This year, we are seeing more cases of COVID infections where children are presenting with symptoms. In addition, the government has cautioned recently that the third wave of COVID infections in India will primarily impact Children. It is important to know the possibilities and prepare accordingly.
The good part is the majority of affected children are having only mild to moderate symptoms and can be managed at home. Only a few will require hospitalization and indoor management and a very small percentage will go on to develop critically or severe COVID symptoms.
As per Dr. Urvashi Rana, Pediatrician, Narayana Multispecialty Hospital, Ahmedabad, “Any child who has fever associated with cough, cold, headache, body ache or other complaints such as vomiting and diarrhea, apart from the routine infectious causes, COVID has to be kept as a differential diagnosis. This is because this time varied presentations of COVID are seen as far as children are concerned. Some of them may present with typical symptoms such as fever, cough, loss of taste and smell senses, fatigue, and while many are showing non-specific symptoms and mimicking any other viral illness ranging from respiratory symptoms, gastral symptoms with or without fever. Newborns may contract the virus from mother of other family members because they remain close to their mother for breastfeeding.”
The majority of COVID cases in children fall in the mild category. They can be managed at home by supportive medication such as antipyretics (paracetamol) to bring down the fever, maintaining proper hydration, and including supplements such as multivitamin vitamin C, zinc, etc. For symptoms such as cough, cold, diarrhea, specific medications may be given. Antibiotic is not indicated in every case and it will depend upon the severity.
If the patient is having moderate to severe COVID illness, hospitalization may be needed and the child is managed by IV fluids, oxygen supplementation, and steroids which is decided on a case-to-case basis. In all children, temperature needs to be monitored nonetheless.
“There is another risk as far as children are concern and that is MISC – Multisystem Inflammatory Syndrome following COVID (post-COVID symptoms). Children who may have tested COVID positive in past 1 or 2 months or have come in contact to COVID positive patient, and remained asymptomatic in that period then some of them may develop sudden outset of fever with complaints such as abdominal pain, diarreha, swelling in the hand and feet, conjunctivitis or any other neurological symptoms like redness in the mouth. Though, it is a very small percentage who may develop this complication but it has been seen in children last year and expected this year too once COVID surge subsides. Such children require extensive workup, blood investigation, echocardiography and they need to be managed with the help of steroids IVIG or higher drugs & medication and need to be monitored very closely,” added Dr. Rana.
As far as prevention of COVID in children is concerned, the basic principle is maintaining social distancing, wearing mask (above 2 year) and use of sanitizer or washing hands with soap and water. For children below 2 years, parents or caretakers need to be very careful about covering their nose.
Other things that parents can do to build the immunity of the child is make them eat healthy and nutritious home-cooked food consisting of vegetables and fruits. Parents should ensure that children with less than 5 years of age get the regular vaccination as per the schedule.