- Do Not go to stores, restaurants, places of worship or other public places.
- Avoid public transportation or ride sharing.
How to Protect Others – When You/Your Child are Sick
- Stay home from school or work if you are sick. Your doctor or local health department will tell you when it is safe to return.
- Cough and sneeze into your shirt sleeve or inner elbow. Don’t cough into your hand or the air.
- If available, sneeze into a tissue and throw it into a trash can..
- Wash hands often with soap and water. After coughing or sneezing are important times.
- Don’t share glasses, plates or eating utensils.
- Wear a face mask when around others.
- Always wear a face mask (if available) if you have to leave your home (such as going to a medical facility). Always call first to get approval and careful directions.
- Carefully avoid any contact with the elderly and people with weak immune systems or other chronic health problems.
Stopping Home Isolation – Must Meet All 3 Requirements (CDC)
- Fever gone for at least 24 hours after stopping fever-reducing medicines AND
- Cough and other symptoms must be improved AND
- Symptoms started more than 10 days ago.
- Patients with no symptoms (and no symptoms developed): stay at home until 10 days have passed since the date of their positive COVID-19 test.
- If you are unsure it is safe for you to leave isolation, check the CDC website or call your doctor.
COVID-19 Testing – Who Needs It?
- Your doctor is the best resource for up-to-date information on the availability of testing in your community and who needs it. Since testing is not urgent, if you have questions, call during office hours.
- There are 2 types of tests:
- Diagnostic Tests: these are performed on nasal secretions and tell us if you have a COVID-19 infection now.
- Antibody Tests: these are performed on blood and tell us if you have antibodies from a previous infection. They are not done until at least 3 weeks have passed from the start of your infection
- Tests for COVID-19 are mainly done on people who are sick (have symptoms of COVID-19). Tests are usually not done on people who have no symptoms.
- Testing is usually performed on patients who have serious symptoms or are admitted to the hospital. It is usually not done on patients with mild symptoms who don/t need to be seen.
- Testing is also needed on adults who have essential jobs and need to know if they can return to the work force.