Coronavirus in children
Coronavirus in children is more easily tolerated and even asymptomatic, says WHO. It turns out that the real number of cases is much higher than the official figures? We answer the most popular questions together with experts

It is believed that children easily tolerate COVID-19. But in China and many other countries, including Our Country, there have already been precedents when schoolchildren were ill with complications (1). We discuss how to protect ourselves in a pandemic and other questions about coronavirus in children with an expert.

How many children in Our Country fell ill with coronavirus

Despite the fact that worldwide child mortality from COVID-19 is only 0,005%, many times more cases of hospitalizations of children in the red zone with a severe course of the disease were registered this fall. And if in the fall, according to the Central Research Institute of Epidemiology of Rospotrebnadzor, children accounted for 5% of the total number of cases, then by the end of January their number had increased to 15%. The reason for this is the Omicron strain, which is more contagious for people of all ages. According to the head of the Ministry of Health, Mikhail Murashko, children become infected with omicron 2,5 times more often than other variants of the virus.

Why children are more resistant to coronavirus

Before the appearance of the “omicron”, experts had several hypotheses explaining the relative resistance of children to SARS-CoV-2.

Children have fewer contacts. First of all, children have a reduced risk of infection due to less contact and communication, as well as travel and movement. Initially it was assumed that they would play a significant role in the spread of infection, however, subsequent studies have shown that often children become infected from other family members or adults in the foci of infection. Adults appear to play a key role in the spread of the virus within families (2).

It is more difficult for the virus to enter the child’s body. The conductor for SARS-CoV-2 is the type 2 receptor ACE2 – it is through it that the coronavirus enters the human body. There are many of these receptors in the mucous membrane of the oral cavity, nose, lungs, intestines, kidneys, blood vessels in adults. And since the coronavirus is more spread by airborne droplets, it most often enters through the mouth and nose. But in children, the ACE2 gene is much smaller in the nasal mucosa, therefore, SARS-CoV-2 is more difficult to penetrate into the children’s body.

Children have immature immunity. Perhaps, the features of innate immunity in children also play a role – its immaturity, which prevents the development of a hyperimmune response and acute respiratory distress syndrome, which is accompanied by severe lung damage. Apparently, children are able to create a more controlled and effective immune response than adults. Children’s bodies are uniquely adapted to fight off the new coronavirus infection.

Children are vaccinated. Another hypothesis of resistance to a new coronavirus infection is vaccination, including against tuberculosis. As you know, children are regularly vaccinated against various diseases, which contributes to the stimulation of innate immunity.

Children have fewer comorbidities. It must be remembered that children, unlike adults, have a relatively smaller number of comorbidities that predispose to the development of an inflammatory response. However, it is already clear that children with a weakened immune system, obesity and diabetes are more severely affected by the coronavirus.

Features of the hemostasis system in children. They have a lower level of proteins involved in blood clotting processes, which prevents the development of thrombosis, which is characteristic of severe forms of the disease in adults.

– Severe cases are rather isolated, exceptional and are associated with the characteristics of the organism of a particular child, his predisposition to certain diseases, which provokes a severe course of a viral infection.

– Groups of special risk – infants and children under one year old. Like the elderly, they are susceptible to severe forms of viral infections. This is due to the fact that in the elderly, the functional defense systems have already weakened, while in babies they have not yet been formed.

Symptoms of coronavirus in children

Symptoms of coronavirus in children are the same as with other viral infections: fever, runny nose, sneezing, cough, sore throat. Loss of smell or taste of food is possible. Severe infection is possible in children with chronic diseases, obesity, diabetes (3).

In adolescence, the incubation period can range from 2-3 to 14 days. In the rest, signs of infection usually appear 3-4 days after infection.

In more severe forms of infection, difficulty breathing, nasal congestion, ear pain, and coughing may occur. The temperature rises to 38,5 ° C, there is an ache in the joints and general weakness. Possible abdominal pain, bloating, diarrhea. Skin rashes on the back and upper chest are also possible.

Treatment of coronavirus in children

For the treatment of coronavirus in children, special drugs are not prescribed – they simply do not exist. Treatment is symptomatic and generally does not differ from the treatment of other SARS. Sit at home, ventilate the apartment, observe the mode of cool moist air. Give your child plenty of water, don’t force him to eat. Rinse your nose with saline solution, gargle. At a high temperature (above 38,5 degrees), give an antipyretic. If dangerous symptoms appear – shortness of breath, painful dry cough, shortness of breath, then intensive medical care and observation in a hospital are required.

The latest recommendations of the Ministry of Health for the treatment of coronavirus say that a child in case of infection with COVID-19 or with signs of SARS should be left at home, call the unified service 122 or the call center of their clinic for a remote consultation with a medical worker. If the condition worsens, call the ambulance service at 103 (4).

Complications of coronavirus in children

As for complications, with coronavirus in children they are the same as with ARVI: pneumonia, bronchitis, sinusitis, acute respiratory failure, pulmonary edema, sepsis, toxic shock, problems with the gastrointestinal tract. Complications occur, as a rule, in children with other diseases. For example, asthma, chronic bronchitis.

The consequences of the transferred coronavirus are sometimes more severe than the disease itself. Of particular danger is the multi-inflammatory syndrome, which can develop several months after suffering covid.

How do children get sick with “omicron”

“Omicron” less often distorts odors or deprives the sense of smell. Most often it begins with general weakness, sore throat, runny nose, fever, cough. Sometimes in the first days fever, diarrhea begins. Some children develop pink spots on their bodies that look like measles rashes, or their fingers become red and swollen. Rarely there are other rashes – vesicles, as with chickenpox, lacy spots, red marks on the nails (5).

In children 2-5 years old with “omicron” lesions of the upper respiratory tract (sinusitis, pharyngitis), bronchitis are more often observed, in children older than 7 years – pneumonia. Therefore, with the spread of the new strain, the number of hospitalizations of children has increased so much.

In general, children tolerate “omicron” quite easily, symptom relief comes faster. The hardest hit are those with chronic diseases.

Do children need a coronavirus test?

According to the guidelines, the test is carried out if a new coronavirus infection is suspected in the presence of symptoms or in contact with patients. Biological samples of sick children (nasopharyngeal swabs, sputum, bronchoalveolar lavage, blood and stool samples) contain virus RNA. To confirm COVID-19 infection, a PCR method is used, which allows the detection of SARS-CoV-2 RNA. Samples should be collected as soon as possible after the identification of a child to be diagnosed.

Prevention of coronavirus in children

The virus is transmitted mainly by airborne droplets. This means that it is very important to avoid crowded places: walk instead of the bus, go down the stairs instead of the elevator, spend the day off not in the shopping center, but in the park or in the forest. Run, play, have fun. A good mood is also important.

The child must eat properly and fully, receive all the necessary trace elements, vitamins. The daily routine is important: the child must get enough sleep, the body must recover, so that the immune system works and protects against infections.

The main recommendations for the prevention of coronavirus in children:

  1. Hand hygiene. Wash your hands often and thoroughly, especially after the street, the toilet, before eating. You need to lather for at least 20 seconds. When walking, take antibacterial wet wipes and a sanitizer (bactericidal hand gel) with you, wipe your hands with them if necessary.
  2. Make sure the child does not touch his face with his hands. This is a problem for adults too: we involuntarily touch our cheeks, nose, forehead, eyes about 15 times an hour, doctors say. Special attention to children who love to pick their noses and bite their nails – it’s time to get rid of bad habits.
  3. Teach your child to cough and sneeze into a tissue and throw it away immediately.. Or in the elbow, in the sleeve of clothing. The main thing is not in the palm of your hand.
  4. 4. Control that children do not touch the handrails of stairs, buttons in the elevator, door handles. The door can be opened with the shoulder, the button can be pressed with the knuckle or elbow.
  5. If a trip to the store, pharmacy, clinic is inevitable, wear a mask.
  6. Irrigate your nose with saline solution, gargle: mucous membranes should not dry out, because they ensure the work of local immunity. Recipe for a homemade solution for a child: a third of a teaspoon of salt in a glass of water.
  7. At home, keep the humidity at 40-60%. Ventilate the rooms regularly, do wet cleaning. Disinfect door handles, bathrooms, kitchens… By the way, the virus lives for a long time on various surfaces that surround us in everyday life. For example, on wood and glass – up to 4 days, on paper and plastic – up to 5 days, on aluminum – up to 8 hours, on steel – up to 48 hours. A simple recipe for a disinfectant solution: 60-100 ml of “Whiteness” per 1 liter of water. Washing clothes at a high temperature also kills viruses.

Coronavirus vaccination for children

The World Health Organization (WHO) has recognized that children can be vaccinated against coronavirus infection.

In Our Country, a vaccine against coronavirus for adolescents aged 12-17 years has been registered. vaccine “Sputnik M”. It will be possible to vaccinate a child with the consent of the parents or the child himself, if he is already 15 years old. As “Sputnik V”, the drug was developed by the National Research Center for Epidemiology and Microbiology named after N.F. Gamaleya. In fact, this is an analogue of the adult vaccine, only five times weaker.

In January 2022, the Ministry of Health gave permission for clinical trials of Sputnik M in children aged 6-11. Tests should take 3-3,5 months.

In China, several million children aged 3 years and older have been vaccinated against the coronavirus.

Popular questions and answers

If a child has recently been ill, is it possible to check after the fact what it was: SARS or coronavirus?

If the child is already healthy, then it is not dangerous to others. The detection of antibodies does not make much sense, since all health forces are focused on identifying the primary sources of coronavirus infection.

There have been reports that it is better not to give ibuprofen to a child with coronavirus – only paracetamol. This is true?

If there is a suspicion of a coronavirus infection, it is not necessary, in principle, to self-medicate. Call the district police officer or an ambulance.

They talk about another way of infection – fecal-oral. What is meant by non-compliance with hand hygiene after using the toilet?

Fecal-oral route can be infected with many infections, but the coronavirus is not among the leaders of this path. Here the main mode of infection is respiratory. Washing hands after using the toilet is an unspoken rule that must always be followed. We know that the coronavirus can remain on hands and clothes for a long time. The person sneezed into his hand, grabbed the toilet doorknob, the viruses remained – that’s the source of infection for you.

Is it possible to walk on the street with a child during an epidemic?

Walking in the fresh air strengthens the child’s immunity, so you need to walk. But choose sparsely populated places: a park, a forest … The ideal option, of course, is to leave the city.

Should I stop breastfeeding if my mother is sick?

There is no evidence that coronavirus infection enters breast milk, however, feeding and contact with a sick mother should be interrupted. The risk of infection in an infant is very high. Mom during the period of illness can be expressed to maintain lactation. However, do not feed your baby with this milk. And breastfeeding resume only after full recovery.

What about routine vaccinations?

If the child is healthy, then all vaccinations are performed according to the schedule. Measles, tetanus, rabies and other diseases have not gone away, and they are very dangerous. The only thing – try to avoid contact with people on the way to the doctor: in public transport, in the corridor of the clinic.

Does the flu shot that many children received in early autumn affect the course of coronavirus in children?

Such a vaccination will not protect against a new infection and will not alleviate the course of the disease. It will only protect against a specific strain of the flu.

Are there any statistics on child deaths from coronavirus?

According to world statistics, mortality in children with coronavirus infection is 0,1-0,2%.

Multisystem inflammatory syndrome poses a particular danger to children. This is a form of delayed multiple organ damage of an inflammatory nature, accompanied by high body temperature for more than 5 days, conjunctivitis, redness and swelling of the palms and feet, lesions of the oral mucosa, skin rash. Mortality from this complication among children is ten times higher than from the coronavirus itself.

Sources of

  1. COVID-19 Transmission and Children: The Child Is Not to Blame. Benjamin Lee and William V. Raszka. Pediatrics August 2020, 146 (2) e2020004879; DOI: https://doi.org/10.1542/peds.2020-004879
  2. Answers to the top five questions about coronavirus in children and adolescents. StopCoronavirus.rf. https://stopcoronavirus.rf/news/20201022-1815.html
  3. President of the Union of Pediatricians of Our Country L.S. Namazova-Baranova on a new coronavirus infection in children (based on the results of 2020) January 11, 2021 https://www.pediatr-Our Country.ru/COVID-19/detail.php?ELEMENT_CODE=koronavirusnaya-infektsiya-u-detey
  4. Ministry of Health. Memo in case of COVID-19 https://minzdrav.gov.ru/news/2022/01/26/18272-minzdrav-rossii-vypustil-pamyatku-dlya-grazhdan-na-sluchay-zabolevaniya-covid-19
  5. Skin signs of COVID-19. https://dermnetnz.org/topics/covid-19
  6. Methodological recommendations “Peculiarities of clinical manifestations and treatment of the disease caused by a new coronavirus infection (COVID-19) in children” (Version 2 of 24.07.2020/0/000) https://static-050.minzdrav.gov.ru/system/attachments/attaches/ 914/03062020/19/original/2_children_COVID-XNUMX_vXNUMX.pdf
  7. Safety of vaccines against COVID-19. WHO: https://www.who.int/en/news-room/feature-stories/detail/safety-of-covid-19-vaccines

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