Current thinking on preventing/reducing covid symptoms, esp. children.

February 9, 2023 1:04 PM

Child (9) just tested positive, with strong fever and headache for the last 15 hours. Parents feeling fine and testing negative. There is a lot of information, but I am tired of wading through the wrong information, and wondering what's new.

Specifically:
1) How much fever/pain merits a Dr.'s visit for the kid?
2) Anything else besides rest, fresh air, fluids, healthy food to help the kid specifically?
3) Anything we parents can do besides masking, ventilation to reduce risk of infection (maybe too late) or at least severity? We are both double boosted, last shot about 4 months ago. Vitamin D?
I remember some recent threads here that address some of this but can't find them. Links to helpful info would be more than enough.
Thanks in advance.

posted by melamakarona to Health & Fitness (11 answers total)

The standard recommendation for pain and fever relief (at least from the UK's NHS) is to alternate Paracetamol and Ibuprofen every two hours (assuming the dosage instructions say every 4 hours for each).
posted by pipeski at 2:31 PM on February 9, 2023

Nitric oxide nasal spray if you can get it. Available through Amazon in US, not sure about UK.
posted by Dashy at 2:37 PM on February 9, 2023 [1 favorite]

Not sure if it’s recommended for children but my husband was prescribed Paxlovid via a telehealth appointment the day his test came back positive. I think there is a window you are supposed to take it during (within 24 hours of a positive test maybe). He ended up not taking it because he’d read info about rebound COVID.

My teenage son and I didn’t get sick. Basically, my husband was confined to a bedroom and had his own bathroom. Anytime he exited the bedroom he wore a mask. If he came out without a mask while we were at work/school then he’s open all the windows and air out the house for 1-2 hours before we came home. We did that for 10 days just to be safe. He was really miserable (fever, headache, cough/congestion fatigue) for about 3 days and then started to improve every day. He still has a mild cough a month later.
posted by victoriab at 4:20 PM on February 9, 2023 [1 favorite]

Paxlovid is not approved for children.
posted by potrzebie at 4:35 PM on February 9, 2023 [1 favorite]

This article in The Lancet talks about nitric oxide spray but mentions that the control group used a saline nasal spray that used benzalkonium chloride as a preservative. Apparently benzalkonium chloride has some virucidal properties, so it wouldn’t hurt to use it if the kid can handle stuff going up their nose.
posted by corey flood at 5:01 PM on February 9, 2023

Paxlovid's window in the US is five days, also. Not that this helps much for you, but it might help others.

I'd say that it doesn't hurt to reach out to your practice by phone if your kid is not happy, and it sounds like you're in that place, depending on what tomorrow brings. The receptionist will have some idea of what to do - I'm sure they've had a lot of practice - and there's a good chance your doctor will talk on the phone rather than bringing in a contagious patient if a conversation is warranted.
posted by How much is that froggie in the window at 9:41 PM on February 9, 2023

There's research supporting the idea that nasal (even saline) rinses shorten the course of COVID and that mouthwash with CPC as a main ingredient kills covid (presumably helping them to some degree rid their body of it sooner and or perhaps reducing the risk of transmission). I see people claiming that the more someone rests during the acute infection, the lower the long term risk, but I don't know if there's science behind it.
posted by slidell at 9:54 PM on February 9, 2023 [1 favorite]

Anything we parents can do besides masking, ventilation to reduce risk of infection (maybe too late)

Don't shrug and give up on masking/ventilation/isolation (to the extent that isolation can happen with children) just because you were already exposed. Infection isn't automatic and limiting your exposure limits your chance of catching it also. This is just anecdotal, but we just had close family go through this, and despite both people being fully exposed and living in a fairly small house with poor ventilation, once the first person starting having symptoms and tested positive, they switched to masks/isolation indoors (to the extent possible in a small house), and the second person never caught it.
posted by Dip Flash at 6:34 AM on February 10, 2023 [1 favorite]

Paxlovid is approved in children above the age of 12. But it’s almost certainly not worth it unless they are severely immunocompromised. The main outcome was hospitalization and death both of which are very rare in children. And the main group it was tested in was adults who were NOT vaccinated. It was a different strain (pre-omicron, so more severe).

I hadn’t seen the evidence of Nitric Oxide nasal spray, but a similar RCT showed benefit for nasal irrigation like a Neti pot (which is what I did with my kids). It purportedly reduces duration if symptoms and viral shedding.

The best thing you can realistically do is help them stay well hydrated and well rested. Tylenol for fever and headache can help (but fever may actually assist with clearance of the virus), ibuprofen for aches and pains. In general, as an Emergency Medicine physician, I only treat my kid’s fevers if they are miserable, not eating or not sleeping. Otherwise I leave them alone.

Ventilation and masking to reduce likelihood of transmission. I don’t think they recommend Evusheld anymore either (which had previously helped).
posted by ghostpony at 10:27 AM on February 10, 2023

Oh and with regards to when to go to the doctor: generally, if they aren’t eating, drinking, peeing or pooping it strongly suggests they may be dehydrated and warrant an exam. Or that something else warrants treatment. If it’s just fever and headache but well controlled with meds, I would seek evaluation on day 4 or 5 of fever if refractory. This can help to rule out concomitant lt infections like bacterial pneumonia which would require treatment. Generally they look sicker and your spider senses will suggest something is wrong.
posted by ghostpony at 10:30 AM on February 10, 2023 [1 favorite]

I'd consider calling my doctor to see if they have any recommendations. I hope your child recovers quickly.
posted by theora55 at 11:24 AM on February 10, 2023