The sixth wave of covid-19, that is beating the infection records of the entire pandemic, it is also reaching the higher rates of pediatric admissions. Are cases mostly mild Y related to the fact that the incidence of the virus is higher than ever, since the omicron variant does not affect minors more than adults. In countries like United Kingdom or USA hospital admissions of children with covid-19 are rising like never before throughout these two years of pandemic. And it also happens in some Catalan hospitals such as Sant Joan de Déu (Esplugues de Llobregat). Throughout Catalonia there were, on January 11 and according to figures from the Ministry of Health, 17 children between 0 and 9 years old entered by covid, the highest figure of all waves.
“We have more children admitted for coronavirus, double or triple than in other waves. But they do not have a serious pathology, but a mild one, “says the Head of Pediatrics at the Sant Joan de Déu Hospital. Juanjo Garcia. If normally in this center I received between 5 or 10 children with covid a day, now they arrive 40 or 50. Most of them do not enter. In fact, in this wave, Sant Joan de Déu has, on average, about 12 or 15 minors admitted, “none of them in the ICU”, García qualifies. These are low figures, but higher, nevertheless, than those of previous waves.
These are small with “underlying diseases” that, when they become infected with covid-19, they “decompensate” and that is why the doctors decide to admit them. “For example, some are children with oncological problems that make feverish pictures and that you prefer to have controlled because you do not know if [la fiebre] It is due to cancer or covid “, adds this pediatrician. This type of patient represents half of the block of children admitted for coronavirus in Sant Joan de Déu.
Many are children with “basic diseases” who, when infected, “decompensate” and that is why they end up admitted
The other half, García continues, is made up of minors who have any other disease (for example, appendicitis) and they are detected for covid once they are in the hospital by performing a Routine PCR. Also they newborn babies infected by the father or mother (“due to their young age, we prefer to have them admitted,” García points out) and children with a respiratory pathology (such as pneumonia or bronchitis) derived from covid-19, but which “it is usually mild.”
Multisystemic inflammatory syndrome
Doctors are especially concerned that some of these children will end up developing, in the coming weeks, the multisystem inflammatory syndrome, a condition in which different parts of the body can become inflamed (including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs) and suffered from minor parts in previous waves.
“Yes we are seeing a increase in cases [hospitalizaciones pediátricas por covid], but many are detected covid by doing a routine PCR because they enter, for example, for appendicitis. That is to say, many times the cause of admission is not the coronavirus “, explains for his part Toni Soriano, of the Unit of Infectious Pathology and Pediatric Immunodeficiencies of the Hospital Vall d’Hebron (Barcelona). Soriano specifies that “the whole world is becoming more contagious” and, although the income of children has risen (“they have gone from zero to two or three), they are still” very few. “
In Sant Pau, the positivity of minors is 40%, while in October it was 13%
This doctor does admit to being “expectant” to see if this “so high” incidence will end up impacting “the next few weeks.” “We are concerned not with the admissions for pneumonia, but with multisystemic inflammatory syndromes. It affects children more than adults, but it occurs four to six weeks later of a SARS-CoV-2 infection, “says Soriano. incidence of this inflammatory condition in the general population is 50 cases per 100,000 inhabitants.
Positivity among those under 18 has been ‘in crescendo’ since October. That month, the Hospital de la Santa Creu y Sant Pau (Barcelona), for example, registered a 13% positivity among minors. Positivity is the indicator that marks the percentage of diagnostic tests that are positive (WHO considers that a pandemic is controlled when it does not exceed 5% in the general population). In mid-December, the positivity among the children cared for in Sant Pau was already 40%.
The last to get vaccinated
“If the incidence increases, hospitalization increases, but it is still quite infrequent for children to be admitted for covid,” he says Gemma García del Cerro, pediatrician of Sant Pau. Children are also infected because, being the last to get vaccinated, they do not have a complete pattern rate as high as other population groups. In addition, the vaccine is only indicated in those over 5 years of age. García del Cerro insists, like his colleagues, that most cases of coronavirus in children are “mild or asymptomatic”.
In the US, a thousand children were admitted to hospitals for covid on January 5; in the UK, minors in hospitals are twice as high as in other waves
The internist and coordinator of the ‘covid plant’ of Sant Pau, Pere Domingo, ask to look at him UK and USA, where there is “a big increase in cases” and “a lot of affectation” in children under 5 years of age. In fact, the United States Government requested on Sunday vaccinate children over five years of age against covid-19 given the rise in hospitalizations of minors due to the advance of the omicron variant. About 1,000 minors were hospitalized on January 5 throughout the country as a result of the pandemic, a record number, according to Rochelle Walensky, director of the Centers for Disease Control and Prevention (CDC, in English). In United Kingdom, For their part, children admitted for covid are twice as many as in other waves, as epidemiologists warn.
NEW—England 🏴 set a another 12th record high pediatric #COVID19 hospitalizations in a month. More than double the rate of former waves. The kids are not alright. Kids should not be hospitalized— have their whole lives ahead of them—PROTECT THEM. #Omicron
— Eric Feigl-Ding (@DrEricDing) January 5, 2022
In Sant Pau there was this Wednesday three children admitted: two in the plant and one in the ICU. “It is a small number compared to adults. But it raises two problems. One, that there is a whole virus reservoir that it is multiplying and that it has the capacity to produce new mutations. Two, if the child is immunosuppressed, everything gets complicated, “concludes Domingo.