Pediatric COVID Risk Is Real

 

We all learned early in the course of the pandemic that the prognosis of adults infected with SARS-CoV-2 is better for some and worse for others. For example, while children, for the most part, appear to be spared the worst of what the virus has to offer, hospitalizations, complications, and deaths are more common in people who are elderly. According to data from the Centers for Disease Control and Prevention, of the 850,000 Americans who have now died from COVID-19, 621,000 (73%) were age 65 and above. People who are poor and have insufficient access to high quality health care are also at risk for negative outcomes. Members of minority communities have been facing disproportionate risks since the start of the pandemic. And doctors know that patients living with heart disease and hypertension, chronic lung disease, immunosuppression, cancer, heart disease and hypertension, obesity, diabetes, and other pre-existing health conditions have a harder time surviving COVID-19.

Children aren’t little adults. They have unique medical situations that increase their risk for being hospitalized and dying from COVID-19. A study published this month in Pediatrics identifies which children are at potentially higher risk of severe COVID-19 and poor outcomes.

• Approximately 30% of children in the study who were hospitalized ended up with severe COVID-19; 0.5% died during hospitalization.

• Kids under 2 years of age fared worse compared with older kids.

• Chronic lung disease, neurologic disorders, cardiovascular disease, prematurity, and airway abnormalities were the top five predictors for severe disease and poor outcomes in children under 2.

• For hospitalized children aged 2 to 17 years, feeding tube dependence, diabetes, and obesity were most commonly associated with severe COVID-19.

• Severe COVID-19 was highest among infants, Hispanic children, and non-Hispanic Black children.

 

The results suggest that stepping up prevention efforts like vaccinations will help protect kids who are most vulnerable. But Edward Nirenberg and Risa Hoshino, MD believe we’ve been failing to protect our children from the harmful virus, especially the ones who are most vulnerable:

Many, though not all, hospitalized children have comorbidities, which are associated with an increased risk of severe COVID-19. These children are as worthy of life and normalcy as those without comorbidities — suggestions that their deaths are normal or acceptable are ableist and unhippocratic. Children’s hospitals are clearly strained by the sheer volume of patients. Suffice to say, the current numbers of COVID-19 hospitalizations in children are very concerning.

 

Nirenberg and Hoshino aren’t buying the misinformed narrative that pediatric risk is minimal or nonexistent. Despite having lower risks than adults, they note that “children have still suffered greatly from the pandemic.”

While severe COVID-19 in children is rarer than in adults, the risk exists. With soaring infections and recent record high hospitalization rates, countless children stand to be harmed. Severe COVID-19 in children may require high acuity care including PICU admission, mechanical ventilation, and pressor support — and unfortunately, death may occur anyway. CDC’s tracker has identified over 80,000 COVID-19 hospitalizations in those ages 0 to 17 since August 2020. The current rate of pediatric COVID-19 hospitalization is higher than it has ever been.

 

More infections with coronavirus means more hospitalizations and, unfortunately, more children permanently injured or dying from the disease:

As of today, over 1,000 U.S. children are documented to have died from COVID-19 and 55 from MIS-C since the beginning of the pandemic — a number far in excess of multiple diseases we prevent with vaccines even after stratifying to an annual average. We must reiterate: children are not supposed to die. Deaths in childhood represent an extremely premature loss of life and are for that reason uniquely devastating. We are also fortunate to live in a country where they are highly anomalous, further underscoring their tragedy. The ripple effects of those losses will reverberate for generations and will have profound implications for health equity, as the burden of these deaths is extremely disproportionate. Today, as we contend with the Omicron variant, we’re continuing to pay for our country’s failures to respond appropriately to the crisis of COVID-19 in kids and it’s painfully clear that the health of our children remains at the bottom of the priority list.

 

Nirenberg and Hoshino say it’s time once again to prioritize kids, their parents and caregivers who have been left behind during the pandemic. Read the rest of their powerful essay here.

 

(Google Images)

 

source http://www.thepediablog.com/2022/01/20/pediatric-covid-risk-is-real/