COVID-19 in children: A paediatrician’s perspective

An insight into the various aspects of COVID-19 infection in children & its consequences, and what you, as a parent, can do to make the management of the infection in particular, and the pandemic in general, smooth for your children.
Covid-19 in children
Covid-19 in children
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The 20-month-old pandemic has affected children the most. With lockdowns and schools closed, children bore the brunt of this pandemic. The good news is that as per WHO, between January 2020 and October 2021 only 2% and 7% of children under the age of 5 and in the 5-14 age group respectively had COVID-19 globally. Here is an insight into the various aspects of COVID-19 infection in children and its consequences, and what you, as a parent, can do to make the management of the infection in particular, and the pandemic in general, smooth for your children.

COVID-19 symptoms and management in children

Children exposed to SARS-CoV2 virus exhibit symptoms within 2-14 days of exposure and present one or more of the following symptoms: fever, fatigue, cough, nasal congestion, diarrhoea, sore throat, etc. Recent evidence has shown that almost half the paediatric COVID-19 cases are asymptomatic. Also, because the symptoms of COVID-19 in children coincide with other infections like influenza, screening symptomatic children for COVID-19 is very challenging. Consult your paediatrician if the symptoms persist for more than 3 days or aggravate over a period of time.

Children with certain underlying medical conditions like obesity, asthma and other lung diseases, diabetes, neurologic and neuromuscular diseases, heart and kidney diseases, and immunosuppressive diseases and babies (<1 year) are at a higher risk of COVID-19 associated risk and need to be monitored under medical care at the onset of the first symptom. Such children can develop respiratory failure, myocarditis or even the infamous Multisystem Inflammatory Syndrome (MISC).

COVID-19 vaccination status for children in India

India’s indigenous vaccine, Covaxin, received approval for administration in children between 2-12 years recently. This will be a two-dose vaccine and is particularly safe compared to other COVID-19 vaccines. Also, Zydus Cadilla’s ZyCoV-D has been approved for kids between 12-18 years.These vaccines will be available very soon once government recommendations are placed. It is highly recommended to get the children vaccinated as soon as the vaccine is available for their age group. Until the COVID-19 vaccine for kids is rolled out, the seasonal flu vaccine offers some protection from certain COVID-related symptoms.

Dr Shashwat MohantyConsultant Pediatric Intensivist and Pediatrician, Pediatrics, Rainbow Children’s Hospital, Visakhapatnam. 

Effect of COVID-19 on mental health of children

Shutting of schools has not only disrupted regular pace of education, it has also created emotional stress and mental health issues in children. Gadgets have become their companions. Excessive screen time and no physical activity or interaction with peers is leading to psychological and behavioural issues. Children are allowed prolonged and unmonitored use of gadgets for online classes, completing homework/ projects and entertainment. It is important to maintain a healthy atmosphere at home and encourage children to explore the world outside these gadgets. Interaction with peers at school gives them a sense of freedom, boosts their confidence, releases any mental stress and fears, and of course, keeps them physically and mentally fit. This also exposes the children to different viruses already prevalent which keeps their immune system primed all the time, thus helping in fighting any subsequent infection with coronavirus.

Pointers to help educate children about COVID-19

Talk to children about COVID-19 appropriate behaviour. Frequent washing and sanitising hands is an absolute necessity. Teach them the importance of masking up and maintaining social distancing, even around their friends.

Update them about coronavirus and related information. Share only verified information from trusted sources.

Reassure them that things will get back to normalcy soon.

Observe and analyse your child’s behaviour closely. At any indication of mental stress and anxiety, do not hesitate to get external help if required. Unlike us adults, children have few or no outlets to let out their feelings and emotions during this pandemic.

Follow the ‘3M’ theory - Minimise their screen time, Monitor their online activity, and Modify their schedule, so that they eat healthy, get enough sleep and can mingle with their friends and peers at home and school.

Be a good role model. Children learn by observing parents and other elders in the family. Do not discriminate against COVID-19 affected people. Always be ready to help others who have been infected. Get vaccinated and encourage others around you to get vaccinated.

This article was written by Dr Shashwat Mohanty, Consultant Pediatric Intensivist and Paediatrician, Pediatrics, Rainbow Children’s Hospital, Visakhapatnam and published in partnership with Rainbow Children's Hospital.

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