Measuring your fever at home before you leave for school may not be enough. Since the first months of this pandemic it has been observed that children run less risk of developing a serious disease and, hardly, the coronavirus infection has led to important symptoms in the youngest. In practice, in the vast majority of cases, children and teens turn out completely asymptomatic or with milder symptoms which, not always, are the most common in adults. In fact, some studies indicate that, in younger patients, fever can occur in just over half of cases, making it more likely that the infection will go unnoticed. Not a small problem that, with the resumption of school activity, makes the task of parents more difficult, who are entrusted with the responsibility of checking the health of their children. What else, in the absence of fever, should make them suspect contagion? And what other signs could they pay attention to? We asked for it to Professor Alberto Chiara, Director of the Maternal and Infant Department of the ASST of Pavia and President of the Italian Society of Hospital Pediatrics (SIPO).
So professor, what do we know today about the symptoms of Covid-19 in children? What are the most common?
Children have milder symptoms than adults. Common symptoms are fever, general malaise, nasal congestion, sore throat, headache, cough, muscle aches, sometimes even diarrhea, nausea and vomiting, and are unfortunately similar to those that appear in flu. In the most serious cases, the little one shows difficulty in breathing and can undergo insufficiency of many organs and systems, such as kidney and heart.
Are the symptoms different from those of adults?
They are similar, although children have milder symptoms. Severe forms and deaths are extremely rare and this is also evidenced by the literature data, which indicate fewer children with severe pneumonia than adults. If we were to therefore consider the risks to the personal health of the child, we can say that they are really negligible. The pediatric patient generally gets little sick and mild forms. In other words, children are as likely as adults to get sick but less likely to have severe symptoms.
Are there any differences between the different age groups?
The symptoms of Covid-19 in the little ones are often absent or mild, however the infection in some cases can lead to the development of complications or peculiar clinical forms. Much attention must be paid, therefore, when children show symptoms of the infection, especially if they are less than one year old and in the presence of pre-existing pathological conditions. Epidemiological data suggest that perinatal transmission of Covid-19 is unlikely if proper hygiene precautions are taken and if breastfeeding is done with safe procedures.
In the absence of fever, what signs can lead to suspicion of contagion?
Sometimes the symptoms are very vague. They must make you suspicious: a general malaise accompanied by fatigue, a cold, some gastrointestinal symptoms (abdominal pain, nausea, vomiting, sometimes diarrhea). Loss of taste and smell can also be a warning sign.
Can Covid-19 cause other problems in children?
In some cases, symptoms of hyper-inflammation, almost always related to new coronavirus infection, have been reported. The suspected association of Covid-19 infection with Kawasaki or Kawasaki-like disease in children has not yet been confirmed. If proven, it would still be an extremely rare event.
What should parents pay attention to?
To protect yourself and reduce the risk of respiratory infections, it is appropriate and necessary to adopt the prevention measures that we all know well by now: use of the mask, distancing and washing hands. It is also important to increase the sanitation of the rooms, therefore to clean and disinfect surfaces, such as tables and handles, and to avoid sharing dishes, toothbrushes (for younger children) and objects such as tablets, smartphones (for children).
If there is a suspicion, what should be done?
The parent who perceives that the child is unwell, regardless of the fever, must keep him at home. It should also be remembered that the fever in children is often not high (<38 ° C) and that, now that we are on the eve of the resumption of school activities, it is important that children go to school in conditions of well-being. They must therefore have no symptoms of any kind: no cold, cough, nausea, vomiting, diarrhea or fever line.
What can parents do to prevent their children from contracting or passing on the virus?
Enforce social distancing both outdoors and indoors, wear a mask (use is not recommended for children under two years of age) and encourage frequent hand washing with soap and water. Often, in children, coronavirus infection is also found in feces and therefore, in children, due to their lifestyle, transmission could occur more easily also via the fecal-oral route.
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