Comorbidity in children impacts severity of Covid-19 infection

The affectations caused by the disease of the SARS-CoV-2 in pediatric patients continue to be investigated, however recent studies suggest that while children are as likely as adults to become infected with the Covid-19, they have fewer symptoms and the disease is less severe.

In an interview with El Economista, Doctor Oscar Tamez Rivera, infectologist-pediatrician and specialist of the Tecnológico de Monterrey, specified that in children who become infected with Covid-19 They have mostly reported mild symptoms in the disease and this has been mainly related to the way their immune system reacts.

According to a study published in the medical gazette, it is pointed out that there are different hypotheses that support the reasons why children have fewer complications. One is related to the angiotensin converting enzyme receptor 2 (ACE2), which is a binding site for the SARS-CoV-2. It has been postulated that children have fewer ECA2 receptors and, consequently, lower affinity compared to adults, so they could be less affected. Another hypothesis is that children are less affected because mortality has been related to comorbidity, which is not so common in this population.

Dr. Tamez Rivera explains that the main symptoms reflected by infected minors, in addition to the common ones (fever, tos and headache) son: “spots on the skin, diarrhea and abdominal pain; and in some cases they present irritability, especially in the lactating population. They can also have central nervous system affectations, such as seizures or symptoms of Guillain-Barré syndrome”.

Likewise, the medical specialist pointed out that pediatric patients who refer more severe pictures of the disease of the Covid-19 are those who suffer from some comorbidity.

“Some of the risk factors in severe infection by Covid-19 sound of cardiovascular nature, that is, in pediatric patients who have problems in their circulatory system, heart or immunodeficiency that causes their defenses to be low, as well as problems in the central nervous system, this population has the same risks as an adult population ”, he explained

According to the pediatrician, as in adults, children can also have sequelae after having fallen ill from the Covid-19However, these occur in very few cases.

“In children, the sequelae can be divided into two: in the medium and long term. In the medium term, 14 and 28 days after being infected, they may present a pediatric multisystemic inflammatory syndrome, this syndrome occurs between 1 and 2% of cases and is characterized by the restart of the fever, diarrhea, abdominal pain or skin manifestations such as spots on the skin or in the eyes, conjunctivitis problems, which tells us about an inflammatory reactivation and can reach the vasculature and the heart muscle ”, he explains.

“In the long-term sequelae they are very similar to what happens with adult patients where the symptoms may pre-exist weeks or months after the patient was cured and the most frequently reported are fatigue, blurry vision, irritability and in some cases difficulty concentrating, this occurs between 8 to 13% of cases and this can affect the quality of life and neurodevelopment of the pediatric population ”.

Finally, Dr. Tamez emphasized that if the patient has suffered more serious symptoms or subsequent changes are detected, it is necessary to carry out a physical inspection, in addition to clinical blood tests to provide adequate and timely medical treatment.


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