In the second wave of coronavirus infections in India, more children are being infected.
According to physicians, a majority of kids have mild symptoms
The age group zero to 20 years accounted for nearly 11.5 percent of the 56 lakh Covid-19 cases recorded in India between January 1 and April 21.
The Bai Jerbai Wadia Hospital for Children in Mumbai saw 150 cases of Covid-19 in the seven months from the start of the pandemic in India in February 2020 to August 2020, an average of 21 cases per month. According to the hospital's CEO Minnie Bodhanwala, the hospital has seen 90 cases in just two months this year.
Indu Khosla, a pediatric pulmonologist at the SRCC Children's Hospital in Mumbai, diagnoses about 15-20 children with Covid-19 every day. “Children were hardly contracting the disease; the caseload was 10% -15 percent of what it is today,” she told a leading news agency in the last wave in 2020. She has seen patients as young as four months old.
According to government statistics, nearly 11.5 percent of the 56 lakh Covid-19 cases registered between January 1 and April 21 were in the age group of zero to twenty years. This is slightly less than the 12% of cases expected in this age group in 2020, but doctors claim they are treating more children and adolescents with Covid-19 in this second wave due to a large number of cases in a shorter time.
During the 14-month pandemic in India, nearly 42% of all confirmed Covid-19 cases were reported in the two months between March 1 and April 30. Furthermore, some strains of the disease are more contagious this time around, affecting nearly all members of a family, according to physicians. However, there are just a few serious cases among youngsters, and even these are usually treatable, they say. India had 33 lakh active Covid-19 cases as of May 2.
Symptoms in children
According to physicians, a majority of children with Covid-19 have gastroenteral symptoms such as vomiting, diarrhea, moderate fever, cough, and cold. Other than paracetamol and multivitamins, they do not need medication. According to Bodhanwala, many children are asymptomatic and are only screened because a family member has Covid-19.
Covid-19 has a small number of cases where it affects children's lungs, resulting in pneumonia and the need for oxygen or, in more severe cases, a ventilator. Children over the age of 13 are more likely to have severe Covid-19, and those with comorbidities are worst hit. “However, since very few children have comorbidities in the first place. Serious Covid-19 cases are seen in a small percentage of children," according to Khosla.
Also, SRCC Children's Hospital, a tertiary care and referral centre, has seen few serious Covid-19 cases in children, and all of her severe Covid-19 patients have recovered to date, according to Khosla. “The child has now recovered,” she said, except in a serious case in which a patient had Covid-19 induced encephalopathy, which indicates the disease had affected the brain and the patient was unconscious.
In serious Covid-19 cases among infants, doctors use steroids including prednisone and dexamethasone, according to Khosla. Based on a D-dimer test, which can help detect blood clots, doctors can use low molecular weight heparin, an anticoagulant.
The antiviral remdesivir, which has been approved for children weighing over 3.5 kg, can be prescribed in cases where the lungs have been severely affected, but only in exceptional circumstances, she added. Remdesivir is rarely required for child patients, according to Bodhanwala.
If a child develops a fever or some other Covid-19 symptom, doctors advise parents to call or video [call] them first before taking their child to the hospital. “About 50 percent to 60 percent of patients only need video consults,” Khosla said. If a high fever lasts more than five days, parents should see a doctor to know if any medical tests are necessary.
Symptoms such as irregular skin rashes, persistent fever, oxygen saturation of 94 percent, trouble breathing, drowsiness, and reduced appetite in children diagnosed with Covid-19, on the other hand, should be reported to a doctor right away, according to Bodhanwala. Wadia Hospital has seen several cases of children with both Covid-19 and typhoid in this second wave, so both diseases must be treated at the same time, she says.
One of the more severe side effects of Covid-19 on infants, which doctors began to notice early in the pandemic, occurs a few days after a child has recovered from Covid-19. According to John Hopkins Medicine, Multisystem Inflammatory Syndrome in Children or Pediatric Multisystem Inflammatory Syndrome causes inflamed blood vessels in the body, which “can limit blood flow, damaging the heart, kidneys, and other organs.”
Multisystem Inflammatory Syndrome in Infants, also known as Pediatric Multisystem Inflammatory Syndrome, is rare and treatable in most cases, according to physicians. It shares symptoms of fever, inflammation, and rash with Kawasaki disease, which affects children under the age of five.
Wadia hospital has seen fewer cases of this syndrome in the current second wave than it did in the first wave when it treated 21 children for Pediatric Multisystem Inflammatory Syndrome. However, this could change in May because Pediatric Multisystem Inflammatory Syndrome is a body's immune response after a child has recovered from Covid-19, according to Bodhanwala.
While most children recover from Multisystem Inflammatory Syndrome in Children or Pediatric Multisystem Inflammatory Syndrome, it requires medical attention and late detection can be frightening for parents, as Khushnooma Kapadia in Mumbai discovered.
Helping children recover
Even if the children have tested negative, doctors advise holding babies and very young children with their positive parent(s). This is because it is very likely that the child has contracted the disease, and entrusting the child's care to others, especially elderly people such as grandparents, can be dangerous.
Children affected by Covid-19 experience more than just the virus; they also feel lonely, isolated, and afraid, according to doctors and families.
The pandemic would affect literacy as well as children's mental and physical development with schools closed, according to UNICEF.