Covid-19 in Children

COVID-19 is a viral disease with a variety of symptoms that arrived in Israel in early 2020 as part of the global COVID-19 pandemic, which first broke out in Wuhan, China in late 2019. Over time, the COVID-19 virus mutated several times. Its mutations are known as variants. Every variant of the disease has different properties varies in infectivity, but in general, the majority of children who contract COVID-19 suffer from mild symptoms or are asymptomatic, and most recover. Even today, it can be established that COVID-19 is more dangerous to adults but is not risk-free for young people.

COVID-19 tests

The COVID-19 test searches for COVID viruses (or more precisely, their genetic material) in the mouth and nose with the use of a swab. This is how the presence of the COVID-19 virus is detected, with or without symptoms. Anyone who tests positive in the COVID-19 test is considered a confirmed COVID case.

Types of COVID-19 tests

• PCR Test: the most accurate test for diagnosing COVID-19. Test results are received between 24-48 hours from the time of collection of the sample (this may vary between different laboratories).
• Antigen test: less sensitive than PCR, the antigen test allows for a faster detection and immediate results as it is not sent to a laboratory.

Ways of transmission

COVID-19 is largely transmitted through droplets of saliva emitted from the respiratory system of a person positive for the disease, for example as a result of coughing or sneezing. It is important to note that even an asymptomatic disease may be contagious.
Another hypothesis posits that infection through contact is also possible, but the chances of this occurring are much lower and such infection can be prevented by maintaining hygiene and washing hands with soap and water.

At-risk groups

As we said, with regards to children, in most cases COVID-19 is not dangerous and usually manifests as mild symptoms, and is sometimes completely asymptomatic. However, children with underlying conditions, such as chronic lung diseases, diabetes, heart disease, hematological diseases and malignant diseases, may experience a more serious and complicated form of the disease.

Duration of incubation and illness

The incubation period of the COVID-19 virus is between two and 14 days, and largely between 3 and 7 days.

Most children remain ill for one and two weeks.

Isolation and recommendations

There is no longer a mandated isolation for anyone who tests positive for COVID-19. Therefore, when children test positive for COVID-19, they are not required to isolate. However, remember that the disease is infectious, so in the case of a confirmed illness, it is important to behave responsibly towards others and abide by the following rules:

• Stay at home: the recommendation is to stay at home for 5 days from the date of the positive test or until the symptoms disappear (fever above 38 degrees, coughing and shortness of breath).
• Avoid meeting others: the recommendation is to not meet people for 5 days from the date of the positive test.
• Protect those in the at-risk groups: it is important that children who test positive for COVID-19 avoid close contact with people in at-risk groups, that is, people over the age of 60 or people with chronic diseases.
• Wear a mask: if you have to leave the house (for instance, to receive medical treatment) - the recommendation is to wear a mask during the entire time outside the house.
• At-risk groups: if the child has COVID-19 and is included in an at-risk group, it is important to consult a physician in the HMO as soon as possible, to determine whether the child needs medical treatment for COVID-19 and to get recommendations as to receiving additional doses of the COVID-19 vaccine.

Treatment

In most cases, there is no need for specific treatment for COVID-19. You can lower fever, alleviate pain, treat nasal congestion, relieve coughing with over-the-counter medicines and ensure sufficient fluid intake. It is important to know that antibiotics cannot help in the case of a viral disease.

If the child regularly takes medications, consult a medical professional regarding the treatment.

Prevention: COVID-19 vaccine

It is now possible to vaccinate all infants and children from the age of six months with the COVID-19 vaccine to protect them from severe morbidity and the long-term effects of the disease (see below). It is particularly recommended to vaccinate infants and babies under the age of 5 who are in an at-risk group due to underlying conditions.

Common side effects of the COVID-19 vaccine usually appear one or two days after the vaccine is given, and mainly include local pain at the injection site, fever, headache, muscle pain and chills. In any case, it is important that you know that there is no chance of contracting COVID-19 through the vaccine.

Post-COVID-19 symptoms in children

Although COVID-19 is not considered extremely dangerous for children, post-COVID-19 symptoms are more significant for them. The symptoms can be divided into 2 categories:

Post-COVID-19 Symptoms (PIMS or MIS-C)

Life-threatening pediatric inflammatory multisystem syndrome in children (symptomatic or asymptomatic) that occurs several weeks after recovery from COVID-19. This is actually an inflammatory disease characterized by high fever for at least 5 days, generally accompanied by other symptoms such as sore throat, stomach ache, rash and headache, and later by inflammation in various organs of the body and even damage to the various systems of the body. Studies conducted on the subject revealed that the COVID-19 vaccine significantly reduced the risk of developing PIMS or MIS-C. For example, a study conducted in Denmark found that among children who were vaccinated in the Omicron period, the chances of developing this syndrome were reduced by 90% in comparison with those who were not vaccinated.

Diagnosis and treatment: if your child suffers from a febrile illness the cause of which is unclear, within 4 weeks after a family member contracted COVID-19, seek medical attention. Treatment primarily involves administration of anti-inflammatory drugs including steroids, and infusion of human antibodies (IVIG).

Long COVID-19

According to estimates, a significant percentage of people who contract COVID-19 will experience symptoms that may last for weeks or months after recovery. These symptoms are called "Long COVID", persistent COVID or chronic COVID. The prevalence of the symptom increases with age and is therefore more common in adults, but also exists in children. Common symptoms include overwhelming fatigue, shortness of breath, attention difficulties, loss of or change in the sense of taste and smell, muscle and joint pain as well as sleep issues in addition to other, more rare symptoms. It is important to know that despite the symptoms, the disease at this stage is no longer contagious, and different symptoms may appear with varying intensities in different patients. Symptoms that did not appear during the active illness may appear occasionally, and symptoms of "long covid" may appear rarely in confirmed cases who were completely asymptomatic during the illness.

Many studies conducted on adults revealed that vaccination significantly reduced the risk of developing these symptoms. According to experts from the CDC (American Center for Disease Control and Prevention) and other experts, the vaccination will likely significantly reduce the risk of these symptoms in infants and babies as well.

Diagnosis and treatment: if prolonged symptoms appear (at least 3 months after the disease), do not disappear and interfere with daily function, you should consult your family physician in your HMO to consider the need for further examination or treatment.