For a long time, the COVID-19 pandemic seemed completely harmless to children. Until the first data began to appear on rare cases of a dangerous complication of coronavirus – multi-inflammatory syndrome. And then the Delta strain came – and the rhetoric changed. Russian doctors say that they have not seen children on mechanical ventilation before, but now they have become commonplace. Two studies by American epidemiologists at once showed that the appearance of the Delta caused an increase and aggravation of childhood morbidity.
According to world statistics, a year ago, children accounted for up to 10% of those infected with SARS-CoV-2 and only up to 2% among those with symptoms. In Russia, the rates were even lower: 6-7% of registered cases of COVID-19. At the beginning of 2021, Rospotrebnadzor reported 8-10% of the total number of cases, emphasizing that children are more likely to carry the infection in a mild form, and adolescents 13-15 years old are most susceptible to infection.
And yet, detailed statistics on the incidence of children and the proportion of hospitalized children at the federal level are not available today. However, in mid-August, disturbing news began to arrive from the regions where the Delta strain reached. Some constituent entities of the Russian Federation began to report a twofold increase in children’s hospitalizations. For example, the Republic of Sakha announced the 30th increase in the number of severe cases among the children’s group, especially in the structure of the age category under 11 years old. “Among children aged from one to 11 years, the incidence rate increased by 34%, at the age from 7 to 12 years – 14%. In this regard, in Yakutsk, a decision was made to deploy a children’s bed fund on the basis of the Children’s TB Dispensary,” the media said. the head of the local Ministry of Health Elena Borisova.
The largest increase in the incidence of covid in the Saratov region was recorded among children under 6 years of age: it was 57%. Bashkortostan and Altai Territory also reported a sharp increase in the incidence of children. By the way, in Altai, an infectious disease clinic on the basis of the Regional Clinical Center for Maternal and Child Health was opened in early July. Local doctors are especially alarmed by the increase in severe cases of coronavirus infection among very young children – children under one year old. “After suffering a coronavirus infection, infants develop complications in the form of urinary tract infections, for example, cystitis. Moreover, these are long-term complications that we have to treat with antibacterial drugs,” said Raisa Leer, head physician of the Barnaul Children’s Polyclinic No. 3.
American epidemiologists from the Centers for Disease Control and Prevention (CDC) have published two studies on how the delta variant of coronavirus affects the incidence of COVID-19 in children and how severe the infection is for them. The results indicate a significant increase in morbidity among minors and a possible aggravation of the course of coronavirus infection in this age group with the arrival of the Delta strain. By the way, today the United States has reached a record rate of hospitalizations for children due to coronavirus infection since the beginning of the pandemic (2.4% of the total number of hospitalizations due to COVID-19). Recall that in America, children over 12 are actively vaccinated.
The first study analyzed hospital admissions in 14 states from March 1 to August 14. The analysis showed that the number of hospitalizations among children and adolescents caused by COVID-19 increased almost fivefold at the end of June to mid-August 2021, and among children aged 0-4 years, the weekly hospitalization rate was almost 10 times higher, ” which coincided with an increase in circulation of the highly transmissive variant of SARS-CoV-2 Delta. ” However, the hospitalization rate was 10 times higher among unvaccinated than among fully vaccinated adolescents. The authors of the work emphasize that it is necessary to closely monitor trends as new data becomes available. For example, although the estimate of the proportion of hospitalized children who required mechanical ventilation during the Delta-dominated period (9.8%) was higher than in the earlier period of the pandemic (6.1%), the comparison of these proportions was based on the relatively small number of children, and the difference was not statistically significant.
“While hospitalizations and deaths associated with COVID-19 are more common among adults, COVID-19 can also have serious consequences for children and adolescents. Therefore, preventive measures to reduce the incidence of severe COVID-19 are critical,” they note study authors. And they urge to continue vaccination, not to abolish the universal mask regime in schools and the mandatory wearing of masks by children from 2 years old in other closed public places and children’s centers. “All teachers, staff, students and visitors in schools and kindergartens, regardless of vaccination status, are encouraged to wear masks,” the American epidemiologists emphasize.
The second study found that the states with the lowest vaccination coverage among children over 12 years of age (49.9%) had the highest hospital admissions rates among this age group, and conversely, where the majority of adolescents were vaccinated (72.2%). ) had the lowest incidence of COVID-19 and the lowest hospitalization among those aged 0-17 years.The number of COVID-19-related ambulances and hospitalizations in the states with the lowest vaccination coverage was 3.4 and 3.7 times the states with the highest vaccination coverage. In selected hospitals, the proportion of COVID-19 patients aged 0-17 years admitted to intensive care was 20% and 18% in July and August 2021. “These data highlight the importance of community vaccination, combined with testing strategies and other prevention measures, to protect children from SARS-CoV-2 infection and severe COVID-19,” the authors of the study note.
Therefore, the CDC recommends considering starting vaccinations in the United States for children under 12 years of age.
Recall that in Russia, research on a vaccine against coronavirus among adolescents has just begun, and only based on its results a decision will be made on whether children need coronavirus vaccinations. Many Russian pediatricians today call it necessary. For example, a well-known pediatrician Sergei Butriy said: “I deeply support childhood vaccination against covid. Firstly, because children do not always tolerate covid easily. And secondly, because children are social carriers, they infect grandparents. And it is almost impossible to achieve herd immunity without vaccinating children, even that notorious 60%. Only when we allow children to be vaccinated will we begin to approach any significant herd immunity figures that can significantly affect mortality and morbidity. “
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