COVID-19 cases among the paediatric population has been on the rise in Tamil Nadu. Doctors have been noticing that more newborns are presenting with symptoms during the second wave of the contagion than in the first wave.
At least 1,000-1,300 children, aged 0-12, are testing positive daily over the past few days. “The number of children testing positive is quite high. When parents test positive, the children, too, are infected,” said S. Srinivasan, State Nodal Officer-Child Health.
Though children were affected, there was no progression to severe disease, said J. Kumutha, expert adviser-child health, National Health Mission-Tamil Nadu. “We are seeing mild to moderate disease in children. Nevertheless, children with co-morbidities, such as malignancies, chronic diseases and other immune-compromised conditions, should be protected as they run the risk of getting infected, and mortality is high,” she said.
Babies born to COVID-19 mothers seemed to be asymptomatic, she added.
There have been a few noticeable changes in the second wave. As Dr. Srinivasan said, “A number of newborns are admitted to the Institute of Child Health and Hospital for Children on the 12th, 13th and 14th day of birth. So far, there have been no problems. In some newborns, there is a history of fever that is unusual. We have noticed some pneumonic changes in X-rays in a few of them.”
N. Chandrakumar, head of the Department of Neonatology, Kanchi Kamakoti CHILDS Trust Hospital (KKCTH), said, “We had a lot of newborns testing positive in the first wave, but most of them were asymptomatic. Now, we are seeing more newborns presenting with symptoms. We have a newborn who presented with COVID-19 pneumonia and was put on ventilator. Now, we have also seen in a newborn the multi-system inflammatory syndrome in children (MIS-C), which was only reported in older children.”
Among all infected newborns, about 20% develop symptoms and the rest are normal. Of them, 1%-2% develop significant symptoms of cough and require admission. About 1%-2% have pneumonia and MIS-C, he said.
What precautions are needed? “Pregnant women who develop any symptom or fever should tell clearly before delivery as any mild infection can have implications for the baby. All mothers should be tested prior to delivery so that we can ascertain if the baby is at risk of infection. We recommend testing the baby in 48 hours,” Dr. Chandrakumar said. He said parents should watch for symptoms of MIS-C in newborns — re-appearance of fever, rash, diarrhoea and irritability.
“We are seeing more children with pneumonia in the second wave, and we continue to see cases of MIS-C,” said Janani Sankar, senior consultant, KKCTH. While a number of children are triaged through tele-consultation, doctors ask the parents to bring the children to hospital in case of any warning symptoms, such as persistent fever, any high grade fever, reduced oral intake, extreme fatigue/lethargy, vomiting, abdominal pain and any new rash, she said.
