COVID-19 in children
SARS-CoV-2 can infect children of all ages but they appear to be less frequently affected compared to adults.
The incidence of infection increases with age. Signs and symptoms may be mild to severe. Infection manifests as cough and fever or body pains (myalgia), tiredness, shortness of breath, watery nasal discharge (rhinorrhea), headache, nausea or vomiting, loose bowel movement, abdominal pain, loss of smell or taste, sore throat, and chills.
Most children with Covid-19 recover within four weeks but some patients may present with symptoms for a longer period. These include tiredness (fatigue), muscle and joint pains, headache, cough, shortness of breath, and changes in sense of smell or taste.
Laboratory findings vary. Complete blood count in infected children may be normal but there may be low white blood cell count, low platelet count, and elevated levels of inflammatory proteins procalcitonin or C-reactive protein.
Does it mean that a child who is obese or diabetic will definitely develop severe illness? No, but the risk is higher compared to children without co-morbid conditions.
Aside from obesity and diabetes mellitus, other conditions that predispose a child to severe Covid-19 are inborn heart conditions like valvular heart defects; body mass index higher than 95th percentile for age and sex; diabetes mellitus; chronic lung disease like bronchial asthma; blood problems like sickle cell disease; use of steroids and other drugs that suppress the immune system; disorders of the nervous system; genetic conditions like Down’s Syndrome;
In some studies, age less than one year old (but data is still not sufficient); need for hospitalization, intensive care, and mechanical ventilation; and childhood cancer.
Multisystem inflammatory syndrome in children or MIS-C is a rare but serious form of Covid-19 that was initially reported in children in Europe and North America and now also being reported in our country. There is marked inflammation of the heart, lungs, kidneys, brain, skin, eyes, and the gastrointestinal organs. The child has persistent fever, develops low blood pressure leading to dizziness and lightheadedness, breathing difficulty, kidney dysfunction, confusion, seizures, stomach aches, diarrhea, red or bloodshot eyes, low blood pressure leading to dizziness, skin rashes, nausea, and vomiting.
These symptoms can occur in different combinations and affected children need hospitalization. Most affected children can completely recover with close monitoring and adequate treatment. MIS-C could be a delayed post-infectious complication of Covid-19.
It is not yet certain if the Delta variant causes more severe illness in children.
Studies have shown that the titer or level of SARS-CoV-2-specific antibodies increases significantly in the breast milk of vaccinated mothers, and these antibodies have the potential to protect breastfeeding infants from Covid-19 illness. Women who are pregnant, thinking about becoming pregnant, or breastfeeding are advised to get vaccinated against Covid-19.
The Health and Technology Assessment Council states there is still insufficient evidence to be used as basis for recommending booster doses of Covid-19 vaccines. The evidence of decreasing or waning immunologic markers or antibody titers does not translate into an increased risk of clinical disease. There is also the possible risk of side effects like myocarditis (inflammation of heart muscle) and Guillain-Barre Syndrome for certain vaccines like adenovirus vectored type. There is currently a shortage of vaccines and using vaccines on unvaccinated groups may save more lives than using them as boosters.
Do you suspect you have Covid-19? These measures will help.
Observe social distancing right away. Observe self-imposed quarantine. If you have the virus, you will not spread it through self-isolation. Your friends, family, or co-workers will appreciate your decision to take a leave of absence from work or from any activity.
Do not self-medicate. Medicines, even commonly prescribed oral antibiotics, may not confer protection and may even be harmful to you. The Covid-19 is a viral and not a bacterial infection. It will go away even without antibiotic treatment if there is no concurrent bacterial infection. SARS-CoV-2 causes viral pneumonia but it does not require an antibacterial drug. Consult a physician if your fever and other symptoms do not subside.
Go for an RT-PCR swab test as soon as you can. The result can affect your access to diagnostic and health care facilities. The result will also guide physicians and other healthcare workers in making decisions on your treatment and will reduce your waiting time in a clinic, emergency room, or hospital.
Accept the reality that each one of us is affected by the pandemic. We all deal with unique, bizarre and seemingly unreal situations. We all deal with fear, frustration, sadness and the uncertainty that the pandemic brings. Just know that you are not alone. And the experience –quarantine, isolation, loneliness, anxiety as you wait for laboratory results, or deal with treatments alone because you are isolated from your family or loved ones – may help you to emerge as a stronger person.
Medical questions or suggestions may be emailed to [email protected] or [email protected].