Children began to get sick more often with coronavirus. How is their illness progressing now? How to properly treat it? How to give a child first aid for respiratory failure? Read the doctor's answers in our article
«I checked how patients are treated in the city children's infectious diseases hospital... Doctors say that in the first wave of morbidity, mostly teenagers got to hospitals. Now most of the patients are children of preschool age. And with a more complex course of the disease and its consequences", - said Vitali Klitschko. Due to the large influx of cases in Kyiv, the mayor is even considering the possibility to place patients in maternity hospitals.
Why did the coronavirus start to attack children more? What features of the treatment of COVID-19 do they have? Answered these and other questions to our site Ekaterina Shabelnik, pediatrician at the R+ Medical Network clinic.
Are children really getting sick with COVID-19 more often?
Ekaterina Shabelnik says that there are more children with covid in her practice. And among them there are indeed more small children. “If earlier we worked with teenagers aged 13-17, now I personally have the smallest 2-month-old patient,” she says.
The expert explains this with an increase in the incidence throughout the country. “He really is, he is not invented. And this is due, among other things, to the fact that people have become more negligent about the coronavirus infection. If earlier, when a person was diagnosed with covid-19, he followed the rules of self-isolation. Now many people wanted to sneeze on them. They visit public places, hide information that they are sick, ”the expert argues.
This negligent attitude extends to the closest family members - children. “Explain, don’t explain that it is necessary to exclude kisses, wear a mask at home, this does not help,” says Ekaterina Shabelnik. It also plays a role that many babies are bottle-fed. “At the same time, they do not receive maternal immunoglobulin, therefore they become more susceptible to infections,” the expert explains.
As a rule, children easily defeat coronavirus / istockphoto.com
2. How is coronavirus being handled by children now?
Previously, most doctors said that children very often endure coronavirus. asymptomatic or very mild.
“Now there are more children diagnosed with covid-19, with obvious symptoms of a viral infection,” comments Kateryna Shabelnik. This:
- elevated temperature;
- rhinitis;
- laryngitis;
- bronchitis.
There are also many children with intestinal manifestations of coronavirus - diarrhea and diarrhea. But coronavirus pneumonia in young children, according to the expert, practically does not occur. They are more characters for teenagers. Ekaterina Shabelnik explains this by the fact that older children lead a sedentary lifestyle, sitting a lot in gadgets. Because of this, the lungs are not so well ventilated, sputum does not come out well and pneumonia occurs. “Therefore, if the child feels fine, do not force him to lie down. Let it move. This is good for the lung tissue,” the expert advises.
As for the loss of smell and taste, the pediatrician does not recommend parents to focus on this symptom. “Children often do not pay attention to the fact that they do not feel the taste or smell,” explains Ekaterina Shabelnik. Therefore, with signs of a respiratory infection, whether there is this symptom or not, it is better to take a test for covid-19.
The expert also says that sometimes among children with coronavirus, there is a Kawasaki-like syndrome.
It is characterized by:
- severe conjunctivitis (red eyes, they hurt, the child complains that he has sand in his eyes);
- severe headaches;
- painful rashes on the body;
- sore throat, as in a sore throat, the child may refuse food and water because of it.
If you see these symptoms in a child, you need to see a doctor for help as soon as possible. “This syndrome affects the vessels of the circulatory system, which can later lead to cardiovascular insufficiency. The sooner the child receives medical care, the lower the risk of such complications,” explains Ekaterina Shabelnik.
With coronavirus, children can have severe conjunctivitis / istockphoto.com
3. How should children be treated for COVID-19?
As a common respiratory disease, says Ekaterina Shabelnik. And this means drinking plenty of water (it is better if the pediatrician calculates the amount of liquid based on the age and body weight of the child) and symptomatic prescription of medications. That is, the temperature has risen - we take antipyretic. Sore throat - gives a special remedy. The expert also says that the effectiveness of taking vitamin D in the treatment of coronavirus disease has been proven. “Children need to be given a daily dose of 1000 units every day,” the pediatrician clarifies.
As for antibiotics, Ekaterina Shabelnik emphasizes that covid-19 is a viral disease, which means that antibiotics cannot be treated. They are prescribed only in case of accession of a bacterial complication. The doctor determines the feasibility of antibiotic therapy using the clinical picture and tests: blood test, C-reactive protein, procalcetonin. So, dear parents, you should not play it safe and give your child an antibiotic in the very first days of illness. You can hurt him a lot.
Do not do a CT scan. “Remember that CT has a very high radiological load. It's about like doing 30 x-rays at the same time, the expert warns. – In addition, you need to lie still for a CT scan. This procedure is carried out for children in very serious condition who are in the hospital. If a child is being treated at home for coronavirus, he has a good saturation, it makes no sense to send him for a CT scan. If the doctor sees that the saturation has decreased, hears wheezing, he will prescribe an x-ray. If necessary - in two projections.
4. How to understand that a child with COVID-19 needs to be urgently taken to the hospital?
Now every family should have a pulse oximeter - a device that shows the oxygen content in the blood. Normally, in children, the device should show 97-100%. “In order to have the right indicators, the child must have warm hands. If they are cold, grind them well before measuring, advises Ekaterina Shabelnik. – Also measure the saturation on different fingers. In addition, do not forget that some pulse oximeters are not designed to measure saturation in children. It should be in the instructions."
It is possible to understand even without a pulse oximeter that there is a problem with the child's respiratory system - by rapid breathing. This is the most obvious symptom of pneumonia. You need to count the breath when the child is sleeping or is in a calm state. The unit of account is inhalation-exhalation.
Breathing rates for children in one minute:
- From birth to two months - 60 units;
- From 2 to 12 months - 50 or less;
- From a year to 5 years - 40 and less;
- From 5 to 12 years old - 30 units or less.
In an ambulance, according to Ekaterina Shabelnik, you need to contact if:
- saturation below 92%;
- the child's respiratory rate is above 60 units;
- his lips, the circumlabial triangle, and his nails turned blue;
- temperature under forty, which is badly confused;
- confused mind,
- strong pain;
- indomitable vomiting;
- green, frothy, foul-smelling feces with bloody discharge.
A high temperature that doesn't go down well is a reason to call an ambulance / istockphoto.com
5. How to help a child at home if his saturation has fallen or he is suffocating?
As we wrote above, with coronavirus disease, children often have laryngitis. In fairness, it should be noted that they also occur with other viral diseases.
Laryngitis is characterized by a nocturnal attack when the child breathe heavily. And you need to know how to give him first aid. “The American Association of Pediatrics developed its rules,” says Ekaterina Shabelnik. The expert told what to do in this case.
- If the child is lying, you need to put him in such a way that the body takes a vertical position.
- Open a window, let in fresh air. If it is hot outside, turn on the air conditioner or open the refrigerator and bring the child to it so that he breathes in cold air. You can give him cool water to drink or eat ice cream.
- In the absence of positive dynamics in the general condition of the child and the increase in manifestations of respiratory failure, drugs should be used. If there is a nebulizer at home, you need to inhale with a drug that will relieve swelling of the vocal cords. For example, Pulmicort. If it is not there, then - "Prednisolone" in the form of a rectal suppository. We remind you that you do not need to self-medicate, contact your pediatrician.
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