A Texas review of more than 100 studies worldwide shows that children who get COVID-19 do just fine | #covid19 | #kids | #childern

The largest review to date of more than 100 studies done worldwide has confirmed a cheering fact: Most children who contract COVID-19 will do just fine.

Overall, they fare much better than grown-ups, except for a distinct minority who develop a severe inflammatory syndrome that mimics the most extreme cases of the disease in adults.

“The main takeaway is that children diagnosed with the virus in general have an excellent prognosis,” said Dr. Alvaro Moreira, an assistant professor of pediatrics at UT Health San Antonio Long School of Medicine, who was the lead author of the review. “It’s rare to see a pediatric patient having to be admitted to an intensive care unit or even the hospital.”

The review — an analysis of 131 studies involving children from 26 countries — was published Friday in EClinicalMedicine, a journal of The Lancet, a prestigious medical publication. The review covered the first four months of the pandemic, from January through May, and involved 7,780 pediatric patients from China, the U.S., Australia and other countries.

Moreira, who is also a neonatologist, said a main goal of the study was to identify and establish standards and guidelines in the study of COVID-19 in pediatric patients, which right now is “all over the place.”

The review found the mean age of children who contracted COVID-19 in the study samples was about 9. About 75 percent contracted the virus from a family member. Almost 20 percent of children were asymptomatic, meaning they had the disease but never showed symptoms of it.

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Of the entire sample, only 11 children developed multisystem inflammatory syndrome, a severe and sometimes deadly form of the disease that includes an unremitting high fever, rash and gastrointestinal issues, like vomiting and diarrhea.

“Although we are hearing a lot about this severe form of the disease in children, this is occurring in very rare circumstances,” Moreira said.

Children with the inflammatory syndrome had a significant decrease in a type of immune cell in their blood, key to fighting off viral infections, he said, compared to children who didn’t develop it. It’s still unclear whether this reduction was caused by the disease, or if the children simply exhausted their supply in fighting it.

Other findings: About 3 percent of children were admitted to an ICU. Seven deaths were reported. The exact cause of death wasn’t always given, Moreira said, but it’s presumed it was secondary to the inflammatory syndrome.

Nine children experienced kidney failure, nine had liver failure and 19 experienced shock. The majority recovered from these complications. Forty two children had to be put on ventilators to assist their breathing.

About 152 children had compromised immune systems or underlying respiratory or cardiac disease, Moreira said.

Children don’t get as sick as adults from COVID-19 seemingly for two main reasons: They have “more adaptable” immune systems, and they don’t tend to have multiple underlying conditions that complicate COVID-19 in adults, such as heart or lung ailments and immune system diseases.

The report described some key findings, such as the common symptoms in children (fever and cough, just like in adults), along with laboratory results and imaging characteristics in children with the virus. It summarized the various treatments that were administered and described the handful of children who developed the inflammatory syndrome.

The majority of studies were from China; the largest involved 2,572 patients reported on by the Centers for Disease Control and Prevention’s COVID-19 team.

Most children in all the countries surveyed only had to receive “supportive measures,” such as hydration, antibiotics and observation, Moreira said.

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There is one caveat: The review doesn’t include a more recent spike in pediatric patients with the inflammatory syndrome in New York, England and Italy. This will likely increase the rates of ICU admissions, complications and deaths, but, overall, it remains a rare outcome, Moreira said.

To analyze the 131 studies, he worked with a team of researchers and medical students from the Long School, Texas Children’s Hospital in Houston, Texas A&M, the University of Texas at San Antonio and others.

And what is the message for parents?

Keep doing those things public health experts recommend, he said. Wash your hands. Keep at least 6 feet apart. Wear a mask. Stay home. Make sure your kids take these precautions as well.

“We know that children who are at home with an infected family member might get it,” Moreira said, “but even if they do, the majority are going to do well.”

Melissa Fletcher Stoeltje is a general assignment reporter covering breaking news, cultural trends and interesting people and goings-on around San Antonio and Bexar County, as well as all across South Texas. To read more from Melissa , become a subscriber. mstoeltje@express-news.net | Twitter: @mstoeltje




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