COVID-19 Diagnosed or Suspected

COVID-19 Infection: What You Should Know 

• You or your child have been diagnosed as having COVID-19 by a positive test OR
• You or your doctor suspect COVID-19 because you have developed symptoms that match (cough, sore throat, headache and/or fever).
• Get a COVID-19 test if you have COVID-19 symptoms or had possible exposure. See Testing, below.
• Most infections are mild, especially in children.
• Here’s some care advice to help the sick person feel better.

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. 
• Treat the symptoms that are bothering you or your child the most.
• Antiviral treatments have been developed for patients who are high risk for complications. They work best when taken early. Check with your doctor for the most current information. 
• Antibiotics are not helpful for viral infections.
• Steroids should only be used for people with breathing problems that need hospitalization. Steroids can suppress the immune system.
• 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.

Fever Treatment

• For fever above 102 F (39 C), you may use acetaminophen or ibuprofen if the patient is uncomfortable. 
• 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. For children younger than 6 months, only give formula or breastmilk. Staying well-hydrated helps the body sweat and give off heat.

Cough Treatment

• 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.
  • Don’t use OTC cough medicines under 6 years of age. Reason: cough is a protective reflex.
• Adults:
  • 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

• COVID-19 often causes a sore throat. Here are some tips on treating it:
• 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.
• Adults: 
  • 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.
• 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.

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.

Headache

• COVID-19 can cause a headache.
• Pain medicine: 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 or taste can be an early symptom of COVID-19.
• In most patients, these senses return within days to weeks.
• In some patients, the return can take several months.

Home Isolation Questions: 

• The CDC recently loosened their recommendations in August 2022. Even though the pandemic is not over, it is no longer as big a threat to our daily lives. COVID-19 will stay with us. People will be making their own choices about levels of risk and protecting those around us.
• Home Isolation for at least 5 days is recommended for those who are sick.
  • Isolation means separating sick people with a contagious disease from people who are not sick (CDC). That means stay at home. 
  • The sick person with a positive lab test 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 wear a mask when around others. 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.
• You can end home isolation after 5 days if there is no fever for 24 hours and you not taking fever-reducing medicine.
• After those first 5 days of home isolation, when out you should wear a mask through day 10 unless you have 2 negative COVID-19 tests taken 2 days apart.

COVID-19 Testing – When and Where:

• If COVID-19 is suspected, get a test to know for sure. You can’t tell by symptoms. Reason: most respiratory viruses cause similar symptoms.
• It is easiest to test at home using a COVID-19 test kit (rapid antigen) . Free kits can be ordered to have on hand using this link: https://www.covid.gov/tests. These kits are also available at most pharmacies and grocery stores. Testing is offered at many sites without a doctor’s order. Many doctor’s offices, retail clinics, and urgent care centers offer testing. Community drive-through sites or pharmacies may also be testing site options.
• Your doctor is the best resource for up-to-date information on testing. If you have testing questions, call during office hours.
• Here are some facts that may answer some of your questions:
• Diagnostic Tests: these are performed on nasal or mouth secretions. The test can tell us if you have a COVID-19 infection now. Timing is important on when to do this test:
  • With Symptoms. Get a test within 1 to 2 days of onset of symptoms. If you test negative and continue to have cold-like symptoms, re-test on day 3.
  • Without Symptoms and with a COVID-19 close contact. You can get a test on day 3 to 5 after exposure. 
• Repeat diagnostic tests: after a positive test, repeat tests are not recommended. Positive tests are reliable. Even after it is safe to stop isolation (currently 5 days), tests may stay positive. A positive test does not mean the patient can spread the infection once the required isolation period is completed. After a negative home test, if you have symptoms, retest at home in 2 days. 
• Antibody Tests: these are performed on blood. They are rarely needed and not currently very helpful. They can sometimes tell us if you have antibodies from a previous infection. They are not done until at least 2 to 3 weeks have passed from the start of the infection. Talk with your doctor if you have questions about this test.

How to Protect Others – When You or Your Child are Sick:

• Stay home from school or work if you are sick. Don’t go to stores, restaurants, places of worship or other public places. Avoid public transportation or ride sharing. Leave the house only if you need to seek medical care. 
• You are most contagious (able to spread the virus to others) during the first 5 days. No visitors. Do not allow any visitors, even friends.
• 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 well-fitting face mask when around others or you have go to a medical facility.
• Always wear a face mask if you have to leave your home (such as going to a medical facility). 
• Avoid contact with the elderly and people with weak immune systems or other chronic health problems.

Call or Contact Your Doctor If:

• Trouble breathing occurs
• You think you or your child need to be seen
• Symptoms become worse

Author: Barton Schmitt, MD, FAAP
Copyright 2022. Updated 8/27/2022
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.