What are the symptoms of pneumonia in a 7-year-old child with autism spectrum disorder (ASD) who had Coronavirus disease 2019 (COVID-19) three weeks ago?

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Last updated: May 4, 2025View editorial policy

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From the Guidelines

Symptoms of pneumonia in a 7-year-old autistic child who had COVID-19 three weeks ago may include persistent cough, difficulty breathing, chest pain, fever, fatigue, decreased appetite, and irritability, and it is crucial to seek medical attention immediately if these symptoms are noticed. In autistic children, these symptoms might be harder to identify as they may have difficulty communicating their discomfort 1. According to the evidence, patients with COVID-19 can present with a range of symptoms, including fever, cough, dyspnea, myalgia, headache, diarrhea, rhinorrhea, sore throat, and pharyngalgia 1. In the pediatric population, symptoms may include fever, fatigue, cough, nasal congestion, runny nose, expectoration, diarrhea, and headache, and as the disease progresses, signs of dyspnea, cyanosis, and systemic toxic symptoms may also present 1.

Key Symptoms to Watch For

  • Persistent cough (which might be wet or productive)
  • Difficulty breathing or rapid breathing (more than 30 breaths per minute)
  • Chest pain that worsens with breathing or coughing
  • Fever (typically above 100.4°F or 38°C)
  • Fatigue
  • Decreased appetite
  • Irritability
  • Behavioral changes like increased agitation, sleep disturbances, or regression in previously mastered skills

It is essential to note that children with autism might show atypical presentations, such as less obvious fever or pain responses 1. The National Institute for Health and Care Excellence (NICE) COVID-19 rapid guideline on managing symptoms in the community recommends putting treatment escalation plans in place for patients with COVID-19, as they may deteriorate rapidly and need urgent hospital admission 1. If you notice any of these symptoms, do not wait to seek care, as pneumonia can progress rapidly in children, especially following a recent viral illness like COVID-19. Treatment typically involves antibiotics if bacterial, supportive care including hydration, rest, and possibly oxygen therapy depending on severity 1.

From the Research

Symptoms of Pneumonia in a 7-year-old Autistic Child with COVID-19

  • The child's symptoms may be similar to those experienced by other individuals with COVID-19, including fever, cough, and shortness of breath 2.
  • However, the child's autism spectrum disorder (ASD) may affect their ability to communicate their symptoms, making diagnosis more challenging 3, 4.
  • A study on COVID-19 pneumonia found that the disease can cause severe hypoxaemia, near-normal lung computed tomography imaging, lung gas volume, and respiratory mechanics, despite high respiratory drive, dyspnoea, and respiratory rate often being normal 5.
  • Another study found that long COVID syndrome can present as neuropsychiatric exacerbations in individuals with ASD, making it difficult to diagnose and manage 4.
  • Common symptoms of COVID-19 include:
    • Fever
    • Cough
    • Shortness of breath
    • Fatigue
    • Anosmia (loss of sense of smell)
    • Ageusia (loss of sense of taste)
    • Headache
    • Sore throat
    • Chest pain
    • Gastrointestinal issues 2, 6
  • Symptom clusters associated with SARS-CoV-2 infection include:
    • Ageusia, anosmia, and fever
    • Shortness of breath, cough, and chest pain 6
  • It is essential to consider the child's individual symptoms and medical history when diagnosing and managing their condition, as well as their ASD diagnosis and any potential interactions with COVID-19 symptoms 3, 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Autism and Access to Care During the COVID-19 Crisis.

Journal of developmental and behavioral pediatrics : JDBP, 2021

Research

COVID-19 pneumonia: pathophysiology and management.

European respiratory review : an official journal of the European Respiratory Society, 2021

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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