Coronavirus infection in the pediatric age group

Since the beginning of the coronavirus pandemic that has been sweeping the planet since the end of 2019, the scientific community and the public have asked many questions that are gradually beginning to be answered.

However, it is possible, that some of the questions discussed in this article, with the passage of time will change or require nuance. Therefore, the reader should be aware that, as of today, the available data on pediatric infection are as discussed below.

First, we all talk about COVID-19 as the virus that has changed our daily reality. I would like to start by commenting that COVID-19 is actually the name of “the disease” and therefore we should speak of COVID-19 as the pathology that develops when one is infected by the coronavirus whose “official” name is SARS-CoV-2. Therefore, the generic name of the “bug” is coronavirus, or more precisely SARS-CoV-2, and COVID-19 is the name of the disease it causes (acronym of coronavirus disease 2019).

The first information coming from China spoke of an infectious disease, contagious via saliva droplets, similar to the flu in terms of symptoms. This pathology mainly affected people over 50 years of age, causing severe pneumonia with a high mortality rate.

Children did not appear in this first picture of the new disease. We pediatricians asked ourselves: “What about the children?” As more information came in, it became clear that the number of infected children was very small and almost none of them presented severe symptoms.

When the epidemic reached Europe and the pediatric cases were analyzed in more detail, we began to be able to answer the questions we all asked ourselves: Do children become infected in the same way as adults? Do they really have a milder form of the disease? Are there severe forms of the disease in children? Do they infect each other? Do they infect adults? How long are they contagious?

Do children get infected as well as adults?

Probably children are less infected and those who are infected present asymptomatic forms or such a mild common cold that they may even go unnoticed. This is a fact confirmed by data from all European countries, as well as by data from countries that have tested pediatric populations such as Iceland and South Korea. Children are infected less compared to adults and are usually asymptomatic or have mild forms of disease.

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Are there severe forms in children?

As with any pediatric infectious disease, from tonsillitis to bronchiolitis, gastroenteritis or chickenpox, there are always severe forms that can force a child to be admitted. In the case of coronavirus, the situation is the same. Admissions are infrequent and the need for intensive care is exceptional.

Regarding the alert raised a few days ago, concerning an increase in severe forms of Kawasaki disease associated with SARS-CoV-2, it is still too early to know the actual number of cases, but it remains an exceptional event and in any case has medical treatment.

Finally, it is important to know the transmission of the disease. It is in this chapter where there are still more questions.

At the moment most experts say that transmission from children to adults is rare (unlike the common cold or the flu), it is rather the other way around, with children catching it from an infected adult. However, more studies are needed to know what happens with transmission between children and from children to adults.

The route of transmission is through droplets that we expel when we talk, cough or sneeze, therefore, one way to protect children is for adults to wear a mask, especially during the period of deconfinement. The use of masks in children is more controversial and should probably only be used by those who are old enough to be able to do so adequately.

In summary, coronavirus affects children less than adults and most have very mild or asymptomatic disease. The number of children admitted with severe disease is minimal and there is practically no mortality. Most children acquire the disease through transmission from an adult.

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There is, therefore, no reason for parents to be very anxious and worried about the appearance of symptoms in their children that may suggest coronavirus infection, since most certainly if it is, the symptoms will be benign. Parents should take care of themselves because they are most at risk and protect grandparents who are the most vulnerable group in this pandemic.