COVID-19 and Immunocompromised Patients: Guidance for Parents

COVID-19 and Immunocompromised Patients: Guidance for Parents

Toddler washing hands.

COVID-19 is spreading in the United States and it is important for parents and caregivers of immunocompromised children and teens to be diligent about precautions and make some preparations.  

We don’t know enough about COVID-19 to be able to predict the impact it will have on kids long-term. We have even less information about how it impacts kids who have compromised immune systems. The limited pediatric data we do have, shows that most children have done well

While there is much we are still looking to understand, we know, with certainty, the best defense we have is in limiting the spread of the illness. 

What does that look like for families who have someone at home whose immune system is compromised? 

First and foremost, practice consistent, quality hand-washing. Every person in your home should be washing hands for at least 20 seconds, with soap and warm water. Wash after using the restroom, before eating, as soon as you get home, after coughing or sneezing and regularly in-between.  

Soap and water is the best way to wash, but if you don’t have access to a sink, a hand sanitizer with alcohol content of at least 60% is a good alternative. 

Next, cover coughs and sneezes. Teach your family to cough/sneeze into their elbows. Even little kids can do this and they will be more likely to do it consistently if they see everyone else do it too. It is also important to teach and remind kids not to touch their mouths, noses, or eyes.

It is good practice to also regularly disinfect high-touch surfaces in your home. Doorknobs, light switches, sink handles and counters/tables, are a good place to start. Disinfect cell phones and any tablets or game controllers that your children use regularly, as well. 

We’re getting lots of questions about masks. The benefit of wearing masks in public is controversial. A surgical mask is not tight fitting and germs can still get through. A benefit might be that it can keep kids from touching their mouth and nose, but it is not a reliable barrier for germs and we do not recommend that children wear them. Instead, we recommend avoiding overcrowded situations as a better way to keep your child from being exposed. 

Contact your child’s specialist or primary care provider

While you are practicing all of these precautions, I also recommend making a call to your child’s primary care physician or specialist to discuss a plan for what to do if your child or another person in your home starts showing symptoms of a virus.  

If you have medical appointments that are important to your child’s care, you should attend them. The risk of getting COVID-19 in the US is low. It is reasonable to cancel non-essential appointments that can be rescheduled. If you are unsure whether or not to attend your child’s appointment, please call ahead. 

If someone in your house is planning to travel, it is worth a conversation to determine if it is necessary. If a family-member has recently traveled to an area with high COVID-19 activity, it is best for your immunocompromised child to avoid contact with the person for at least 14 days. Information about who has traveled when and to where, is extremely important information to share with your child’s provider when you call to discuss a plan. 

It is also worthwhile to prepare for a possibility that your family will need to stay home for many days and away from public places. Ensure your kitchen is stocked, ensure you have necessary medical supplies and prescription medications on-hand, check levels of basic over-the-counter medications and buy new if needed. 

We are taking the spread of this virus seriously and hope that you will too. It is important to stay calm and think clearly. Be diligent with all of the precautions outlined here and stay in close contact with the provider who knows your child and his or her condition best.  

I also recommend that parents regularly seek information about what is happening with the virus – the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) are both updating their websites daily with the most up-to-date information.  

For additional information, visit Cincinnati Children’s COVID-19 information page. You can also review answers to questions about visiting Cincinnati Children’s during this time.

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Felicia Scaggs Huang, MD, MSc

About the Author: Felicia Scaggs Huang, MD, MSc

Dr. Scaggs Huang is the Associate Director of Infection Prevention and Control at Cincinnati Children’s. She is a pediatric infectious disease physician who has clinical interest in preventing hospital acquired infections in critically ill children. She is a member of the preparedness team for COVID-19.

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Comments

  1. Amanda March 11, 13:52
    Thank you for this! As a family that has to frequently visit various children’s campuses, I was curious if there are any extra measures or approaches being taken to help prevent the spread as far as extra cleaning, limiting provider/patient touching, etc.?
    • Kate Setter
      Kate Setter March 12, 12:06
      Hi Amanda - thank you for asking about this. We follow the highest cleaning standards regularly during respiratory virus season. Our practice exceeds the current recommendation from the CDC related to COVID-19. We are screening every patient and family for risk at check-in and ensuring individuals who have travel risk or respiratory symptoms receive a mask and wait in a closed room, away from other patients. Some of our providers are choosing not to shake hands, but a physical exam is usually important to the care they provide, so they will continue to touch patients to provide care. Hand hygiene is paramount and we are being even more careful than usual. Please feel free to ask any provider at any time to wash hands again.
      • Concerned Parent March 16, 07:45
        This level of care and concern unfortunately doesnt seem to be spread across your departments evenly! I see the Valet, the most non essential of services, still in operation! That's a crazy level of unneeded cross contamination, lack of oversight and regard for basic patient safety! They have no idea who's car they are in, going car to car, exchanging cash, no ppe which wouldnt matter anyway. I'm very concerned that on paper your response sounds good but on the ground in practice it's not really fully implemented or thought through on all levels.
        • Kate Setter
          Kate Setter March 23, 14:02
          Hi Concerned Parent - We are implementing new procedures and precautions every day. Please reach out to our Family Relations team to discuss any ongoing concerns you have. Their email is advocates@cchmc.org and their phone number is 513-636-4700.
  2. Brandi March 15, 13:21
    Are children with EOE at greater risk of complications from the Coronavirus? Thank you!
    • Kate Setter
      Kate Setter March 23, 13:57
      Hi Brandi - The EoE team has provided this guidance that will likely be helpful to you: https://www.cincinnatichildrens.org/patients/coronavirus-information/condition-specific/eosinophilic-disorders
  3. C Baggett March 17, 11:09
    Dr. Huang, my son was an EoE patient at CC, but is now an adult. I know that EoE is an auto-immune disorder, but what about immuno-deficiency? I can't seem to find a link between the two online. Are EoE patients considered immune deficient at any level? Thank you for your time!!
    • Kate Setter
      Kate Setter March 23, 13:43
      The EoE team has provided this guidance this will likely be helpful to you: https://www.cincinnatichildrens.org/patients/coronavirus-information/condition-specific/eosinophilic-disorders. Thank you for your question!
  4. Odie March 19, 07:50
    I'm a nurse at a Nursing Home. My wife has Lupus. Do you think I should wear a mask while I am at work in order to prevent transmission to my wife when I get home?
    • Kate Setter
      Kate Setter March 23, 13:46
      Hi Odie - This question would be best to ask your wife's doctor or another member of her care team. They know her condition best and will be able to offer guidance to you about how you can protect her.
  5. OSU Renee March 21, 19:51
    Are immunologist or ID doctors in the US or other countries treating patients with XLA who have been diagnosed with Covid-19? If so, which treatments are being used and the results thus far? dangerous is this for our children with XLA? How dangerous is this for XLA patients? I understand the T-cells are fighting off the virus but the dead cells in a non-XLA patient would be cleared by antibodies/B-cells. My son's immune system obviously doesn't produce B-cells so how are the dead cells being removed? Other cells? He receives Sub-Q Hizentra bi-monthly, from what I know his treatments are not able to rid of the dead cells. Help... Any information would be helpful.
    • Kate Setter
      Kate Setter March 23, 13:53
      Hi Renee - How the virus impacts people in different patient populations is still very much unknown. Please reach out to your son's care team with these questions, if anyone knows if there is any data related to patients with XLA it will be the specialists. Thank you.