What should parents know about COVID-19 and testing measures?
A large population is affected by the second wave of COVID-19, including children, which is a surprise for many parents as in the first wave, children were fairly protected against the infection. Due to this sudden rise in the cases of COVID Positive Children, a lot of parents are searching for reliable information on the best practices and care for their children.
This article will help give you information about the most frequently asked questions faced by parents like you. The answers are based on current research and scientific evidence to help maintain reliability.
What are the COVID Symptoms observed in Children?
Your child can show various symptoms based on the progression of the disease. The stages can be – asymptomatic (exhibit no symptoms at all), mild, moderate, and severe based on guidelines provided by ICMR.
Almost, 60-70% of the infected children are asymptomatic (No visible symptoms at all); amongst the children having symptoms, less than 10 – 20% of children may need hospitalization, and only 1-2% may require intensive care due to severe illness. The chances of your child developing severe COVID-19 disease are fewer than adults due to lesser expression of specific receptors to which coronavirus binds to enter the host and affect their immune system.
Stage 1: Initial onset of disease: Most of the children will exhibit mild illness.
After the virus enters your child’s body. It starts multiplying rapidly for a week. During this phase, your child can be asymptomatic or will experience mild symptoms like :
- Fever, headache, body pains, fatigue, and tiredness.
- Respiratory symptoms like cold, cough, sore throat
- Stomach pain, Vomiting, Diarrhoea, Loss of appetite
- Older children can complain of loss of taste or smell.
Most children (80-90 %) recover from a mild illness in about a week or two without any future complications.
Stage 2: Development of infection in lungs or pneumonia (affects 10-20% of patients)
Symptoms include ongoing fever, worsening of cough, rapid breathing, and borderline low oxygen levels (90 -94%). To observe any change in the breathing rate you can refer to the approximate upper limit for breathing rate at different age:
- New-born (up to 1 month)- 60 breaths per minute
- Infant (1 month to 1 year)- 50 breaths per minute
- Preschool child (1- 5 years)- 40 breaths per minute
- School going child (above five years )- 30 breaths per minute
Stage 3: Exaggerated immune response to viral infection leading to cytokine storm
Cytokines are chemical mediators produced by immune cells to fight any viral infection. Due to severe infection, your body can suffer from cytokine storms, which can lead to exaggerated symptoms.
The symptoms of stage 3 Covid-19 infection are :
- Severe hypoxia (oxygen saturations less than 90%) and breathlessness (grunting, fast breathing, severe chest retractions)
- Acute respiratory distress syndrome-ARDS (severe breathlessness due to fluid in the lungs)
- Lethargy, seizures (fits)
- Sepsis (blood infection)
- Thrombosis (formation of clots)
- Shock (fall in blood pressure)
- Multi-organ dysfunction (failure of multiple organs)
During this second wave, ensure that you avoid unnecessary travel and get medical help if your child is sick. Help your kid take all the preventive measures which are advised for adults like social distancing, mask hygiene, proper sanitization and avoiding going out in public groups.
Which group of children are at risk of severe illness?
Children under one year of age and those with underlying comorbidities are at greater risk for severe illness. Also, children with immunity disorder, whether acquired or congenital and children on long-term immune suppressants are at higher risk.
When should you get your child tested?
It is difficult to differentiate between the symptoms of COVID-19 and other common cold / viral infections due to similar symptoms. So, a child with any of the symptoms listed above should get tested for COVID-19 to confirm the diagnosis.
Make sure you isolate your child while awaiting the test results to reduce the spread of the virus. Also, get your children tested if any adult family member has tested COVID-19 Positive. Here is the list of available diagnostic tests for COVID-19 :
- RT-PCR is the best test presently available to confirm the diagnosis of COVID-19. The samples are collected from the nose and/or throat with a swab since not all cases are detected on the first try accurately. Repeat the RT-PCR test if the symptoms related to COVID-19 persist.
- Rapid antigen tests confirm the presence of COVID-19 by detecting viral proteins which offer quick but less accurate results than RT-PCR. Considering that it gives fairly inaccurate results at times, you should follow up with an RT-PCR test if your test is negative to confirm the same. This will eliminate the possibility of false-negative results.
- Antibody test detects antibodies produced in response to viral infections through a blood sample. But it is ineffective in diagnosing COVID-19 in the early stages of infection as antibodies only develop in the later stages of infection.
A positive antibody test only indicates whether someone has had the disease in the past. However, the test is helpful in the diagnosis of multi-system inflammatory syndrome in children (MIS-C), which develops weeks after the COVID-19 infection.
- CT Scan should only be done in severe COVID-19 cases under the guidance of a physician as CT Scan carries a risk of exposure to radiation and should not be used as a primary method to diagnose COVID-19 infection in your child.
Both isolation and quarantine are methods for preventing the spread of COVID-19. Quarantine is used for someone who has come in contact with COVID-infected patients or is COVID-19 positive. As the maximum incubation period in COVID-19 infection is 14 days, the recommended quarantine period also stands at 14 days.
In addition, a minimum of 10 days of isolation is recommended for asymptomatic patients, and if the symptoms don’t go away, you may have to investigate and treat the COVID infection under doctors’ guidance.
It is beneficial to maintain the health of your family and children by following a balanced diet, keeping yourself hydrated, getting enough exercise and sleep. Also, keep monitoring your child’s mental health by talking to them frequently about their feelings and by occupying them in various indoor activities.
The current times are hard for parents and children, but together armed with proper precautions and various other COVID-19 measures, we can help keep ourselves and those around us safe and sound. Remember to contact your family doctor or paediatrician for their advice if you feel the need to do so (you can use telecommunication in most non-severe cases to reduce the risk of community transmission).