Exactly two years ago the COVID pandemic began in Spain. During this time, information has been published continuously, which has contributed to achieving a broad knowledge of the disease, its form of transmission, diagnosis and prevention in record time.
In March 2021, the Spanish Association of Pediatrics (AEP) and the Spanish Association of Primary Care Pediatrics (AEPap) published a guide on the impact of COVID-19 on children which, a year later, required a new and exhaustive revision.
Thus, under the title ‘COVID-19 in Paediatrics: critical assessment of the evidence’ , a new guide has been published that reviews the scientific evidence accumulated in the last year on the virus and the disease it causes in children. We summarize its main points.
SARS-CoV-2 is a virus that is spread mainly by the respiratory route (droplets and aerosols). Therefore, proximity and ventilation appear to be key parameters in transmission .
Thus, the risk of infection in a closed environment is 20 times greater than outdoors, hence the importance of ventilation as a preventive measure .
But in addition, the risk of transmission of SARS-CoV-2 depends on other factors such as:
- The viral load of the issuer.
- The concentration and size of the aerosols emitted , which depend on the activity that the patient is developing (minimum when breathing calmly and progressive increase when talking quietly, loudly, singing, coughing, intense physical activities)
- The length of time a person is exposed to aerosols from another infected person, as well as the amount of viral load in them.
- Personal vulnerability.
In children with COVID-19 , fever is the most common symptom , followed by cough and upper respiratory tract involvement (one in four children has respiratory symptoms).
Other symptoms described are digestive (mainly vomiting), general symptoms such as fatigue, loss of appetite or malaise, and neurological symptoms with headache.
For its part, the involvement of the skin and mucous membranes that was seen at the beginning , now seems to decrease, while one of the most relevant data has been the notification of a high percentage of asymptomatic cases .
For the diagnosis of SARS-CoV-2 infection , the sample taken from the respiratory tract is always more reliable than saliva samples , especially in situations of low prevalence. Our website is completely build for parenting keep visiting for more topics.
As for the type of diagnostic test recommended to detect the disease, RT-PCR (real-time PCR) remains the test of choice. Antigenic tests are useful in symptomatic infections and also in the study of asymptomatic people with known contact with SARS-CoV-2, not being recommended in asymptomatic people with no known contact.
Treatment against COVID-19
Regarding the efficacy of treatments in the pediatric age, several observational studies have appeared that have compared the efficacy of immunoglobulins with or without corticosteroids in multisystem inflammatory syndrome, with heterogeneous results, so general recommendations cannot be established .
New experimental studies have been presented in the adult population that support the efficacy of certain treatments, although as it is indirect evidence it does not allow recommendations to be made in the pediatric age.
Use of masks
Much has been said in this time of pandemic about the effective use of masks in children, and the information that was available came from observational studies.
However, after the publication of a large community clinical trial that has evaluated the efficacy of masks in SARS-CoV-2 infection, their protective effect has been demonstrated .
Vertical transmission and breastfeeding
In aspects such as transmission from infected mother to newborn, scientific information confirms what was already known throughout the first year of the pandemic: the risk of mother-to-child transmission is very low .
SARS-CoV-2 has not been found in breast milk, nor has it been transmitted through breastfeeding . Instead, antibodies are transmitted through breast milk , especially the antibodies produced after the administration of SARS-CoV-2 vaccines to mothers .
Face-to-face education and COVID-19
During the first part of the pandemic, schools were closed to prevent transmission of the disease. But in September 2020 the educational centers reopened their doors, and they have remained that way ever since, betting on face-to-face activity .
According to the review of published studies, the reopening of schools and the return to face-to-face teaching activity is not associated with an increase in community transmission of COVID-19 , provided that hygiene and social distance measures are properly applied .
Studies have also been compiled on the effects on children of virtual education replacing face-to-face education , and negative effects on the school performance of primary and secondary students have been evidenced , this effect being more predominant in children from disadvantaged families.
Vaccines in the pediatric age
The area of vaccines has brought important changes in the last year. In summary, the published efficacy data for vaccination against SARS-CoV-2 in the adolescent population , from 12 years of age , are close to 100%, with safety and immunogenicity comparable to other populations.
As for the secondary effects produced by the vaccines , they are generally mild or moderate, of a transitory nature, with serious adverse effects being exceptional.
Studies on the efficacy, immunogenicity and safety of the vaccine in children over five years of age are underway , and the results will be known shortly.