“Barking cough”: the expert spoke about the features of the flow of “Omicron” in children

With the advent of Omicron, doctors began to talk about a sharp increase in childhood morbidity. However, they reassured: for children, infection with a new strain of coronavirus passes like a mild cold. And, they say, with the advent of each new sub-option of Omicron, more and more children get sick, but they get sick more easily.

Is COVID-19 safe for children with the advent of Omicron? Statistics show: no. Claims of a milder course of coronavirus with new sub-options are nothing more than an attempt to downplay the impact of SARS-CoV-2 on children, experts say.

According to British statistics, in less than 8 months of 2022 in England, as many children died from COVID-19 as died in total in 8 months of 2020 and 2021.

As a microbiologist, assistant to the Department of Science at the Pedagogical Faculty of Manchester Metropolitan University Victoria Doronina, told MK, Omicron turned out to be almost the strain that had been expected since the beginning of the COVID-19 epidemic: “It spreads rapidly, but since it penetrates less into the lungs, it multiplies in the nasopharynx, the disease usually proceeds more easily than in the original version, and even more so in Delta. That is, an increase in the rate of spread of the virus occurs due to the severity of the disease.

– What is the difference between its course in children and adults?

– In children, the nasopharynx becomes more easily clogged with mucus – we are all familiar with the ever-snotty nose in children. In addition, Omicron often causes inflammation of the upper respiratory tract in children, which is accompanied by a sharp, barking cough. It’s called “croup”. Plus, Omicron can cause vomiting and diarrhea, which is much less common in adults.

– The world is seeing an increase in hospital admissions among very young children. What can it say?

– Hospitalization of young children with extremely high fever, vomiting and diarrhea is the standard pediatric protocol. As I said above, all these are typical symptoms of the Omicron disease in children. After replenishing fluids lost during vomiting and diarrhea and reducing the temperature, children are observed in the hospital. But the hospital in children does not mean an extremely serious illness. British and South African studies show that intubation (“on a ventilator”) and death of children with “Omicron” is two times lower than with “Delta”. And if you consider that the virus is spreading much faster, and there are a lot of asymptomatic carriers, then four times. The number of children in hospitals is not decreasing because more children are getting sick.

The fact that children are sick with covid from birth was known before, as women in childbirth who were sick with covid passed it on to their babies. The younger the child, the more worrying the symptoms are, and the more likely the child is to end up in the hospital.

– The latest sub-options of “Omicron” VA. 4 and VA. 5 show higher pathogenicity. How does the disease proceed with these varieties of “Omicron” in children?

– The most common are still sore throat and runny nose. However, the vomiting and diarrhea that I mentioned above are much more common than with the original Omicron. By and large, it doesn’t matter which variant a child or an adult is sick with, you need to look at the symptoms and respond accordingly.

– How common is “long covid” or post-covid in children?

– Like adults, children get “long covid” – when the symptoms of the disease, such as fatigue, last a month or more after the end of the acute illness. In addition, children also have a “multisystem syndrome” – inflammation of the internal organs. And finally, the world is experiencing a surge in liver inflammation in children who have had covid. While the cause is unclear, it can be either the result of infection with the coronavirus or the activation of other viruses against the background of a weakened immune system.

Covid remains a lottery – it can pass asymptomatically, or it can lead to a serious chronic illness. Unfortunately, children are also forced to play the lottery, starting from birth.

– What to expect in Russia with the beginning of the academic year?

– A repetition of what happens every year (if there is no quarantine) – the accumulation of children in a closed room will lead to the spread of respiratory infections. Since 2020, COVID – 19 and its many variants have been added to them. As usual, children will bring these infections home and infect adults. If adults do not have immunity to any variant of COVID-19 as a result of a recent illness or vaccination, adults will get sick. Any variant of the coronavirus in a significant number of people is unpleasant.

– Can the coronavirus mutate so that it becomes more dangerous for children than for adults? Are there such examples in history?

– Theoretically, it can, for example, if the strain begins to penetrate more intensively into children’s lungs, without losing the ability to spread rapidly. The virus “looks” for unoccupied ecological niches, and children have a relatively weak immune system. No wonder the mass of viral diseases are childhood diseases – measles, mumps. They were highly infectious and highly pathogenic, but mass immunization quickly erased their memory. Mass vaccination in children is unlikely, which gives COVID-19 the opportunity to spread among children and select more deadly variants, as happened with Delta among adults.

… Meanwhile, Hong Kong doctors are reporting new symptoms of COVID-19 in children. These include hoarseness and stridor (whistling and noisy) breathing. In severe cases, acute airway obstruction is observed.

Notably, there are two confirmed cases in children who have been classified as “severe” and are being treated in the pediatric intensive care unit at Princess Margaret Hospital.

One of them, a 17-month-old boy, developed a fever, convulsions and short-term respiratory arrest. He developed croup after being infected and had just received his first dose of the vaccine that day. Expert consultants to the government of the SAR believe that the boy’s condition was caused by the COVID virus. Another 10-year-old boy developed a high fever and tested positive and sought medical attention for difficulty breathing.

Chuan Shuk-kwan, director of the Infectious Diseases Division of the Health Protection Center of the Government Department of Health, told media that some of the infected children developed croup, which is an inflammation of the larynx, windpipe, and bronchi. These are new symptoms that were not observed during previous waves of covid. Previously, they sometimes met with parainfluenza, but now they are clearly associated with Omicron. Indicative of the potential for long-term symptoms of COVID-19 is that about 19% of children who have recovered from COVID-19 present with at least one of the following symptoms during outpatient observation: memory loss, cognitive impairment, insomnia, headaches and discomfort.