June 29, 2020, 1:30 pm | Read time: 4 minutes
In a Europe-wide study, researchers examined how severely children are affected by the coronavirus. According to the study, COVID-19 deaths among young patients are very rare. However, the doctors noticed differences in how the disease manifests compared to adults. FITBOOK summarizes the study’s findings.
Children rarely become seriously ill after being infected with the coronavirus SARS-CoV-2. Only in very few cases does the illness become life-threatening. COVID-19 deaths among children are the exception. This conclusion was reached by an international research team led by Marc Tebruegge. The scientists published their Europe-wide study on coronavirus in children in the renowned journal “The Lancet Child & Adolescent Health.”
Children across Europe also affected by coronavirus
A network of doctors, originally researching tuberculosis in children, inquired in April 2020 at 128 children’s hospitals in 31 European countries about how many children needed treatment for coronavirus. Seventy-seven hospitals reported a total of 582 cases. This means the coronavirus pandemic has also reached the youngest across Europe.
Since the numbers mostly came from specialized clinics, the researchers initially assumed that mainly severe cases would be reported. To their relief, however, there were only a few cases with severe infection.
A quarter of the children suffered from respiratory infections
Infections of the lower respiratory tract, including the trachea and bronchi, affected 143 children, which is 25 percent. Pneumonia was radiologically confirmed in 93 of them. Twenty-five children (4 percent) required mechanical ventilation. When ventilation was necessary, it usually lasted longer, up to a maximum of 34 days.
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COVID-19 deaths in four children
Of the 582 reported coronavirus cases, four children died from COVID-19. All four were older than ten years. Two of the children had pre-existing conditions. One child had complications from a stem cell transplant months earlier, and the other was not mechanically ventilated due to the severity of their pre-existing conditions.
Among the two deceased children without pre-existing conditions, one had previously been on a ventilator in an intensive care unit. The other child succumbed to cardiac and respiratory arrest on the way to the hospital.
Notable: Many children fell ill suddenly
A concerning finding of the study is that most surviving children fell ill suddenly. Only 25 percent were weakened by pre-existing conditions. This contrasts with adult patients, where typically older individuals and those with long-standing conditions such as hypertension, diabetes, or heart failure are more severely affected by COVID-19. Keyword: high-risk patients. FITBOOK reported that 20 percent of those with pre-existing conditions are expected to experience severe illness.
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Symptoms: Fever, cough, diarrhea–but no Kawasaki syndrome
Three hundred seventy-nine children (65 percent) had a fever. Three hundred thirteen children (54 percent) had upper respiratory tract infections (such as sore throat and cough). One hundred twenty-eight children (22 percent) had diarrhea. Notably, 92 children (16 percent) were asymptomatic–the infection was discovered incidentally, leading to their hospitalization for observation.
In the spring, reports worldwide increased about a severe inflammatory form of COVID-19 in children. FITBOOK reported on the so-called Kawasaki syndrome. The good news: The syndrome, now known by the cumbersome name “PIMS-TS,” was not detected in any child in this European study. Researchers therefore suspect that the inflammatory syndrome remains a very rare form.
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What medications were given to children for coronavirus?
Forty children were treated with hydroxychloroquine, a drug with potential antiviral effects. Remdesivir was administered to 17 patients. Six children received lopinavir-ritonavir. Three children were given oseltamivir. Other medications administered included corticosteroids (22 children), immunoglobulin (7), tocilizumab (4), anakinra (3), and siltuximab (1).
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Researchers overall reassured by study results
Marc Tebruegge, the lead author of the study and head of the Institute of Child Health in London, expressed relief over the results of the Europe-wide investigation in a press release. “Our study provides the most comprehensive overview of COVID-19 in children and adolescents to date. We were reassured to see that the mortality rate in our cohort was very low. It is likely even lower, as many children with mild illnesses were not medically treated and therefore not included in this study.”
Even though the majority of children and adolescents only experience mild illness, Tebruegge warns not to forget the severe cases. “A significant number of children develop severe illness and require intensive care support. This should be considered in the planning of health resources during the pandemic,” says Tebruegge.