The 'Runny Nose' Test For Covid In Kids: What Parents Need To Know

Some assume that sniffing and sneezing is probably just a cold – but how accurate is it?
HuffPost UK

We’ve all heard of the ‘runny nose test’ – that if your child is sniffing and sneezing, the likelihood is that it’s just a cold and not coronavirus.

And now that the weather has changed and autumn is drawing in – not to mention the return to school after six months of homeschooling – we’re likely to find ourselves drowning in a sea of snotty tissues. Grim.

But how accurate is the ‘runny nose test’ and when should you worry about keeping your kids at home, self-isolating, or getting them tested for Covid-19?

Tim Spector, professor of genetic epidemiology at King’s College London, who helped to developed the Covid Symptom Study App believes children with a runny nose and no other symptoms do not have coronavirus – and should not get tested. The government states: “Your child does not need a test if they have a runny nose, are sneezing or feeling unwell but do not have a temperature, cough or loss of, or change in, sense of smell or taste.”

Spector said children under the age of 18 show different symptoms to adults – and even if they’re coughing, they’re far more likely to have a common cold. “Kids really don’t seem to lose that sense of smell and they also don’t seem to get the cough and shortness of breath as much either,” he told The Telegraph. “So it’s a different picture at different age groups.”

He said over the next few weeks, while the system is stretched, parents should think carefully about whether it’s appropriate to burden the NHS by getting their child a test. “By all means keep your kid at home, but don’t rush around the country trying to get a test for something that is highly likely to be a cold and not Covid,” he told BBC Radio 4’s Today programme.

So, a runny nose and a cold means your child doesn’t have coronavirus? Well, Margaret McCartney, a GP, told BBC Radio 4 it isn’t this simple – because a child can have both.

She referenced a study published in the BMJ that looked at 651 children under 19 admitted to hospital with Covid-19. The most common symptom in kids was a fever, and then a cough – but there were lots of other symptoms too, one of which was a runny nose.

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Another study published from Belfast looked at the children of healthcare workers and found almost 7% of children had positive antibodies to Covid-19. Within them, half had no symptoms at all and a third had a fever.

“They didn’t find that a runny nose was more likely with Covid,” said McCartney, “but a few children that had Covid-19 did have these symptoms at some point. So it wasn’t a good symptom to tell who had Covid-19 and who didn’t. You could get a runny nose both with Covid-19 and without.”

This means having a runny nose doesn’t mean it can’t be coronavirus. “There are no absolutes in medicine,” said McCartney, adding that there are no symptoms that can distinguish clearly between a normal cold in children and coronavirus. In the previous study mentioned, she said 12% of kids who had a runny nose also had Covid-19.

She added that the vast majority of kids with a runny nose won’t have Covid-19 because it’s so rare in children – but it’s not a good enough test to know between them, “so we can’t go on statistics alone”.

McCartney encouraged parents to go by the government advice: get a test for your child if they’ve got one of the three symptoms: a fever; a new, continuous cough; or a change in their taste or sense of smell.

Speaking to HuffPost UK, A&E doctor Dr Sarah Williams, agreed: “Parents only need to take their children for a Covid test if they have a cough, fever, loss of taste or smell. If they have a runny nose without any of those key symptoms, definitely not. A child may have a cold, but they could also have Covid-19, and therefore present with more symptoms. If you don’t test for it, there’s no way to rule it out.”

McCartney added that parents should avoid sending their children to school or nursery anyway if they’re ill and it’s understandable that parents want to be cautious about sending them back until they’re properly recovered.

What are the most common symptoms of Covid-19 in kids?

According to the Covid Symptom Study app, more than half (52%) of school-aged children who tested positive for Covid-19 don’t report any of the classic ‘adult’ symptoms we’re used to looking out for – such as a cough, fever, or loss of smell or taste – in the week before and after the test.

A third (33%) of children who tested positive for Covid-19 never experienced any of the 20 symptoms listed in the app, which suggests that many children are asymptomatic.

Here are the most common signs of Covid-19 in children, according to the Covid Symptom Study app:

Signs of coronavirus in children

  • Fatigue (55%)

  • Headache (53%)

  • Fever (49%)

  • Sore throat (38%)

  • Loss of appetite (35%)

  • Skin rash (15%).

And here’s how they compare to the symptoms experienced by adults who tested positive for coronavirus.

Signs of coronavirus in adults

  • Fatigue (87%)

  • Headache (72%)

  • Loss of smell (60%)

  • Persistent cough (54%)

  • Sore throat (49%).