Ten minors have succumbed to COVID-19 in Maharashtra since the outbreak hit the State on March 9. The youngest fatality is a 13 month old baby girl from Pune, who had megaloblastic anaemia and acute malnutrition. In resemblance to the global trend, children in the State have shown more resilience against the SARS CoV-2 than adults but experts warn that malnutrition and pre-existing illnesses may cause a high risk.
‘Some underlying conditions’
Of the 10 fatalities, four were below 10 years while six were between 11 to 18 years. At least half of the children had some underlying conditions, said State’s surveillance officer Dr. Pradeep Awate. “The COVID-19 related complications in children are negligible and they bounce back very quickly. The mortality is also very low,” said Dr. Awate. He said that the State had reported 2,722 positive cases in the age group of below 10 years and the case fatality rate was merely 0.1%. While the State has not segregated data of positive cases in the 11-18 years age group, there were a total of 5,338 cases between 11-20 years and the case fatality in this group was equally low.
Paediatrician and infectious diseases expert Dr. Tanu Singhal from Kokilaben Dhirubhai Ambani Hospital said that overall as a group, children tend to do well but there is a small subset that develops the severe disease. “They relatively do better than adults because of the innate immunity, healthier lungs, etc.,” said Dr. Singhal. Absence of risk factors like obesity, smoking, drinking and comorbid conditions like diabetes and hypertension also works for the young ones.
Mostly asymptomatic
Paediatrician and critical care expert Dr. Soonu Udani from SRCC Children’s Hospital said that most children have mild symptoms or are asymptomatic. “They mostly present with symptoms like cough and fever. But we have had at least four children who came with abdominal pain and diarrhoea,” said Dr. Udani, adding that of the 45 minors with COVID-19 that they have treated so far, the condition of only one was serious and required intensive care. “This 17-year-old boy had been to many hospitals before he came to us. He required non-invasive ventilator support but has now got better,” she said. Two other babies who tested positive were malnourished and also required heart surgeries, but both of them also bounced back, she said.
New concern
A new concern has now emerged with an inflammatory syndrome associated with COVID-19 seen in children. “It is a rare manifestation and two such cases have been reported in Tamil Nadu and one in Kerala,” said Dr. Singhal. Clusters of such cases have been reported in the U.K. and U.S.A. where children have suffered from single or multi-organ failure. A paper published in The Indian Journal of Paediatrics on May 28 reported the case of a five-year-old boy from Kerala highlighting the atypical presentation.