“It is not true that children do not get covid and do not need hospital treatment. The risk is there for everyone. Only the vaccine can protect them ». The pediatrician Piero Valentini, head of pediatric infectious diseases of the polyclinic Twins from Roma, observes the little patients day by day, visits them, monitors them and tries to understand what could be the right move to make them heal. “They get sick at any age, from infants to teenagers. The first patient we treated – he remembers almost having them one by one – was eight months old. Then there were other bigger ones ».
Do children therefore risk getting infected and sick like adults?
“Of course, I’ve seen several since the pandemic started. The incidence of covid cases in pediatric age is significantly lower than in adulthood and in the elderly in particular, but there is no age that can be spared. Right now, we have two, one of which is an unvaccinated teenager with an acute covid infection and another with persistent symptoms for about 3 months. We are doing investigations to understand if we are facing that picture known as long covid. But there are also very small patients. Only a few days ago we discharged a newborn who became infected by his mother ».
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A baby already positive at birth?
“Yes, Mom got infected just before giving birth. That is in fact the phase in which in a pregnancy it is more possible the transmission of an infectious agent from the mother to the fetus. After the birth, we also had to hospitalize the little one because he had a high fever and a respiratory picture that worsened in the following days. He needed oxygen supplementation to keep conditions stable. Then, for the rest, it was a pretty good development and after two weeks we discharged him ».
Wasn’t Mom vaccinated?
“Unfortunately not. It was a coincidence, she had postponed the vaccination for organizational reasons and unfortunately she got infected ».
And for 15 days she couldn’t hug the little one?
“She was slightly symptomatic and so to allow her to be together with the baby we also admitted her to the pediatric ward to allow her to continue breastfeeding him.”
Is the baby okay now?
“We discharged him, but we will continue to follow him. The problem is that covid is a new disease. What is emerging, in the context of the so-called long covid, is that there are people who may have persistent symptoms, the most varied, after an acute covid infection. And there are also subjects who may have no symptoms in the acute phase and vice versa may also present important pictures, such as the famous multisystemic inflammatory syndrome, which is the most severe form of covid in pediatric age, and can manifest itself after two, three months from the moment there was an infection. ‘
What symptoms do children usually have?
“It is a framework that does not have the possibility of being defined from the laboratory point of view above all. They are symptoms that have characteristics similar to those caused by Kawasaki disease and in part similar to septic shock. However, it is a truly new picture ”.
What are the most frequent complaints you have observed?
“Some children, for example, have an alteration in some coagulation parameters, sometimes they need to be treated with cortisone drugs, sometimes with immunoglobulins, or they have to undergo anticoagulant therapy. Generally speaking, they come out well, but they may have heart involvement, that is myocarditis or pericarditis “.
And many of these are you still treating them despite being healed?
«Of course, for example, we followed some adolescents who still had respiratory problems after some time. They got tired easily, they showed breathlessness after even minor efforts, and by subjecting them to some combined instrumental tests, that is cardiopulmonary exams, we have seen that these subjects can present in some areas of the lung an alteration of the vascularization. Probably, they too undergo those phenomena of microthrombosis of the pulmonary circulation that has been widely described in the cases of adults ».
Should they continue to take medications?
“Yes, if the need arises, we will evaluate whether it is appropriate to start treatment with anticoagulants.”
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Treating such young patients suffering from a pathology that is in many ways still unknown must be even more challenging.
“We are certainly used to seeing children who have even more serious problems. However, it is obvious that when you have more detailed knowledge and you know exactly the way to go, you feel at least calmer ».
Is there only the vaccine left to protect the little ones?
“Of course. The famous cases of myocarditis as side effects are a small number compared to the now innumerable doses of vaccine administered. These are also minor cases that were resolved quickly. We must protect everyone with the vaccine ».