Why is the coronavirus milder for children, how to recognize the symptoms of infection and how to react when the test is positive? The microbiologist and virologist, Dr. hab. Tomasz Dzieiątkowski.
- Children are more easily infected with SARS-CoV-2 than adults, have fewer symptoms and are weaker. Why? – There are several hypotheses on this subject – explains the virologist, Dr. Tomasz Dzieiątkowski
- The disease usually makes itself felt by a low-grade fever and general breakdown. As Dzieiątkowski explains, there are also reports of diarrhea during COVID-19 and, in a small percentage of children – skin rashes
- How can I tell if my child is infected? What should worry parents? As the expert admits – in the absence of symptoms, it is impossible to determine the disease without performing a test
- For more up-to-date information on the coronavirus epidemic, visit the TvoiLokony home page
Grażyna Zenowicz, Newsweek Zdrowie: After six months of the SARS-CoV-2 coronavirus pandemic, we already know for sure that children suffer from COVID-19 more easily than adults or the elderly. Is it because the children are more resilient?
Dr hab. Tomasz Dzieiątkowski: There are several hypotheses about this, but the most serious one is that the milder course of COVID-19 in children is due to the specific structure of their cells. Well, there are fewer ACE2 receptors on cells in children, through which – as we have already learned – the coronavirus penetrates the cell membrane and attacks the cell. Due to the fact that children have fewer of them, it is more difficult for the coronavirus to penetrate the cell and thus children suffer from the disease asymptomatically or with little symptoms.
THE ARTICLE COMES FROM NEWSWEEK ZDROWIE 3/2020 MAGAZINE
But can they still be the source of the virus spreading to other people?
– Yes, although we are still not 19% sure whether children are more or less infectious than adults. The existing data from the world and research indicate, however, that children infect others less than adults suffering from COVID-XNUMX. In short, if a sick child coughs on someone, there is less chance that they will infect that person with the coronavirus.
- Coronavirus in children. What symptoms should worry the parent? Important advice from a pediatrician
How can I tell if my child is infected with the coronavirus?
– Children are usually considered likely to be infected with COVID-19 when it is known that the child has dealt with someone who is sick. In a situation where the disease is asymptomatic, it cannot be diagnosed without a test. In other cases, the symptoms are very nonspecific, they are difficult to distinguish from the symptoms of other diseases. The child may have a low-grade fever or a fever, but not as high as an adult, and is broken and lethargic. There are also reports of diarrhea during COVID-19 and, in a small percentage of children, skin rashes. Severe coronavirus infection in children is very rare, usually children with severe comorbidities.
What if the test result is positive? How can I help my child?
– In most cases, it is enough to leave them alone. About 60 percent. children, the course of COVID-19 does not require any medical intervention and it is enough to observe the child. The doctor must be notified in such cases as high fever or shortness of breath. It is also important to keep the child in isolation until the test is negative for the presence of the virus in the body. Parents and other household members should also stay in isolation with the child. Usually, if a child is infected, the parents are also diagnosed with the disease.
How many children have been diagnosed with COVID-19 infection in Poland so far?
– It must be clearly stated that epidemiological data in this age group are incomplete. Until June, 2442 cases of SARS-CoV-2 infection in people under 18 were reported to the Ministry of Health. This number is certainly underestimated, as most pediatric patients are asymptomatic with coronavirus infection. Children are estimated to account for 2-3 percent of all reported COVID-19 cases.
How should a child – a preschooler or a primary school student behave – not to pose a threat? What behaviors should we parents teach our children?
– First of all, they will be generally applicable hygiene rules. You should show your child how to properly put on and take off the mask, teach them how to wash their hands properly (this can be done in the form of fun) and explain that outside the home, try not to touch things that other people touch. It is also important to ensure that your children do not meet in public places or in larger groups when they are not attending school. Of course, if a child is unwell they should stay at home and rest, and if another household member has an infection, the child should not be in the same room with him / her.
- In the US, parents sent children with coronavirus infection to schools
Recently, there are reports that the disease caused by the coronavirus can leave permanent damage to the body.
Indeed, several articles have appeared in medical journals alarming that even a mild COVID-19 infection can lead to permanent fibrosis of the lung tissue. Similar damage may also appear in the parenchyma of the kidneys and the heart muscle. In fact, however, today it is far too early to say how often this is the case, whether the changes are truly irreversible, and whether they also affect children’s bodies.
- Unusual symptoms of COVID-19 in children. More and more cases
In children, it is said to cause symptoms of a rare condition – Kawasaki disease. What kind of illness is that?
– It is a very rare autoimmune disease, causing inflammation of small blood vessels and the appearance of characteristic bruises on the skin. The disease, which affects mainly children up to the age of five, was described in the mid-70s and it was suspected from the beginning that it might be infectious. It has been taken into account that influenza viruses, old types of coronaviruses and parvovirus B19 are the triggers for Kawasaki disease. However, a study suggesting a relationship between Kawasaki disease and the SARS-CoV-2 coronavirus was conducted on a small group of children; for example, the first one was attended by 10 children, only two of whom turned out to be infected with the new coronavirus.
- More and more teenagers are ill. Are they spreading the virus?
There are new studies and discoveries about the coronavirus almost every day. Which of them are particularly noteworthy as they bring really new information about the virus?
– Although we have known this virus for only six months, it has been quite thoroughly researched. The latest analyzes show that there are four genetic variants in the world that differ in their infectivity and the potential to cause severe symptoms of the disease. Among them are the so-called super-infectious variants – one of them is Option 4, which has so far dominated in Europe. However, its high infectivity goes hand in hand with a relatively low pathogenicity, i.e. infected people usually experience the coronavirus mildly. On the other hand, in China and partly in the USA, the first variant is dominant, which was not as highly infectious as the fourth, but caused severe disease symptoms.
Is there a chance that the virus commonly known as the crown by Poles will leave us as soon as it came?
– Unfortunately, practically none. Until recently, many scientists, including myself, believed that the SARS-CoV-2 coronavirus would be characterized by a seasonal pattern of illness similar to influenza, i.e. it would attack mainly in spring and autumn, and would fade away in summer. Today we can see that there is no chance for it, because the number of cases started to increase in our country in the middle of summer. And it is similar in other countries as well. So it looks like the virus will be circulating around people all the time in smaller or larger waves.
And the vaccine? When?
– Certainly not this year. We don’t really know when it will be available on the market. According to the latest information, there are two research teams in the world from Pfizer and AstraZeneca that are closest to developing a vaccine. Their preparations have just passed the third phase of clinical trials. However, it is worth knowing that this stage will take at least six months, and this is a very accelerated procedure compared to the tests of other drugs. I am very supportive of both vaccine teams, but we are not at all sure that, for example, the tested vaccines will not fall off during this phase, because they will not provide a sufficiently effective response from the immune system, and the work will have to be started all over again. I wouldn’t expect a vaccine until the first quarter of 2021.
What, then, should we think about bringing the children back to school? The virus is still raging, the vaccine will not be available for a long time, the autumn peak of flu cases is ahead of us, and perhaps also the coronavirus. Should schools be closed?
– It’s a very difficult question. From an epidemiological point of view, it would be best for the children to stay at home. It’s not just that they can get infected at school. Most likely their disease will be mild. But after all, school is not only children, but also teachers, often just before retirement. In the case of smaller children, we must also take into account the fact that their parents and grandparents accompany them to school. One child, even asymptomatically infected, can mean many infected adults and a whole crowd of people in quarantine.
- CDC: Even asymptomatic children can pass the coronavirus to their loved ones
But on the other hand …
– On the other hand, we have children locked in prisons of their rooms in front of computers. It is mainly the school that provides children and young people with social contacts and the possibility of social development. Without these contacts, they will develop worse and will not use their potential. Locking them at home may not only lead to disorders in psychosocial development, but may also cause significant problems with the mental health of children and adolescents. Today I cannot give a clear answer as to whether the children should stay at home or go to school. You definitely need to closely monitor the situation and adapt it to the pace of the spread of the coronavirus.
Is it possible to somehow prepare a child’s immune system to face the coronavirus?
– It should be emphasized that it is not possible to pharmacologically improve the functioning of the immune system, and the advertised dietary supplements will not help. Strengthening nonspecific immunity is a process that is spread over months, if not years. This can be done to some extent with the help of a hygienic lifestyle, eating healthy, sleeping for at least 8 hours, and avoiding stress. All of this is extremely difficult in today’s world, and in the age of COVID-19, almost impossible.
Is it worth getting my child vaccinated against flu?
– Of course. This vaccine will not give us immunity against SARS-CoV-2, but it may prevent infection with influenza viruses to some extent. The overlapping of the season of flu and flu-like infections with COVID-19 will be a real challenge for the healthcare system in Poland and around the world. It will be difficult for doctors to distinguish between these two infections on the basis of symptoms, and in the event of the so-called superinfections, i.e. overlapping of these two pathogens, the symptoms of the disease would be much more severe. Therefore, I strongly encourage you to get vaccinated against influenza viruses as soon as the vaccine is in pharmacies.
Dr hab. Tomasz Dzieiątkowski – microbiologist and virologist from the Medical University of Warsaw.
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