When the coronavirus started to spread in China and nearby countries, scientists observed that the elderly, those who have weakened immune systems, and those with underlying health conditions were most vulnerable to succumbing to coronavirus disease (COVID-19).
It seemed as if the virus spares children and adolescents. However, as the pandemic progressed, the number of children contracting the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, has steadily increased.
The U.S. Centers for Disease Control and Prevention (CDC) released new guidance revealing that the number and infection rate of COVID-19 cases among children have steadily increased between March and July, which may worsen as schools start to re-open.
This transmission electron microscope image shows SARS-CoV-2, the virus that causes COVID-19, isolated from a patient in the U.S. Virus particles are shown emerging from the surface of cells cultured in the lab. The spikes on the outer edge of the virus particles give coronaviruses their name, crown-like. Image captured and colorized at NIAID's Rocky Mountain Laboratories (RML) in Hamilton, Montana. Credit: NIAID
Infection among children
In the United States and across the globe, where more than 21.82 million people have already contracted the virus, fewer cases of COVID-19 have been reported in children between 0 and 17 years of age compared to adults.
The number and rate of infection in children have increased over the past months. The CDC said that this is maybe due to the lack of testing in children and focusing on adults and those who are at high-risk.
The CDC also reported that while there is an increase in infections in children, the hospitalization rate among this age group is significantly lower compared with adults, hinting that children are at low risk of developing severe COVID-19 infection.
Recent data shows that the rate of hospitalization among children is 8 per 100,000, while the rate for adults is about 164.5 per 100.000. Further, children have lower rates of mechanical ventilation and deaths compared with adults but warned that 1 in 3 children hospitalized due to COVID-19 in the U.S. was admitted to the intensive care unit, which is the same rate in adults.
CDC added that children with certain underlying health conditions and infants who are less than 1-year old might at a heightened risk of severe illness. Of the children who developed severe COVID-19, most have underlying health conditions.
Just like adults, children who develop severe COVID-19 may have respiratory failure, shock, myocarditis, acute renal failure, coagulopathy, and multi-organ system failure. They are also at a high risk of developing multisystem inflammatory syndrome in children (MIS-C).
Transmission among children
The health agency noted that it is still unclear whether children are as vulnerable to SARS-CoV-2 infection compared with adults. There is still no evidence on whether children and adolescents can transmit the virus as effectively as adults.
“Recent evidence suggests that children likely have the same or higher viral loads in their nasopharynx compared with adults and that children can spread the virus effectively in households and camp settings,” the CDC explained.
School closures have helped mitigate the spread of the virus in the United States, especially among children. This may explain the low incidence of COVID-19 in children compared with adults. With the schools starting to re-open in the United States, it is unclear if
“Comparing trends in pediatric infections before and after the return to in-person school and other activities may provide additional understanding about infections in children.
Increasing testing in children can help mitigate the spread of the virus. The CDC advises parents to ask their health care providers about testing.
“As children return to school and other in-person activities, pediatric healthcare providers should be prepared to answer questions from families about testing and when it is safe to return to school or be with people outside the household,” the CDC added.
Still, the CDC reiterates the importance of educating children and their parents on everyday infection prevention measures, including the importance of washing the hands, social distancing, and wearing of masks in public.
The CDC released updated isolation guidance and warned that people recovering from COVID-19 should not assume they automatically have three months of immunity from reinfection. The report comes after a string of reports claimed that those who recovered from the infection would be naturally resistant to the second bout of infection.
“There are no confirmed reports to date of a person being re-infected with COVID-19 within 3 months of initial infection. However, additional research is ongoing,” the CDC said.
“Therefore, if a person who has recovered from COVID-19 has new symptoms of COVID-19, the person may need an evaluation for reinfection, especially if the person has had close contact with someone infected with COVID-19. The person should isolate and contact a healthcare provider to be evaluated for other causes of their symptoms, and possibly retested,” it added.