Covid 19 in children and teens shares many things in common with the illness in adults, but also some notable differences.
In Covid 19 Pandemic, most of the attention has been centered around adult patients. This has happened because children below 18 years of age, constitute only about 20 percent of new cases, and are likely to be either having no symptoms or minor illness. The severe or complicated cases, and deaths are uncommon. This picture may change with the newer waves of Covid 19, and the cases in the children and the teens may start increasing, both in number as well as severity.
In this article, we will try and understand Covid 19 in Children better. It will help us manage this pandemic better.
Covid 19 in children: Similarities with Adult Covid 19
Covid 19 clinical features in children and teens share many similarities to Adult Covid 19.
1. Similar incubation period. 2- 14 days (Average 6 days)
2. Similar overall symptoms
3. Similar virus loads in nose and throat
4. Similar rates of secondary infections
5. Similar rates of spreading infection to others
Covid 19 in Children: Symptoms
In symptomatic patients, there can be:
A) General Symptoms:
Fever, Headache, Fatigue, Muscle Pains, Poor Feeding, Loss of appetite, Loss of Taste &/or Smell
B) Respiratory Symptoms:
Cough, Sore Throat, Runny or Blocked Nose
C) Gastrointestinal Symptoms:
Nausea, Vomiting, Diarrhea, Abdominal Pain
Most common symptoms are Fever and Cough.
Covid 19 danger signs in children and teens
1. Persistent fever or cough
2. Increasing breathing difficulty
3. Chest Pain or Tightness
4. Severe Gastrointestinal Symptoms
5. Confusion or Drowsiness
6. Pale grey or bluish discoloration of lips or nail-beds
Urgent medical care, including hospitalization and supportive care including assisted ventilation may be needed in such situations.
Multi-System Inflammatory Syndrome in Children (MIS-C)
An important complication of Covid 19 is Multi-System Inflammatory Syndrome in Children (MIS-C).
It is characterized by fever, lab evidence of inflammation and severe illness involving 2 or more major systems, or organs in a child with evidence of current, or recent Covid 19 infection, or exposure to a Covid 19 case within last 4 weeks.
It presents with symptoms like persistent fever, abdominal pain, vomiting, diarrhea, skin rash, red eyes, redness or swelling of mouth or lips, redness or swelling of hands or feet, headache, dizziness, light-headedness, fast heart-beat and rapid breathing.
Covid 19 in Children: High Risk Patients
Certain categories of children are more at risk for Severe Covid 19 symptoms. Children younger than 1 year and children with complex or chronic medical conditions (Genetic, Developmental or Metabolic conditions; chronic diseases such as asthma, diabetes, hypertension, obesity, chronic heart/lung/kidney/neurologic disease, certain hematologic conditions or immunosuppressed states) represent such High Risk patient categories.
Covid 19 Treatment in Children
Treatment of Covid 19 in children and teens depends upon severity of infection. Mild to moderate cases can be treated at home symptomatically with analgesic-antipyretics, saline gargles, saline nose drops and adequate fluid intake.
Severe cases may require hospitalization, oxygen supplementation and assisted ventilation. Antiviral Medicines (like Remdesivir), Immuno-modulators (like Tocilizumab), Steroids and Anti-Coagulants may be used on case-by-case basis as per country- or- center-specific protocols.
Covid 19 in Children: Prevention is the key!
Prevention against Covid 19 is essential for all ages. Social distancing, ‘No touch’ greetings, Hand-washing, Face-Mask (above 5 years of age), Avoiding needless gatherings, outings and traveling, and Vaccination are most important in this regard.
Currently Pfizer vaccine and Moderna vaccine are authorized for use in children. Pfizer vaccine can be used safely above the age of 5 years and Moderna use is advised after the age of 12 years.
*(Image by André Santana AndreMS from Pixabay)