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  • Worried About Your Child's Fever Or Cough? How Doctors Will Determine If He Has COVID-19

    These guidelines can give you an idea of what to expect when you see your doctor.
    by Kitty Elicay .
Worried About Your Child's Fever Or Cough? How Doctors Will Determine If He Has COVID-19
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  • No parent wants their kids to suffer from the coronavirus disease 2019 (COVID-19). The good news is that in the majority of confirmed cases, children only exhibit milder symptoms or none at all. (Click here for a list of symptoms of COVID-19 in children.)

    “Hindi sila nababalita na grabe ang epekto,” shared Dr. Anna Ong-Lim, a pediatric infectious disease specialist in an interview with CNN Philippines. “Kung meron man, ubo, sipon, at pangkaraniwang trangkaso ang nakikita natin sa bata.”

    The Philippine Pediatric Society (PPS) and Pediatric Infectious Disease Society of the Philippines (PIDSP) recently came out with updated guidelines on how to properly assess and treat children with suspected or confirmed COVID-19. While these guidelines are intended for pediatricians, general and family practitioners,  and  other  healthcare professionals, it may also be helpful for parents so they know what signs to look out for in their kids and how they can properly manage the illness at home if it does not require hospitalization.

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    Symptoms of COVID-19 in children

    According to the guidelines, the first step for doctors is to investigate whether your child has had any symptoms of influenza-like illness (ILI) — sudden onset of a fever higher than 38 degrees Celsius, and cough or sore throat. They will also determine if your child has symptoms similar to Severe Acute Respiratory Infection (SARI) and if it occurred within the last seven days.

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    Symptoms frequently seen in children with COVID-19 include:

    • fever with an axillary temperature of 38 degrees Celsius and above
    • cough
    • sore throat
    • difficulty breathing (fast breathing, chest indrawing, noisy breathing in a calm child)

    Other symptoms that may also be present (and will need close observation) include:

    • rhinorrhea (runny nose)
    • diarrhea
    • vomiting
    • abdominal pain
    • fatigue
    • headache
    • rashes
    • myalgia (muscle pain)
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    How pediatricians determine a suspect COVID-19 case in children

    After evaluating the symptoms, the child’s travel history or history of close contact must also be observed. This includes close contact with sick individuals or suspect, probable, or positive COVID-19 patients, whether from home or during travel.

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    Close contact is defined as interacting with a confirmed or probable case within two days before or up to 14 days since their symptoms began, including:

    • Face-to-face contact with a COVID-19 patient within 1 meter and for more than 15 minutes
    • Providing direct care for patients with COVID-19 without using proper personal protective equipment
    • Staying in the same close environment as a COVID-19 patient (i.e. staying in the same household, sharing a workplace, classroom, or being in the same gathering) for any amount of time
    • Traveling in close proximity (within 1 meter) with a COVID-19 patient
    • Other situations, as indicated by local risk assessments

    The PPS and PIDSP note that “exposure to a patient who is still being investigated for COVID-19 is not considered close contact.”

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    Classification of suspect COVID-19 cases in children

    If a child is considered a suspect COVID-19 case, they can be classified as either a suspect COVID-19 case with severe/critical symptoms or suspect COVID-19 case with non-severe symptoms.

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    Suspect COVID-19 case with severe and critical symptoms present the following:

    1. Any child with cough or difficulty breathing plus at least one of the following

    • Central cyanosis (blue discoloration on the tongue and lips)
    • Severe respiratory distress (e.g. grunting, very severe chest indrawing)
    • Signs of pneumonia with a general danger sign: inability to breastfeed or drink, lethargy or movement only when stimulated, unconsciousness, or convulsions
    • Chest indrawing and fast breathing

    2. Any child with suspected or proven infection and more than 2 symptoms falling under the SIRS criteria, of which one must be abnormal temperature or white blood cell count (sepsis)

    3. Any child presenting with septic shock

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    Suspect COVID-19 case with non-severe symptoms presents the following:

    Mild symptoms:

    • Uncomplicated respiratory tract viral infection
    • Non-specific symptoms such as fever, fatigue, cough, anorexia, malaise, muscle pain, sore throat, dyspnea, nasal congestion, or headache
    • In rare cases, Diarrhea, nausea, and vomiting

    Moderate symptoms

    • Frequent fever
    • Frequent cough (mostly dry which may become productive)
    • Wheezing but no obvious shortness of breath

    If you are worried about your child's symptoms, these guidelines can give you an idea of what to expect when you see your doctor, but remember that it should not replace a consultation with your doctor. It is best to call or schedule a visit with a health professional if your child falls sick. (Read the full guidelines from the PPS and PIDSP here.)

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    The DOH now provides free telemedicine consultations for all COVID-19-related medical advice and non-COVID-19 health-related concerns. Call their 24/7 hotline at +632 894-26843 (COVID) or click here for more information. For free medical consultation from pedias, ob-gyns, and more, click here.

    For the latest news and updates on COVID-19, check out reportr.world/covid-19.

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