It is more difficult to diagnose the severity of children's condition with COVID-19
How children cope with the new coronavirus infection, what complications can there be after the disease, and how to prevent the infection of a child in the pandemic? Svetlana Senek, the deputy chief physician for medical work at the Children's Clinical Hospital, told Tatarstan residents about these and many other questions on the live account of the operational headquarters of the republic for countering the spread of COVID-19. Realnoe Vremya presents the main recommendations of the pediatrician for parents.
More sick babies
Children are suffering from the new coronavirus infection like adults. The clinical manifestations of their diseases have not changed in comparison with last year — the new strain manifests itself in the same way. However, doctors note an increase in the number of sick children of the first year of life — babies can get sick severely, because the immune system is not yet formed properly to adequately respond to the virus.
At the same time, if adolescents are most often infected from each other and this process is difficult to control, then the disease of children of the first year of life and newborns occurs mainly when they are infected from unvaccinated parents.
In children aged 14-16, the clinical picture is almost the same as in adults. The doctor noted that the disease is more severe if the child is overweight or suffers from diabetes.
According to the observation of the doctor, teenage schoolchildren and students get sick more severely, because they have hormonal alteration of the body.
“The immune system does not always respond adequately to infection, and with the coronavirus infection, the immune system is always hyperreactive. In puberty, autoimmune diseases are often provoked, hereditary diseases and coronavirus infection does not go very easily.”
The doctor called the main measure of preventing the incidence of coronavirus for young people over 18 years old — to get vaccinated if there are no chronic diseases in the acute stage.
If a child (of any age) still gets infected, it is necessary to make a home visit. The following symptoms should alert parents: if the child has a subfebrile temperature, weakness, lethargy for several days. When children are sick with Covid-19, intoxication and temperature are not very pronounced, but in any case, this is a reason to seek medical aid, since in the future this will help prevent the development of complications.
Where parents should apply for treatment if the child is ill:
- To the City Children's Hospital No. 1. If the test result for coronavirus is positive or the child is ill — has signs of SARS, and has been in contact with a patient with Covid-19.
- To the Children's Republican Clinical Hospital. With a confirmed diagnosis and a severe course of the disease — for example, in children with chronic diseases, overweight, cerebral palsy.
“Most often, children, except for those age groups that have been mentioned earlier, cope with the coronavirus infection almost asymptomatically: one or two days of low fever — and children recover. It happens that parents do not even know that the children have been ill," the doctor states. “The danger of this situation lies in the possible complications of repeated illness, which is still difficult to talk about due to that the epidemic is relatively short-lived.”
In children with Сovid-19, there are a number of features that are not characteristic of the course of the disease in adults: multi-inflammatory syndrome that occurs in the third or fourth week after the disease, if it occurs in severe form, skin damage and gastrointestinal tract damage — toxic hepatitis. The latter is determined by tests — an increase in the level of certain enzymes indicates problems. The doctor noted that it is important to identify these conditions, since they can later manifest themselves in the form of chronic diseases.
“It is more difficult to diagnose the severity of the condition of children, because often there are not enough clinical manifestations — the child can be cheerful and it looks easy to cope with the disease, it is necessary to do a workup, because COVID-19 is also a lesion of the brain vessels.”
Speaking in more detail about skin lesions in children with Covid-19, Svetlana Senek described the manifestations of Kawasaki syndrome, which, according to the doctor's observations, has recently been common after the coronavirus infection.
“Kawasaki syndrome is vasculitis, a vascular lesion. Clinically, it looks like subcutaneous hemorrhages, quite extensive, which occur both on the skin and on the mucous membranes, of varying degrees of manifestation — up to necrosis. The syndrome is characterised by high fever, skin manifestations, damage to the mucous membranes — by the type of conjunctivitis, damage to the mucous membranes of the mouth, enlarged lymph nodes. Kawasaki syndrome is accompanied by a certain cyclicity: high fever is replaced by a rash, the rash is replaced by exfoliation — the picture is like with scarlet fever," the pediatrician described possible manifestations of the disease.
If Kawasaki syndrome occurs, the child must be treated only in a hospital. The doctor focused on the danger of Kawasaki syndrome in the third or fifth week of the disease: there may be such a complication as a lesion of the coronary vessels — something that is typical for adults and not typical for children, after which sudden death may occur, or in the future this disease may cause an early heart attack in an adult.
How to deal with the consequences of the virus
The doctor said that all children with a confirmed coronavirus infection are registered at a dispensary at their place of residence or are being monitored at a dispensary in the Children's Clinical Hospital if they have been seriously ill.
A rehabilitation programme for children who have undergone Covid-19 has been developed and is being implemented on the basis of the Children's Clinical Hospital and other urban medical institutions.
Senek urged parents not to take rehabilitation lightly and to make sure that the child attends rehabilitation events. This is important, because as part of the rehabilitation, a full comprehensive examination of the child's body is carried out, including a biochemical blood test, an electrocardiogram is taken, X-ray examinations are prescribed. At the stage of examination, it is possible to determine complications after the coronavirus infection in a child. For example, toxic hepatitis after coronavirus cannot be detected without a biochemical blood test.
As for preventive measures, the doctor is convinced that it is not necessary to restrict children's communication with each other, but they should communicate in the open air.
“Active games are very important for the health of children, fresh air is also the prevention of excess body weight. You should also teach children to wash their hands more often, do not go into the elevator if there are already several people there. It is necessary to exclude visits to shops, cafes, water parks, and any other enclosed spaces.”