COVID-19 is less fatal and causes milder symptoms in children

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Children and adolescents are less likely than adults to develop severe COVID-19 or die from the disease, confirms the world's largest hospital study. Researchers are also providing new information on the symptoms of the multisystem inflammatory syndrome associated with SARS-CoV-2.

Because they are affected less frequently and severely than adults, it is still difficult to gain knowledge about Covid-19 in children. But as a summary of studies published by the Public Health France agency explains, several conclusions have been drawn as the epidemic progressed. For example, a small proportion of all reported COVID-19 cases in the European Union and the United Kingdom involve children, and if diagnosed positively, children are much less likely to be hospitalized or have a fatal outcome than adults. because the infection is usually milder or asymptomatic.

The latest study published in the BMJ journal by researchers from the University of Edinburgh analyzed the clinical characteristics of children and young people admitted to a hospital with COVID-19 in the United Kingdom confirms that they generally have a less severe infection than in adults. Specifically, the researchers analyzed data from 651 children and youth under the age of 19 with COVID-19 admitted to 138 hospitals in England, Wales and Scotland between January 17 and July 3. The mean age was 4.6 years and the majority (58%) did not present comorbidities such as neurological disease or asthma.

It's confirmed: less serious

The results showed that the number of children and youth who died from COVID-19 was relatively low, six in total. Three of the deceased children were babies born with other serious health problems and the other three children were between 15 and 18 years old and also had serious health problems. Approximately 18% of hospitalized children and youth who participated in the study were admitted to intensive care. The researchers found that the children most at risk of needing intensive care were those under one month of age and 10 to 14 years old and, like adults, obesity. Ethnicity has been shown to be a risk factor.

"There have been no deaths among healthy school-age children," the study's lead author, Professor Calum Semple from the University of Liverpool, explains to the BBC. Among the children studied, 52 were diagnosed with multisystemic inflammatory syndrome (MIS-C), which the scientific community suspects is related to COVID-19 and whose symptoms resemble those of Kawasaki disease, with a more marked inflammatory note. This disease is characterized by inflammation of the lining of the blood vessels, especially those of the heart (coronary arteries). It mainly affects young children before the age of 5.

Other symptoms of multisystem inflammatory syndrome

The researchers found that these children were five times more likely to be admitted to intensive care. Symptoms generally seen in people with this syndrome include conjunctivitis, skin rash, and gastrointestinal problems (abdominal pain, vomiting, diarrhea). But their study also uncovered new symptoms related to COVID. -19 in these children with MIS-C. These include headaches, fatigue, muscle pain, and a sore throat. Finally, the platelet level was also much lower in the blood of the children with MIS-C than in those without it.

If it is an observational study, the scientific team highlights that these results can help to refine the criteria of the World Health Organization (WHO) for the multisystemic inflammatory syndrome related to the coronavirus. Because based on these analyzes, the definition of this syndrome could be expanded to include the symptoms of fatigue, headaches, sore throats and muscle aches in addition to those already listed by the UN agency. Also, the combination of these symptoms and a low platelet count could better identify children who are more severely affected by MIS-C.

"This report is the most detailed description of COVID-19 and MIS-C in children. We have provided a new understanding of MIS-C that will help manage this rare but serious condition, but now parents can rest assured that serious infections they are very rare in children, "concludes Pr Calum Semple. This study was published as many countries prepare for the start of school and the question arises of what role schools play in the transmission of SARS-CoV-2.

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