Covid-19 child and baby: symptoms, test and vaccines

Covid-19: what is the “immune debt”, from which children could suffer?

Pediatricians are warning about a hitherto little mentioned consequence of the COVID-19 pandemic on children’s health. A phenomenon called “immune debt”, when the decrease in cases of many viral and bacterial infections causes a lack of immune stimulation.

The COVID-19 epidemic and the various hygiene and physical distancing measures implemented over several months will at least have made it possible to reduce the number of cases of well-known viral infectious diseases compared to previous years: influenza, chickenpox, measles… But is this really a good thing? Not necessarily, according to a study published by French pediatricians in the scientific journal “Science Direct”. The latter assert that the lack of immune stimulation due to the reduced circulation of microbial agents within the population and the numerous delays in vaccination programs have led to an “immune debt”, with an increasing proportion of susceptible people, especially children.

However, this situation “could lead to larger epidemics when non-pharmaceutical interventions imposed by the SARS-CoV-2 epidemic will no longer be needed. “, Fear the doctors. This side effect was positive in the short term, as it made it possible to avoid overloading hospital services in the midst of a health crisis. But the absence immune stimulation due to the reduced circulation of microbes and viruses, and a drop in vaccination coverage, have led to an “immune debt” which could have very negative consequences once the pandemic has been brought under control. “The longer these periods of ‘low viral or bacterial exposure’, the more the likelihood of future epidemics is tall. “, Warn the authors of the study.

Fewer pediatric infectious diseases, consequences for children?

Concretely, some epidemics could be more intense in the years to come. Paediatricians fear this may be the case with community pediatric infectious diseases, including the number of visits to hospital emergencies and practices decreased significantly during confinement, but also beyond despite the reopening of schools. Among these: gastroenteritis, bronchiolitis (especially due to respiratory syncytial virus), chickenpox, acute otitis media, nonspecific upper and lower respiratory tract infections, as well as invasive bacterial diseases. The team recalls that “their triggers are early childhood infections, most often viral, almost inevitable in first years of life. “

Still, for some of these infections, the negative consequences could be compensated by vaccinations. This is why pediatricians are calling for increased compliance with the vaccination programs in place, and even for an expansion of the target populations. Note that last July, the World Health Organization (WHO) and Unicef ​​were already alerting to an “alarming” drop in the number of children. receiving life-saving vaccines in the world. A situation due to disruptions in the use of vaccination services due to the COVID-19 pandemic: 23 million children did not receive the three doses of the vaccine against diphtheria, tetanus and pertussis in 2020, this who could cause new outbreaks in the following years.

However, some viral diseases are not the subject of a vaccination program. Like chickenpox : all individuals contract it during their lifetime, most often during childhood, vaccination is therefore only intended for people at risk of severe forms. In 2020, 230 cases were reported, a decrease of 000%. Due the inevitability of chickenpox, “Young children who should have contracted it in 2020 may contribute to a higher incidence in the years to come,” the researchers say. In addition, these children will have “aged” which could lead to a greater number of serious cases. Faced with this context risk of epidemic rebound, the latter wish to broaden the vaccine recommendations for chickenpox, therefore, but also rotavirus and meningococci B and ACYW.

Covid-19 baby and child: symptoms, tests, vaccines

What are the symptoms of Covid-19 in adolescents, children and babies? Are children very contagious? Do they transmit the coronavirus to adults? PCR, saliva: which test to diagnose Sars-CoV-2 infection in the youngest? We take stock of the knowledge to date on Covid-19 in adolescents, children and babies.

Covid-19: Young children are more contagious than adolescents

Children can catch the SARS-CoV-2 coronavirus and pass it on to other children and adults, especially in the same household. But researchers wanted to know if this risk was greater according to age, and it turns out that children under 3 years old would be the most likely to infect those around them.

While studies have shown that children generally have less severe forms of COVID-19 than adults, this does not necessarily imply that the latter transmit the coronavirus less. The question of knowing whether they are as or less contaminants than adults therefore remains, especially since it is difficult from the available data to assess their role precisely. in the dynamics of the epidemic. In a new study published in the journal “JAMA Pediatrics”, Canadian researchers wanted to know if there was a clear difference in the probabilities of transmission of SARS-CoV-2 at home. by young children compared to older children.

According to study results relayed by the New York Times, infected babies and toddlers are more likely to spread COVID-19 to others in their homes than adolescents. But conversely, very young children are less likely than adolescents to introduce the virus. To come to this conclusion, the researchers analyzed the data on positive tests and of COVID-19 cases in the province of Ontario between June 1 and December 31, 2020, and have identified more than 6 households in which the first person infected was under the age of 200. They then looked for further cases in those outbreaks within two weeks. the positive test of the first child.

Young children are more contagious because they are more difficult to isolate

It turns out that 27,3% of children had infected at least one other person from the same household. Adolescents accounted for 38% of all first cases in homes, compared to 12% of children aged 3 and under. But the risk of transmission to other family members was 40% higher when the first infected child was 3 years old or younger than when he was 14 to 17 years old. These results may be explained by the fact that very young children require a lot of practical care and cannot be isolated when they are sick, the researchers suggest. Moreover, at an age when children are “jack-of-all-trades”, it is difficult to make them adopt barrier gestures.

“People who have raised young children are used to having sputum and drooling on the shoulder. “Dr. Susan Coffin, an infectious disease specialist at Children’s Hospital in Philadelphia, told The New York Times. “There’s no getting around it. But use disposable tissues, wash your hands immediately after helping them wipe their noses are things a parent of an infected child can do to limit the spread of the virus in the household. If the study does not answer the questions of whether the infected children are also contagious than adults, this shows that even young children play a special role in the transmission of infection.

“This study suggests that young children may be more likely to transmit the infection than older children, the highest risk of transmission has been observed in those aged 0 to 3 years. », Conclude the researchers. This discovery is important, since better understanding the risk of transmission of the virus according to pediatric age groups is useful for the prevention of infection within the outbreaks. But also in schools and daycares, in order to minimize the risk of secondary transmission in families. Scientific team calls for further studies on a larger group of children of different ages to establish this risk even more precisely.

Covid-19 and inflammatory syndrome in children: a study explains the phenomenon

In very rare cases in children, Covid-19 has led to multisystem inflammatory syndrome (MIS-C or PIMS). In a new study, researchers provide an explanation for this still unknown immune phenomenon.

Fortunately, the majority of children infected with the Sars-CoV-2 coronavirus develop few symptoms, or are even asymptomatic. Corn in very rare cases, Covid-19 in children evolves into multisystemic inflammatory syndrome (MIS-C or PIMS). If we first spoke of Kawasaki disease, it is in fact a specific syndrome, which shares certain characteristics with Kawasaki disease but which is however different.

As a reminder, multisystem inflammatory syndrome is characterized by symptoms such as fever, abdominal pain, rash, cardiovascular and neurological problems occurring 4 to 6 weeks later infection with Sars-CoV-2. Diagnosed early, this syndrome is easily treatable with the help of immunosuppressants.

In a new scientific study published on May 11, 2021 in the journal Immunity, researchers at Yale University (Connecticut, USA) attempted to shed light on this phenomenon of immune overreaction.

The research team here analyzed blood samples from children with MIS-C, adults with a severe form of Covid-19, as well as healthy children and adults. The researchers found that children with MIS-C had immune reactions distinct from other groups. They had higher levels of alarmines, molecules of the innate immune system, which is mobilized quickly to respond to all infections.

« Innate immunity may be more active in children infected with the virus ”said Carrie Lucas, professor of immunology and co-author of the study. ” But on the other hand, in rare cases, it can get too excited and contribute to this inflammatory disease. », She added in a communicated.

The researchers also found that children with MIS-C exhibited marked elevations in certain adaptive immune responses, defenses to fight specific pathogens – such as coronaviruses – and which generally confer immunological memory. But instead of being protective, the immune responses of some children seem to attack tissues in the body, as in the case of autoimmune diseases.

Thus, in very rare cases, children’s immune response sets off a cascade of reactions that harm healthy tissue. They then become more vulnerable to autoantibody attacks. The researchers hope that this new data will contribute to the early diagnosis and better management of children at high risk of developing this complication of Covid-19.

Covid-19: nasal swab tests authorized for children

The Haute Autorité de Santé has given the green light to the deployment of antigenic tests by nasal swab for children under 15 years of age. This extension to the youngest should massively increase screening in schools, from kindergarten.

Antigenic tests by nasal swab, with rapid results, are now allowed for children under 15. This is what the Haute Autorité de Santé (HAS) has just announced in a press release. These tests will therefore be used to screen for Covid-19 in schools, together with saliva tests, which represents an additional tool for screening for Covid-19 among the youngest.

Why this change in strategy?

Selon the HAS, “The lack of studies in children had led the HAS to limit (the use of antigenic tests and self-tests) to those over 15 years old”. However, as additional studies have been carried out, the screening strategy is evolving. “A meta-analysis carried out by the HAS shows encouraging results in children, which now makes it possible to extend the indications and to consider the use of antigenic tests on nasal samples in schools. With a result in 15 to 30 min, they constitute a complementary tool to the salivary RT-PCR tests to break the chains of contamination within the classes ”, reports the HAS.

Nasal swab tests should therefore be deployed on a massive scale in schools “Within nursery and primary schools, colleges, high schools and universities, both among students, teachers and staff in contact with students”, specifies the HAS.

The trump of these antigenic tests: they are not sent to a laboratory, and allow rapid screening, on site, within 15 to 30 minutes. They are also less invasive and less painful than a PCR test.

Antigenic tests from kindergarten

Concretely, how will this happen? According to HAS recommendations, “Students, high school and college students can perform the self-test independently (after a first performance under the supervision of a competent adult if necessary). For primary school students, initially supervised self-sampling is also possible, but it is preferable that the test be done by parents or trained staff. For children in kindergarten, the sampling and the test must be carried out by these same actors. “ Remember that in nursery school, saliva tests are also practiced.

Whatever screening test is performed, it remains subject to parental authorization for minors.

Source: Press release: “Covid-19: the HAS lifts the age limit for the use of antigenic tests on a nasal swab ”

Covid-19 self-test: all about their use, especially in children

Can we use a self-test to detect Covid-19 in our child? How do the self-tests work? Where to get it? We take stock.

Self-tests are on sale in pharmacies. Faced with the epidemic upsurge, it may be tempting to carry out one or more, in particular to reassure yourself.

Covid-19 self-test: how does it work?

The self-tests marketed in France are antigenic tests, in which the sampling and reading of the result can be carried out alone, without medical assistance. These tests are carried out via a nasal self-sampling. The instructions specify that it is a question of introducing the swab vertically into a nostril over 2 to 3 cm without forcing, then gently tilting it horizontally and inserting it a little until meeting a slight resistance. There, it is then necessary rotate inside the nostril. The sample is shallower than the nasopharyngeal sample performed during conventional PCR and antigen tests, which are carried out in the laboratory or in a pharmacy.

The result is quick, and appears much like a pregnancy test, after 15 to 20 minutes.

Why do a Covid self-test?

The nasal self-test is used to detect people who have no symptoms and who are not contacts. It allows you to know whether or not you are a carrier of Sars-CoV-2, but would only be of interest if it is done regularly, every two to three days, specifies the instructions.

If you have symptoms or if you are in contact with a person who tested positive, it is recommended that you instead resort to a conventional, more reliable PCR test. Especially since obtaining a positive result in a self-test requires confirmation of the diagnosis by PCR.

Can self-tests be used in children?

In an opinion issued on April 26, the Haute Autorité de Santé (HAS) now recommends the use of self-tests also for those under 15 years of age.

In the event of symptoms suggestive of Covid-19 and persistent in a child, especially in the event of fever, it is advisable to isolate the child and consult a general practitioner or a pediatrician, who will judge the need to perform a test. screening for Covid-19 (PCR or antigen, or even saliva if the child is less than 6 years old). The physical examination is important so as not to miss a potentially more serious disease in the child, such as meningitis.

It is therefore better to avoid performing self-tests at all costs, at least in children. After all, the gesture of sampling remains invasive and may be difficult to perform correctly in young children.

[In summary]

• Overall, children and babies seem to be less affected by the Sars-CoV-2 coronavirus, and when they are, they develop less severe forms than adults. Scientific literature reports asymptomatic or not very symptomatic in children, most often, with mild symptoms (colds, fever, digestive disorders mainly). In babies, it is especially the feverwhich dominates, when they develop a symptomatic form.
• In very rare cases, Covid-19 in children can cause multisystem inflammatory syndrome, MIS-C, affection close to Kawasaki disease, which can affect the coronary arteries. Serious, this syndrome can nevertheless be managed in intensive care and lead to a complete cure.
• The issue of Sars-CoV-2 coronavirus transmission in children has been the subject of debate and several studies with conflicting results. It seems, however, that a scientific consensus is emerging, and thata priori children spread the virus less than adults. They would also be contaminated more in the private sphere than at school, especially since masks and barrier gestures are mandatory in schools.
• As to tests to detect the presence of the coronavirus, the antigen test is now authorized in children under 15 years of age, in whom as well as saliva tests,  
• The n’existe a priori no contraindication to vaccinating children. Tests carried out by Pfizer and BioNTech find effective protection against the coronavirus in children. Before vaccination of children, laboratories will have to obtain the agreement of the various regulatory authorities around the world.

AstraZeneca Suspends Covid Vaccine Trials in Children

If Pfizer & BioNTech announces a 100% effectiveness of its vaccine in young people from 12 to 15 years old, for the moment AstraZeneca stops its trials in the youngest. We take stock.

Clinical trials, carried out on more than 2 200 adolescents in the United States, show a 100% efficacy of the Pzifer-BioNTech vaccine in 12-15 year olds. They could therefore be vaccinated before the start of the school year in September 2021.

A start in February

For its part, AstraZeneca laboratories had also started clinical tests last February, in the United Kingdom, on 240 children aged 6 to 17 years, in order to be able to start a vaccination anti-Covid of the youngest before the end of 2021.

Suspended trials

As of March 24, in the United Kingdom, 30 cases of thrombosis have occurred in adults following vaccination with AstraZeneca. Among these cases, 7 people died.

Since then, some countries have completely suspended vaccination with this product (Norway, Denmark). Others like France, Germany, Canada, only offer it from the age of 55 or 60, depending on the country.

This is why clinical trials in British children are on hold. The University of Oxford, where these tests were taking place, is awaiting the authorities’ decision to know whether or not it is possible to resume them.

In the meantime, children who participated in the AstraZeneca clinical trial must continue to attend scheduled visits.

Covid-19: Pfizer and BioNTech announce that their vaccine is 100% effective in 12-15 year olds

Pfizer and BioNTech laboratories say their vaccine provides robust antibody responses against Covid-19 in adolescents aged 12 to 15. The detail. 

Le Pfizer & BioNTech vaccine was the first vaccine against Covid-19 to be approved at the end of 2020. Until now, its use has been authorized for people aged 16 and over. This could change following the phase 3 clinical trials that have just taken place.

100% efficiency

benefits clinical tests have in fact been carried out on 2 260 adolescents in the USA. They would have shown a 100% efficiency vaccine against Covid-19, including the British variant of the virus.

Vaccinated before September?

After the 12-15 years, the laboratory launched in trials on younger children: 5 to 11 years old. And from next week, it will be the turn of the little ones: from 2 to 5 years old.

Thus, Pfizer-BioNTech hopes to be able to start vaccination of children and adolescents before the next school year in September 2021. To do this, they must first obtain the agreement of the various regulatory authorities around the world.

How many vaccines?

To date, Pfizer-BioNTech has distributed 67,2 million doses of its vaccine in Europe. Then, in the second quarter, it will be 200 million doses.

Covid-19: when should I have my child tested?

While the Covid-19 epidemic is not weakening, parents are wondering. Should you have your child tested for the slightest cold? What are the symptoms that should make one think of Covid-19? When to consult with a fever or cough? Update with Professor Delacourt, peditor at the Necker Sick Children Hospital and President of the French Pediatric Society (SFP).

It is not always easy to distinguish the symptoms of a cold, of bronchitis, from those of Covid-19. This causes the concern of parents, as well as many school evictions for the children.

Recalling that the symptoms of infection with the new coronavirus (Sars-CoV-2) are generally very modest in children, where we observe fewer severe forms and many asymptomatic forms, Professor Delacourt indicated that fever, digestive disorders and sometimes respiratory disorders were the main signs of infection in the child. “When there are symptoms (fever, respiratory discomfort, cough, digestive problems, editor’s note) and there has been contact with a proven case, the child must be consulted and tested.”, Indicates Professor Delacourt.

In case of symptoms, “Better withdraw the child from the community (school, nursery, nursery assistant) as soon as there is any doubt, and seek medical advice. “

COVID-19: the immune system of children would protect them from a severe infection

A study published on February 17, 2021 reveals that children are better protected against severe COVID-19 than adults because their innate immune system attacks faster the coronavirus before it replicates in the body.

Because they are less frequently and less severely affected by SARS-CoV-2 than adults, acquiring knowledge about Covid-19 in children remains difficult. Two questions emerge from these epidemiological observations: why are children less affected et where do these specificities come from? These are important since research in children will allow advances in adults: it is by understanding what differentiates the behavior of the virus or the body’s response according to age that it will be possible to ” identify mechanisms to target. Researchers at the Murdoch Institute for Research on Children (Australia) put forward a hypothesis.

Their study, which involves analysis of blood samples from 48 children and 70 adults, and published in the scientific journal Nature Communications, claims that children would be better protected against severe forms of COVID-19 because their innate immune system attacks the virus quickly. In concrete terms, specialized cells of the child’s immune system target the SARS-CoV-2 coronavirus more quickly. Researchers believe that the reasons children have mild COVID-19 infection compared to adults and the immune mechanisms underlying this protection were unknown until this study.

Symptoms often milder in children

« Children are less likely to be infected with the virus and up to a third of them are asymptomatic, which is significantly different from the higher prevalence and severity seen for most other respiratory viruses.says Dr Melanie Neeland, who conducted the study. Understanding the underlying age-related differences in the severity of Covid-19 will provide important information and possibilities for prevention and treatment, for Covid-19 and for possible future pandemics. All participants were infected or exposed to SARS-CoV-2, and their immune responses were monitored during the acute phase of infection and for up to two months afterward.

Taking as an example a family with two children, positive for the coronavirus, the researchers found that the two girls, aged 6 and 2, had only a slight runny nose, while the parents experienced extreme fatigue, headaches, muscle pain, and suffered loss of appetite and taste. It took them two weeks to fully recover. To explain this difference, the researchers found that infection in children was characterized by activation of neutrophils (white blood cells that help heal damaged tissue and resolve infections), and by reducing early response immune cells, such as natural killer cells in the blood.

A more effective immune response

« This suggests that these infection-fighting immune cells migrate to the sites of infection, quickly eliminating the virus before it has a chance to actually take hold. Adds Dr Melanie Neeland. This shows that the innate immune system, our first line of defense against germs, is crucial in preventing severe COVID-19 in children. Importantly, this immune reaction was not replicated in the adults in the study. The scientific team was also intrigued by finding that even in children and adults exposed to the coronavirus, but whose screening turned out negative, the immune responses were also modified.

According to the researchers, “ children and adults had an increased neutrophil count for up to seven weeks after exposure to the virus, which could have provided a level of protection against the disease “. These findings confirm the results of a previous study conducted by the same team which showed that three children from a Melbourne family had developed a similar immune response after prolonged exposure to the coronavirus from their parents. Although these children were infected with SARS-CoV-2, they developed a very effective immune response to prevent the virus from replicating, which means they have never had a positive screening test.

Skin symptoms reported in children

The National Union of Dermatologists-Venereologists mentions possible manifestations on the skin.

« For now, we see in children and adults redness of the extremities and sometimes small blisters on the hands and feet, during a COVID epidemic. This outbreak of what looks like frostbite is unusual and concomitant with the COVID epidemic crisis. It could be either a minor form of the COVID disease, either a late manifestation after the infection that would have gone unnoticed, or a virus other than COVID which would arrive at the same time as the current epidemic. We are trying to understand this phenomenon », Explains Professor Jean-David Bouaziz, dermatologist at Saint-Louis Hospital.

Coronavirus: what risks and complications for children?

Apart from possibly patients who have been infected and have recovered, no one is truly immune from infection with the new coronavirus. In other words, all populations, including babies, children and pregnant women, are susceptible to contracting the virus.

However, according to existing data, children seem rather spared. They are relatively unaffected, and when infected with Covid-19, they tend to have benign forms. When complications occur in young people, they are most often related to other causes. This is what doctors call “comorbidity”, that is, the presence of risk factors linked to another pathology.

Serious complications related to Covid-19 are extremely rare in children and adolescents. But they are not totally excluded, as the deaths that have occurred in several of them since the start of the epidemic are painful reminders.

In an article in Le Parisien, Dr. Robert Cohen, doctor of pediatrics, recalls that each year, “oIt is not known why in some these infections progress unfavorably. Infectious diseases are sometimes unpredictable but it is quite rare. You know every year children also die from the flu, measles and chickenpox ».

What is MIS-C, the new disease linked to Covid-19 that affects children?

With the onset of Covid-19, another disease, affecting children, emerged. Close to Kawasaki syndrome, it is however different.

It is sometimes called PIMS, sometimes MISC… Recalling Kawasaki disease, this syndrome which has affected at least a thousand children around the world since the Covid epidemic is intriguing researchers. He is now named multisystem inflammatory syndrome in children, or MIS-C.

MIS-C would appear about 1 month after infection with Covid-19

According to two studies, published Monday, June 29, 2020 in the ” New England Journal of Medicine », The symptoms of this disease appear several weeks after infection with the SARS-CoV-2 virus, a median of 25 days according to a first American national study. Another research carried out in New York stops for a period of one month after the first contamination.

MIS-C due to Covid-19: a greater risk according to ethnicity?

The disease is still confirmed as very rare: 2 cases per 100 people under the age of 000. Researchers in both studies found that the affected children were more black, Hispanic, or Indian-born children, compared to white children.

What are the symptoms of MIS-C?

The most common sign in this research in affected children is not respiratory. Over 80% of children suffered from gastrointestinal disorders (abdominal pain, nausea or vomiting, diarrhea), and many experienced skin rashes, especially those under five. All had fever, very often for more than four or five days. And in 80% of them, the cardiovascular system was affected. 8-9% of children have developed a coronary artery aneurysm.

Previously, the majority of children were in good health. They did not present any risk factor, nor any pre-existing disease. 80% were admitted to intensive care, 20% received invasive respiratory support, and 2% died.

MIS-C: different from Kawasaki syndrome

When the disease first appeared, doctors noted many similarities with the kawasaki maladie, a disease that mainly affects infants and very young children. The latter condition creates inflammation of the blood vessels which can cause problems with the heart. New data confirms that MIS-C and Kawasaki have things in common, but that the new syndrome usually affects older children, and triggers more intense inflammation.

The mystery remains to be clarified on the causes of this new affection. It would be linked to an insufficient response of the immune system.

Children, “healthy carriers”, or spared from the coronavirus?

At the start of the coronavirus pandemic, it was almost taken for granted that children were mostly healthy carriers: that is, they could carry the virus without having symptoms of the disease, transmitting it more easily during their games between them, and to their relatives. This explained the decision to close schools and nurseries, to prevent the spread of the coronavirus epidemic. 

But what we took for a certainty is today called into question. A recent study tends to prove that, ultimately, children transmit the coronavirus little. “It is possible that children, because they do not have many symptoms and have a low viral load little transmit this new coronavirus “, Kostas Danis, epidemiologist at Public Health France and lead author of this study, told AFP.

Covid-19, colds, bronchitis: how do you sort things out?

As winter approaches and while the Covid-19 epidemic does not abate, parents are wondering. Should you have your child tested for the slightest cold? What are the symptoms that should make one think of Covid-19? When to consult for fever or cough? Update with Prof. Delacourt, pediatrician at the Necker Children Sick Hospital and President of the French Pediatric Society (SFP).

It is not always easy to distinguish the symptoms of a cold, of bronchitis, from those of Covid-19. This causes the concern of parents, as well as many school evictions for the children.

Covid-19: what to do in case of symptoms in children?

Recalling that the symptoms of infection with the new coronavirus (Sars-CoV-2) are generally very modest in children, where there are fewer severe forms and many asymptomatic forms, Professor Delacourt indicated that fever, digestive disturbances and sometimes respiratory disturbances were the main signs of the infection in the child. “When there are symptoms (fever, respiratory discomfort, cough, digestive problems, editor’s note) and there has been contact with a proven case, the child must be consulted and tested ”, indique le Pr Delacourt.

In case of symptoms, ” it is better to withdraw the child from the community (school, nursery, nursery assistant) as soon as there is any doubt, and seek medical advice. »

Coronavirus: few symptoms in babies except fever

American researchers say in a study published in September 2020 that babies with COVID-19 tend to suffer from a mild illness, mainly accompanied by fever. And this despite the fact that screening tests confirm the presence of a viral load.

From the beginning of the COVID-19 epidemic, the infection does not seem to affect toddlers much, so scientists have little data to study the effect of SARS CoV-2 in this population. But a small study of 18 infants with no significant medical history and published in ” The Journal of Pediatrics Provides reassuring details. Doctors at the Ann & Robert H. Lurie Pediatric Hospital in Chicago say that infants under 90 days tested positive COVID-19 tend to do well, with little or no respiratory involvement, and fever was often considered the main or only symptom.

« Although we have very little data oninfants with Covid-19in the United States, our results show that most of these babies have mild symptoms and may not be at greater risk of developing a severe form of the disease as initially discussed in China Says Dr. Leena B. Mithal, lead author of the study. “ Most of the infants in our study suffered from fever, suggesting that in young babieswho consult because of fever, Covid-19 could be an important cause, particularly in regions where community activity is developed. However, it is also important to consider bacterial infection in young infants with fever. »

Fever, cough and gastrointestinal symptoms, suggestive signs

The study specifies that 9 of theseinfants were admitted to hospital but did not need respiratory assistance or intensive care. The latter were admitted mainly for clinical observation, monitoring food tolerance, ruling out bacterial infection with intravenous antibiotics in infants under 60 days of age. Among these 9 infants, 6 of them presented gastrointestinal symptoms (loss of appetite, vomiting, diarrhea) preceded by cough and congestion of the upper respiratory tract. They were also eight to present only fever, and four with a cough or strong pulmonary ventilation.

After carrying out tests for the direct detection of the infection using the PCR technique (from a biological sample, most often nasopharyngeal), the doctors observed thatyoung infants had particularly high viral loads in their samples, despite mild clinical illness. ” It is not clear whether young infants with fever andtested positive for SARS-CoV-2must be hospitalized Adds Dr Leena B. Mithal. ” The decision to admit a patient to hospital is based on age, the need for preventive treatment for bacterial infection, clinical evaluation, and food tolerance. »

One thing is certain, however: the scientific team recommends using rapid screening for SARS-CoV-2in those cases where infants are clinically well but have a fever. It should be noted that numerous searches are being carried out in order to find out whether there is a link between the Kawasaki disease and Covid-19 since an abnormal accumulation of cases was observed in France and abroad. According to the Academy of Medicine, this is a separate pathology, as the symptoms noted (severe abdominal pain, skin signs) are grouped under the name of “pediatric multisystem inflammatory syndrome” and the age of the children affected (9 at age 17) is higher than in the usual form of Kawasaki disease.

Covid-19: infants little affected by the infection

A Canadian study published in December 2020 examining the clinical characteristics and severity of Covid-19 shows that infants who get the infection are doing surprisingly well. Indeed, most of the babies examined mainly presented with fever, a mild illness and did not require mechanical ventilation or intensive care treatment.

Covid-19 is a disease that affects very differentlyadults, children… and infants. A study conducted by researchers at the University of Montreal and published in the JAMA Network Open reveals that the latter, compared to adults, do quite well when infected with SARS-CoV-2. Although babies are at higher risk of developing serious illness and complications from other common viruses (influenza, respiratory syncytial virus), what about the current epidemic?

The study, conducted at CHU Sainte-Justine on infants (under 1 year old) who contracted Covid-19 during the first wave of the pandemic between mid-February and the end of May 2020, shows that many quickly recovered and only had very mild symptoms.The study specifies that in Quebec and across Canada, infants have had a higher rate of hospitalization due to Covid-19 than other pediatric age groups. The researchers reveal that out of 1 babies tested, 165 of them (25%) were declared positive for Covid-19 and among these a little less than a third (8 infants) had to be hospitalized, these stays being of two days on average.

A higher hospitalization rate but …

According to the scientific team, “these short hospitalizationsmore often reflected the routine clinical practice that all newborns with fever are admitted for observation, undergo an infection check-up and receive antibiotics pending results. In 19% of cases, other infections, such as urinary tract infections, were responsible for the fever in the infant. More importantly, in 89% of cases, coronavirus infection was benign and none of the babies required oxygen or mechanical ventilation. The most common signs were symptoms in the gastrointestinal tract, followed by fever and upper respiratory tract manifestations.

Furthermore, no significant difference in clinical occurrence between older (3 to 12 months) and younger (less than 3 months) infants was observed. “ Clinical signs andthe severity of the diseasein infants in our series differ from those reported in children and older adults. Our patients presented with a predominance of gastrointestinal symptoms, even in the absence of fever, and generally mild illness. », They add. Although the study is limited by its small sample size, the researchers believe their findings should reassure parents about the consequences. of coronavirus infection in infants.

A new study will be conducted at CHU Sainte-Justine to understand the differences in the immunological response to SARS-CoV-2in infants and their parents.Further work is also needed to better understand the pathophysiological mechanisms underlying the immune response to infection in infants. Because an essential question remains: why the clinical signs and the severity of the disease in infants differ from those reported in children and older adults? ” This can be a key element in addressing the underlying morbidity associated withto infection with SARS-CoV-2in adults », Conclude the researchers.