Covid-19 in children milder but that’s no reason to relax

The Coronavirus infection among children is relatively mild when compared to adults and they have better chances at recovery.

KOCHI: The Coronavirus infection among children is relatively mild when compared to adults and they have better chances at recovery. But there is a high probability that infection can be fatal in children with underlying chronic respiratory, cardiac and renal diseases. Also, malnutrition and immune deficiency can contribute to a serious condition among children.

Symptoms in children
Children generally present milder symptoms and usually recover within 1 to 2 weeks. Besides cold-like symptoms -- such as fever, dry cough, sore throat, runny nose, and sneezing -- gastrointestinal manifestations, including vomiting and diaorrhea, have also been reported. 

There is no direct evidence of vertical mother-to-child transmission, but newborns can be infected through close contact. Reports from different parts of the world suggest that a large proportion of the infected children appear to be asymptomatic. It remains unclear why children are less severely affected than older individuals. It could be, because:

• Immune system function/expression in children is not fully developed, which might lead to absence of severe immune responses after infection.
• Covid-19 virus exploits the ACE2 receptors to gain entry inside cells. Immaturity of ACE2 receptors in children could be another factor.
• Recurrent exposure to viruses like respiratory syncytial virus in winters can induce more immunoglobulin evels against the new virus infection
• At the time of outbreak it was winter vacation in China, Europe & USA and summer vacation in India, which helped avoid a collective cluster disease by chance.

Precautions to be taken 

• Seek medical care as early as possible if your child has a fever, cough or breathing difficulty.
•  Educate your child to cover the mouth and nose with a tissue or flexed elbow while coughing and sneezing. Dispose the used tissue immediately and wash
• hands with soap and water or use alcohol-based hand rub. Do not touch any object or face after coughing or sneezing.
• Avoid your child coming in close contact with anyone who has a cold, fever or flu-like symptoms.
• Clean the house and commonly touched objects, including toys, at least once a day with disinfectant solution
• Avoid taking your children to crowded places and try to keep them engaged with indoor activities. One can allow activities in house premises provided the number of children is not more than two.
• Children with fever cough and running nose should not be allowed to meet elderly.
• More emphasis should be given for a nutritious diet rich in vitamins (B, C & D) and encourage your child to drink plenty of water. Also adequate hours of sleep will help in enhancing the immunity.
•  Irrespective of the present pandemic, vaccination protocol for children and newborn should be strictly followed.
• Mothers can continue breastfeeding if they develop Covid-19 but they should take adequate precautions to prevent transmission.
  
  Dr Tinku Joseph K 
  is a consultant interventional pulmonologist at Amrita Hospital, Kochi. He is also the chief editor of International Pulmonologist’s Consensus on Covid-19