Are more children getting infected in second COVID wave
Senior doctors said the number of children affected by COVID-19 in the second wave was more as the overall number of coronavirus cases increased
One of the key differences between the ferocity of the second wave versus the first was that the new variants in circulation the second time were seen to be impacting children as well.
According to reports, more children were affected by COVID-19 in the second wave in states like Karnataka and several districts of Maharashtra. Technomiz spoke to two senior doctors in Maharashtra who agreed that there were a higher number of pediatric cases in the second wave. However, they added that the overall number of coronavirus cases was higher and hence, the number of children getting infected went up.
They also said that the disease is generally mild in children and the mortality rate is also low.
Dr Tushar Parikh, consultant neonatologist and paediatrician at Motherhood Hospital in Pune’s Kharadi said “We saw the maximum number of paediatric patients, during the entire pandemic, in the month of April 2021 and this also corresponds to data from the Pune Municipal Corporation and I think also the data for India”.
Parikh said there could be two reasons for this: One, this could be due to the new strain could be more infectious in children, although there is no substantial evidence for that. Secondly, the overall number of patients is very high and hence the number of paediatric patients also increased.
“The infectivity for the variant found in the UK was higher in all age groups. For the new strain, there is nothing to say that it is more infectious in children,” he said.
Singapore had in May shut schools, flagging concerns over new variants, including the B.1.617 strain detected in India, affecting children more.
Dr Ankit Gupta, lead paediatric critical care specialist at the Wockhardt Hospital at Mumbai’s Mira Road, stated that it would be wrong to say that the new variant found in India was spreading faster among children. The variant was spreading equally among children and adults but the number of children infected was proportionally more this time as entire families were testing positive for COVID-19 , he said.
“Wockhardt, being a tertiary care center, admits only moderate to severe cases. Approximately more than 50 pediatric COVID-19 cases were admitted in the second wave (till 29 May),” Dr Ankit said, adding that he must have treated approximately more than 100 pediatric coronavirus cases on OPD (Out-Patient Department) basis.
After that too, the hospital was receiving 1-2 paediatric patients per day, Dr Gupta said, but cautioned that the number could reflect a “referral bias”. Children are referred to Wockhardt as it is tertiary care centre and smaller nursing homes may not have a similar number of COVID patients.
What has the government said?
“If we look at all data, including Indian data from the first and second wave or even global data, there is no data to show that either the virus or new variants led to more serious infection among children,” AIIMS-Delhi Director Dr Randeep Guleria said in a press briefing on Tuesday.
“According to the second wave data, out of all the children admitted to hospitals with COVID-19 , 60-70 percent had co-morbidities or low immunity, some were on chemo-therapy. Most healthy children who were infected recovered without the need for hospitalisation.”
There’s no evidence to prove that children will be affected in the #Covid third wave. According to the second wave data, Out of all the kids admitted in hospitals, 60-70% had co-morbidities or low immunity: @MoHFW_INDIA #Unite2FightCorona pic.twitter.com/pVkstNCH9L
— PIB India (@PIB_India) June 8, 2021
Thus, he said there is no evidence that the next wave will lead to severe illness in children.
The Indian Academy of Pediatrics (IAP) too, in a statement dated 22 May, said that almost 90 percent of infections in children are mild/asymptomatic and the incidence of severe disease is not high in kids.
“Fortunately, children have been relatively less affected so far due to several factors. The most important reason is the lesser expression of specific receptors to which this virus binds to enter the host and also their immune system,” the statement read.
Speaking in the context of a third wave, NITI Aayog member (health) Dr VK Paul told India Today TV,” Till now, children have displayed similar seroprevalence as adults, which means, they are as much affected as adults.”
According to The Times of India, Paul had said last week that although most children who contract the disease are asymptomatic, in some cases the virus can affect them severely in two ways. In the first case, pneumonia-like symptoms have been reported. Second, some cases of a multi-inflammatory syndrome have been found among children who recently recovered from COVID-19 .
What are the symptoms seen in children?
Parikh highlighted that the symptoms seen in adults and those in younger patients were different. The infection is also mild among children, he stressed.
“Symptoms in adults are usually related to the respiratory tract and fever while the reason for admission is hypoxia —which is less oxygen, breathing difficulty and lung involvement. Whereas, in paediatric patients, symptoms are more general -poor appetite, loose motions and dehydration. They have fever, cough, and cold. In the paediatric age group, specifically, we are also seeing gastro-intestinal symptoms like vomiting, loose motions and stomach pain. We are also seeing a lot of patients with mouth ulcer and stomatitis and some with rashes.”
The senior doctor, however, added that COVID-19 in children in generally mild and the symptoms like rashes, fever, cold and cough generally last for 3- 4 days. “Blood investigation is generally done if fever lasts more than four days. In children less than five years of age, generally the causes of admission poor appetite, reduced food intake and dehydration are the causes of admission”.
“Children more than eight years of age may have lung involvement. Obesity has been found to be the biggest risk factor in adults from data in Pune. More than diabetes, obesity shows a correlation with death among adults. In the paediatric age group, death (due to COVID-19 ) doesn’t occur as much, but children above the age of eight with obesity are landing with lung disease or pneumonia and may require oxygen and ICU admission,” he said.
Gupta said that children will have similar symptoms like any other viral illness, including running nose, fever, lethargy and also gastrointestinal manifestations like diarrhea, loose motions and vomitting.
Febrile convulsions — a very common pediatric disease, to which children 5 months to 5 years old are prone —has been observed in very small children and babies when the fever crosses 101-102 degrees. he said.
He added that children below the age of one and those with comorbidities like asthma, renal issues, heart diseases, genetic diseases or diseases where the immunity is low are at higher risk. Obesity is also a risk factor, he added.
The Union health ministry has come out with guidelines for the treatment of children affected with COVID-19 , based on the categorisation of disease into mild, moderate and severe.
The Directorate General of Health Services (DGHS) also recently came out with comprehensive guidelines for the management of COVID-19 among children.
With inputs from PTI
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