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Study of Indian children with Covid finds infection is mostly mild or asymptomatic

Indian Paediatric Covid Study Group monitored 402 children with Covid between March and November last year, found only 9.7% to be moderate to severe cases, while 13% succumbed to disease.

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New Delhi: Among children infected with Covid-19, a large number will likely be asymptomatic or the extent of the illness mild, a new study has found. The only exceptions are children with comorbidities. Of the 402 children who were monitored in the study, only 13 per cent succumbed to the disease.

The study was conducted by the Indian Paediatric Covid Study Group, which includes leading doctors from medical institutions from across the country. ThePrint has a copy of the study.

Between March and November 2020, the researchers observed 402 children suffering from Covid — from those infected at birth, to patients aged 12 years. The study was carried out at five medical centres in India — the All India Institutes of Medical Sciences (AIIMS) in Delhi, Bhubhaneswar and Jodhpur, the Karnataka Institute of Medical Sciences in Hubli, and the Sher-I-Kashmir Institute of Medical Sciences (SKIMS) in Srinagar. The hospitals were chosen to represent the five zones of the country — north, south, east, west and centre.

The study made several findings: The most common symptom observed was fever, affecting 38 per cent of the patients; the majority of the patients (54 per cent) were mildly symptomatic; and moderate to severe cases comprised only 9.7 per cent, revealed Dr Kana Ram Jat, one of the lead authors.

Covid among children has been a subject of concern lately, especially after more children were affected in the second wave that hit the country this year than in the past year. According to ICMR Director-General Dr Balram Bhargava, about 3.4 per cent of the patients in the first wave and 4.4 per cent of patients in the second were children.

With talks of a third wave possibly occurring, AIIMS Delhi Director Dr Randeep Guleria, recently said that Covid vaccines for children will likely be available in India by September-October.

However, the Indian Academy of Pediatrics (IAP) in a statement dated 22 May, iterated that almost 90 per cent of infections in children are mild/asymptomatic and the incidence of severe infection in them is rare.

Also read: Young children may not need Covid vaccines: ICMR chief tells MPs’ panel amid 3rd wave fear

44% of subjects had comorbidities

Of the 402 patients, 190 were admitted at AIIMS Delhi, 74 at AIIMS Bhubhaneswar, 68 at KIMS, 60 at AIIMS Jodhpur and 10 at SKIMS.

While 2.8 per cent of the patients were neonates or newborns, 11.4 per cent were less than a year old, 29.9 per cent were aged between 1 and 5 years and 55.9 per cent children were in the 5-12-year-old category.

More than 50 per cent of the group had come in contact with confirmed Covid positive patients and about 44 per cent had underlying comorbidities.

The most common comorbidity in the subjects was malignancy (such as leukemia), followed by cardiac diseases. Of the 13 per cent who succumbed to Covid, five had disorders of the central nervous system, three were suffering from leukemia, three had congenital heart diseases, one had steroid-resistant nephrotic syndrome (a kidney disorder) and type-I diabetes.

“Besides the presence of fever, rash and vomiting, underlying comorbidity, thrombocytopenia, high urea, low total serum protein (which could indicate malnutrition or inflammatory bowel diseases) and raised C-reactive protein (used to check the extent of C reactive protein, from the liver, in blood) were factors associated with moderate to severe disease in children,” said Dr Jhuma Shankar, the study’s co-author.

However, the study also stated that “…the variability of symptoms may be different due to different geography and differences in the testing strategy”.

The 25-page study also stated that most of the children who had symptoms received “supportive therapy” (symptom-based treatment), while the asymptomatic ones didn’t receive any such treatment. However, in specific cases, such as those with severe infections, the children were given antibiotics and antiviral therapy.

Since the study didn’t include children who were under home isolation, the average time period for those hospitalised and monitored for the study was 10 days.

Meanwhile, according to another new study, symptoms of a rare condition associated with SARS-CoV-2 in children, known as multisystem inflammatory syndrome (an inflammatory reaction to the virus that could manifest at the time of Covid infection or within one or two months of recovery), usually gets resolved within six months despite severe illness.

The study, which was published in the The Lancet Child & Adolescent Health journal in May, looked at cases of ‘Paediatric Inflammatory Multisystem Syndrome: Temporally Associated with SARS-CoV-2 (PIMS-TS)’ in 46 children treated at the Great Ormond Street Hospital in the UK, between 4 April and 1 September 2020. The average age of the subjects was 10 years. Only eight had pre-existing comorbidities. None of the patients died.

(Edited by Poulomi Banerjee)

Also read: Why Covid variants seem to appear in Maharashtra first


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