The coronavirus mainly affects the elderly and patients weakened by already existing chronic diseases. However, there are risks of contamination by Covid-19 for young children, even if this population is not the most affected. It is for this reason that the schools remained open during the second lockdown. What are the symptoms and risks for babies and children? 

In April 2020, Britain sounded the alert about an increase in cases of children in hospital with symptoms similar to Kawasaki disease, itself close to MIS-C (multisystemic inflammatory syndrome) or also called PIMS for pediatric multisystem inflammatory syndromes. Doctors at Necker Hospital in Paris, also declared an inflammation syndrome in 25 patients aged less than 15 years. Those children and presented inflammatory signs in the heart, lungs, or digestive system. Similar cases have also been reported in Italy and Belgium. In May 2020, Public Health France counted 125 cases of children presenting clinical signs similar to this rare disease. Among these children, 65 have tested positive for Covid-19. The others are suspected of having been infected. This explains a more than probable link between the PIMS and Covid-19 in children. The link is confirmed nowadays “the data collected confirm the existence of a rare multisystem inflammatory syndrome in children with frequent cardiac involvement, linked to the COVID-19 epidemic “. In addition, according to the UK’s National Health Service, the MIS-C has already affected more than a thousand children and young adults around the world since the end of April. There are nearly 551 in France.

Sadly, a 9-year-old boy from Marseille has died. He had received medical follow-up for 7 days in a hospital environment. This child suffered severe illness and cardiac arrest in his home. His serology was positive for Covid-19 and he was suffering from co-morbidity “neuro-developpementale“. In children, MIS-C would appear about 4 weeks after infection with the Sars-Cov-2 virus. 

The doctors wished to inform the health authorities, who transmitted the information to the population. It is important to continue to adopt the same behaviors and not to give in to anxiety. This remains a very low proportion of affected children. The children’s body is resisting rather well, thanks to appropriate monitoring and treatment. Their health improved quite quickly.

According to Inserm, those under 18 represent less than 10% of all cases of Covid-19 diagnosed. For children with multisystem inflammatory syndromes, which affect the whole body, the risk of associated death is less than 2%. Deaths are exceptional among children under 15 and represent 0,05% (among 5-17 year olds). In addition, children with chronic respiratory disease (severe asthma), congenital heart disease, neurological disease (epilepsy), or cancer are three times more likely to be admitted to intensive care in the event of Covid-19 them children and in good health. In addition, the children represent less than 1% of total hospitalizations and deaths with mention of Covid-19.

Situation in the world

Few babies and young children report symptoms related to Covid-19. However, there is no such thing as zero risk: we must therefore remain cautious. Globally, less than 10% of people who have been infected with the new coronavirus are children or young adults under the age of 18. In China, the country in which the global epidemic began, more than 2 children have been infected with Covid-19. Baby deaths, positive for Covid-19, are exceptional worldwide.

Situation in Europe

Elsewhere, the situation is not without giving some concern to parents of young children. In Italy, nearly 600 cases of children have been described. They were hospitalized, but their condition did not deteriorate. Cases of children and adolescents under the age of 18 have been reported in Europe (Portugal, Great Britain, Belgium and France). According to the Public Health France report, dated August 17, 2020, less than 5% of cases of children infected with Covid-19 have been reported in the European Union. Children (under the age of 18) would be much less likely to develop a severe form of Covid-19. In them, the infection manifests itself very little, that is to say, it is almost asymptomatic. Moreover, children “Excrete the same amount of virus as adults and are therefore contaminants as adults are”. 

Cases of coronavirus in children in France

The Scientific Council affirms, in an Opinion of October 26, that ” children aged 6 to 11 appear less susceptible, and less contagious, compared to adults. They have mild forms of the disease, with a proportion of asymptomatic forms around 70% ».

In a report from Public Health France, surveillance data for the disease in children shows that they are less affected: 94 children (0 to 14 years old) were hospitalized and 18 in intensive care. Since March 1, 3 child deaths have been recorded for Covid-19 in France. However, cases of children affected by Covid-19 remain exceptional and represent less than 1% of hospitalized patients and deaths and less than 5% of all reported cases in the European Union and the United Kingdom. Furthermore, ” children are much less likely to be hospitalized or to have a fatal outcome than adults ”. 

Childhood coronavirus screening test

Le salivary test deploys in educational institutions. From May 10 to 17:

• 255 Covid-861 tests were offered;
• 173 tests were performed;
• 0,17% tests were positive.

The conditions for performing a PCR test in children are much the same as for adults. If there is no suspected Covid case in the entourage, the test is only indicated for children aged 6 or over, or with symptoms that persist for more than 3 days. On the other hand, in the event of suspicion in the entourage and if the child presents symptoms, it is advisable to carry out a screening test. Parents must make an appointment in the laboratory or possibly with the child’s pediatrician. While waiting for the results of the test, the child must stay at home and avoid contact while continuing to apply barrier gestures. If the test is positive, he must remain isolated for 7 days.

On November 28, 2021, the EasyCov saliva test was validated by the French National Authority for Health. It is suitable for children and which present symptoms of Covid-19. On the other hand, it is not sufficiently effective (92% against 99% required), in the case of an asymptomatic infection.

Since February, Jean-Michel Blanquer, the Minister of National Education, launched a massive screening campaign in schools. To carry it out, saliva tests are offered to students and require parental permission. On the other hand, the PCR testing is not recommended in children under 6 years old.

What to do on a daily basis?

Even though children and babies are generally less affected by the coronavirus than adults or the elderly, it is important to follow the recommendations given to adults and to have them applied to children: 

• Wash your hands very regularly with soap and water before and after touching your baby
• Do not put the baby’s pacifier in the mouth, rinse it with clean water 
• If parents are infected or have symptoms, wear a mask 
• Lead by example by applying the right gestures to adopt and encourage children to do them: blow their nose in a disposable tissue, sneeze or cough into their elbow, wash their hands frequently with soapy water
• Avoid shops and public places as much as possible and within the limits of authorized establishments

In France, children from the age of six must wear a Category I surgical or fabric mask at primary school. In middle and high schools, it is compulsory for all students. In Italy, a country severely affected by the coronavirus, children from 6 years old must also wear a mask. 

What are the symptoms of Covid-19 in children?

In October, symptoms of Covid-19 have been demonstrated in children by an English study. Most are asymptomatic. For others, fever, fatigue and headaches seem to be the clinical signs most common in children and. They may have a feverish cough, loss of appetite, rash, diarrhea, or be irritable.

Symptoms of Covid-19 in adults are the same for children and babies. Usually it starts with a cough, nasal congestion with or without fever. Diarrhea can appear, as well as headaches. The symptoms of the novel coronavirus are, at first, similar to those of a cold or seasonal flu. Parents should be vigilant about other illnesses that children can develop. Covid-19 is not the only infection that children can get.

What to do in case of symptoms?

If a baby or toddler shows symptoms of Covid-19, you must contact the doctor and not go to his office. The doctor may suggest a video call appointment to give his diagnosis. He will be able to tell if it is a contamination by the new coronavirus or not. It could just as easily be a seasonal virus. In any case, we must not panic. Monitoring of the child’s state of health is recommended, in particular by taking the temperature twice a day.

In the event of signs of seriousness, such as breathing difficulties associated with cyanosis, mottling or tachycardia, the doctor should be contacted as soon as possible, or even the Samu on 15.