There appears to be no substantial evidence to suggest that children will be more affected or have greater illness severity due to Covid-19 in the anticipated third wave, according to a new report prepared by the Lancet Covid-19 Commission India Task Force after convening an experts group comprising leading paediatricians to examine the issue of ‘paediatric Covid-19’ in India.
However, it cautioned, the health system needs to gear up for a paediatric case load with adequate infrastructure, earmarked facilities at primary, secondary and tertiary levels of care, oxygen availability, appropriate equipment, trained manpower, drugs and injectables among others, all of which are specific to children.
The report authors, which included three doctors from AIIMS, Delhi including Sheffali Gulati, Sushil K Kabra and Rakesh Lodha said the infection’s symptomatology in children in India appears to be globally comparable.
“Most children with Covid-19 are asymptomatic, and amongst those symptomatic mild infections are predominant. Most children have fever with respiratory symptoms, and often present with gastrointestinal symptoms (such as diarrhea, vomiting, pain in abdomen) and atypical manifestation compared to adults. The proportion of symptomatic children increases as age increases as does the severity in such age groups,” the report stated.
In the absence of a national database on clinical presentation and outcomes of infected children during the two surges noted thus far, the data of approximately 2,600 hospitalised children, below the age of 10 years (excluding neonates), from 10 hospitals (both public and private), in Tamil Nadu, Kerala, Maharashtra and Delhi-NCR region, was collected and analysed.
According to the data, mortality rates amongst these surveyed hospitalised Covid-19 positive children below the age of 10 years was 2.4 per cent and about 40 per cent of the children who died had comorbidities.
“Nine per cent of all hospitalised COVID-19 positive children presented with severe illness, under 10 years of age. The above observations were similar during the two surges of COVID-19 infections India has experienced,” the Lancet document said.
On multisystem inflammatory syndrome (MIS-C) in children, the report said, risk factors for this condition include obesity, asthma, compromised breathing, developmental disorders, cardiac disease, cancers or immunocompromised children as well as those who have undergone surgeries.