COVID Hospitalizations Rising in Kids Too Young for Vaccine

Written by Serena McNeiff, HealthDay Reporter>

Thursday, January 13, 2022 – Although COVID-19 has claimed the lives of many children and caused serious illness in many of them, it is generally agreed that the virus is less likely to seriously harm young children.

But new data from the US Centers for Disease Control and Prevention reveals a troubling trend: The rate of hospitalizations linked to COVID-19 among children under 5 years old grew dramatically last week, while the same rate for children ages 5 through 17 years has remained relatively stable.

The latest numbers have raised concerns that younger members of the community may be more susceptible to the Omicron variant than their older peers. Affected children, ages 4 and under, are in the age group not yet eligible for the coronavirus vaccine.

While scientists’ knowledge of Omicron is still developing, experts say a sudden increase in pediatric hospital admissions is developing Not It indicates that Omicron is more dangerous to young children than other variants.

Overall, the Centers for Disease Control and Prevention (CDC) report revealed that the record number of infections in recent weeks has led to an increase in hospitalizations.

But among children, the under-five age group experienced the largest marked increase.

During the week of December 26 through January 1, CDC data shows that more than 5 out of every 100,000 hospitalized children ages 0 to 4 contracted COVID-19, nearly double the rate reported in early December before The Omicron variant is starting to take over. For older children, ages 5 to 17, the rate was significantly lower, at 1.4 per 100,000, in line with previous weeks.

Throughout the epidemic, children made up only a small subset of hospitalizations, and hospitalization rates for all other age groups remain much higher than those seen in children.

However, the significant increase in pediatric hospital admissions is worrying. But according to Dr. Richard Malley, a pediatric infectious disease specialist at Boston Children’s Hospital, the numbers aren’t particularly surprising. Mali said the increase in hospital admissions is an expected consequence of the unprecedented number of cases.

“If the risk of contracting the virus increases, even if children are generally less susceptible to the severe consequences of that infection, then this small number of children who would normally be hospitalized with COVID will increase,” he explained.

To add to the uncertainty, CDC Director Dr. Rochelle Walinsky stressed that hospitalization rates could be affected by “accidental” cases. She said the CDC’s data includes children who have tested positive for COVID-19 but may be hospitalized for other reasons. “Many children are hospitalized with COVID unlike Because Covid,” Walinsky said in December.

Some states sort hospital numbers

“Hospitals have become very good at screening everyone who enters hospital,” Malley explained. “And now, people are hospitalized for one reason, and then the positive test comes back and they are reported as a child in the hospital with COVID, even if the cause of hospitalization is, for example, a broken bone.”

Some states, including Massachusetts and New York, are working to correct this problem by creating a system that distinguishes between accidental cases and true hospitalizations due to COVID. But at this point, it is not clear which portion of the hospitalizations are accidental.

Another factor to consider is that young children who seek hospital treatment do not always have severe illness.

Santosh Nadepuram, a pediatric infectious disease specialist at Cedars-Sinai Maxine-Donetz Children’s Health Center in Los Angeles, explained that hospitals would accept young children even if their symptoms weren’t particularly worrisome. Most often, these babies need supportive care, such as oxygen, hydration, and monitoring by a team of professionals while they fight the infection.

When severe infections occur in children, they tend to affect those with underlying conditions, including obesity, prediabetes, heart problems, and asthma. According to Nadipuram, symptoms that should prompt parents to bring their young children to the hospital include difficulty breathing, rapid breathing, dehydration, and extreme irritability or tiredness.

Unfortunately, he said, “the symptoms are actually very general, and they apply to other respiratory viral infections.”

For the most part, young patients who seek hospitalized COVID-19 care are not seriously ill, according to Mali.

“Although not to underestimate how terrifying and anxious it would be for a child to be hospitalized with COVID, in general, these children are not as severely affected. Most are not in a critical condition like the adults we see with COVID-19,” he said.

However, doctors are looking for multisystem inflammatory syndrome (MIS-C), a rare condition that some children develop a few weeks after they contract COVID-19.

Alison Messina, a pediatric infectious disease specialist at Johns Hopkins All Children’s Hospital in St. Petersburg, Florida, said a spike in MIS-C cases may resurface in the coming weeks.

“We haven’t seen a lot of MIS-C yet, but I’m waiting to see what happens next month because we might see an uptick,” Messina said.

Omicron may be less likely to cause long-term problems

But there is some hope that Omicron may be less likely to cause long-term or delayed effects, including MIS-C, than other COVID-19 variants.

At this early stage of the Omicron wave, experts are still learning about its unique mechanisms and how it may or may not affect patients differently. However, there is increasing evidence that this particular strain of COVID-19 is focusing its attack on the nose and throat. Other variants, such as delta, were more adept at moving into the lower respiratory tract and wreaking havoc in the lungs.

Nadipuram explained that with earlier variants of COVID-19, the timeline for severe infections is often extended, and problems usually start once the virus reaches the lungs.

“Severe symptoms in the first two waves are kind of delayed — which means you had COVID, and then you were intubated for a while, especially in really high-risk people who are 70 and over,” he said. “Then there’s going to be an inflammatory reaction, and they’re going to collapse, and those are the people we’ve seen in our intensive care units.”

Nadipuram said Omicron appears to be working on a tighter schedule. “At the moment, this seems to behave very much like a very severe, very short-lived illness, where you get it, and 12 to 24 hours later you have symptoms.”

Signs that an omicron infection is taking a turn for the worse tend to come on quickly and clearly. “Patients kind of choose a lane,” Nadipuram said with Omicron. “If they’re low-risk and they’re doing well, they recover, which means they get better. And if they’re high-risk patients, they get sick during that acute period of time.”

From the available evidence and what he observed in the hospital, Nadipuram believes that Omicron is less likely to surprise doctors with long-term effects and delayed reactions, including MIS-C.

“We don’t worry about these long-term after-effects that occurred after two, three or four weeks as our patients used to have these terrible inflammatory diseases, including this other MIS-C entity that we were worried about in children,” he said. “We just don’t see it anywhere because this particular strain seems to be at work in the here and now.”

However, only time will tell what to expect from the Omicron variant. Mali said that even if it proves to be less dangerous than previous strains, the huge number of infections would still result in a great deal of casualties and losses. He added, “This is not the right message we want to send, which is that this virus is not that bad, and therefore it is okay if we drop some of our precautions.”

For now, children under the age of five will remain at risk, especially while awaiting approval of a vaccine for this age group. It’s not likely that a vaccine will be available any time soon because clinical trials are still ongoing.

Meanwhile, Walinsky said the key to protecting these very young children from getting the COVID vaccine is to ensure that everyone around them is vaccinated and boosted.

“Please, for our young children, those who are not yet eligible to be vaccinated, it is very important that we surround them with the people who have been vaccinated for their protection,” she pleaded during Friday’s media briefing on the issue.

Resources

  • Richard Maley, MD, Pediatric Infectious Diseases, Boston Children’s & rsquo
  • S Hospital, and Professor of Pediatrics, Harvard Medical School, Boston
  • Santhosh Nadipuram, MD, Pediatric Infectious Diseases, Cedars-Sinai Maxine Dunitz Center for Children’s Health, Los Angeles
  • Alison Messina, MD, chief, pediatric infectious diseases, Johns Hopkins All Children’s Hospital, St. Petersburg, Florida.
  • US Centers for Disease Control and Prevention, COVID Data Tracker Weekly Review, January 7, 2022

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