According to new findings, it said the infection’s symptomatology in children in India appears to be globally comparable.
There appears to be no substantial evidence to suggest that children are going to be more affected or have greater illness severity thanks to COVID-19 within the anticipated third wave, consistent with a replacement report.
The Lancet COVID-19 Commission India Task Force prepared the report after convening an experts group comprising leading paediatricians from the country to look at the difficulty of ‘paediatric COVID-19’ in India.
It said the infection’s symptomatology in children in India appears to be globally comparable.
"Most children with COVID-19 are asymptomatic, and amongst those symptomatic mild infections are predominant. most youngsters have fever with respiratory symptoms, and sometimes present with gastrointestinal symptoms (such as diarrhea, vomiting, pain in abdomen) and atypical manifestation compared to adults. The proportion of symptomatic children increases as age increases as does the severity in such age groups," the report stated.
In the absence of a national database on clinical presentation and outcomes of infected children during the 2 surges noted so far , the info of roughly 2,600 hospitalised children, below the age of 10 years (excluding neonates), from 10 hospitals (both public and private), in Tamil Nadu , Kerala, Maharashtra and Delhi-NCR region, was collected and analysed.
According to the info , mortality rates amongst these surveyed hospitalised COVID-19 positive children below the age of 10 years was 2.4 per cent and about 40 per cent of the youngsters who died had comorbidities.
"Nine per cent of all hospitalised COVID-19 positive children presented with severe illness, under 10 years aged . The above observations were similar during the 2 surges of COVID-19 infections India has experienced," the Lancet document said.
Three doctors from AIIMS, namely Sheffali Gulati, Sushil K Kabra and Rakesh Lodha, contributed to the study.
Kabra said but 5 per cent children would require hospital admission in COVID-19 and out of them the mortality is of two per cent.
"Say out of 1 lakh, 500 children get hospitalised and a couple of per cent of deaths are reported among them. So in one lakh, mortality of only one or two children is seen. In children, intrinsically the disease is a smaller amount severe. Very low proportion requires hospitalisation and really small proportion of mortality is reported. The mortality is additionally contributed by underlying diseases within the sort of comorbidities like diabetes, cancer, anemia or severe malnutrition. In normal children, mortality is extremely rare," he told PTI.
The data was also evaluated separately for the time periods like the 2 surges, March 2020-December 2020 and January 2021-April 2021.
Comparable observations were recorded during a multicentric study which examined 402 children hospitalised in Indian hospitals, of which 90 per cent were asymptomatic to mildly symptomatic, and of 318 cases wherein 44 per cent had underlying co-morbidities, it said.
"Based on the info available, there appears to be no substantial evidence to suggest that children would be more affected or would have greater illness severity thanks to COVID-19 infection within the anticipated third wave. Studies also indicate that children have milder disease, better prognosis, and low mortality as compared to adults," it said.
On multisystem inflammatory syndrome (MIS-C) in children, the report said, risk factors for this condition include obesity, asthma, compromised breathing, developmental disorders, cardiac disease, cancers or immunocompromised children also as those that have undergone surgeries.
Although figures indicate low mortality rates from acute COVID-19 in older teens, it appears to be higher in those that are obese. Most published data suggest mild to moderate predisposition in most cases and low mortality linked with MIS-C.
"Preliminary review of cases within representative facilities further corroborates the low case severity and low overall mortality rates in children. That said, the health system must fix for a paediatric workload with adequate infrastructure, earmarked facilities at primary, secondary and tertiary levels of care, oxygen availability, appropriate equipment, trained manpower, drugs and injectables among others, all of which are specific to children," the report said.
The national-level clinical protocols must be adhered to in the least levels of facilities and every one providers adequately trained, almost like adult protocols.
"The health system must maintain its routine programs like immunisation and nutrition and identify high risk patients beforehand for better management. Vaccines will form a crucial a part of the preventive strategy for adults and also eventually for youngsters and this must be evaluated and implemented expeditiously.
“Behaviour change communication and media management must be prioritised to assist alleviate panic and anxiety. Schools must be reopened cautiously face to face , with options for online access as required , but with a firm resolve to bring normalcy back as quickly as possible in children's lives,” the report added.
