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Prolonged COVID in children manifests itself through physical and psycho-emotional effects

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They were infected two years ago and the ravages of COVID-19 have not gone away yet. In May 2020 Sarah (name protected) and her family fell ill. They all contracted the virus one by one until, in August, the youngest of her children, Paula, (protected name) also fell.


Paula was 9 years old when she became ill with COVID-19. Today she is 11 and is still undergoing treatment for arthritis. Her doctors have attributed her complications and sequelae to prolonged COVID.

The World Health Organization considers prolonged or persistent COVID to be symptoms that appear three months after infection and remain in the patient.

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An article published in the medical journal “The Pediatric Infectious Disease Journal” in December 2021, which reviewed 14 scientific investigations carried out on 19,500 children and adolescents who had contracted COVID-19, determined that between 2% and 10% of patients had prolonged COVID.

According to the publication, there are two main consequences that children could present after coronavirus infection: Pediatric Multisystem Inflammatory Syndrome and the aforementioned prolonged COVID.

In the latter, the main affectations are towards the sensory, neurological, cardiorespiratory systems and mental health, the document indicates.

In this regard, the child neurologist Dennis López indicates that as a result of COVID-19, “many of the multisystemic inflammatory processes occur throughout our body. There is a cascade of factors that occur when there is an infectious inflammatory process in our body and they cause deterioration in different organs”.

There are no studies or figures in Ecuador

In Ecuador, the number of how many children and adolescents have been diagnosed with COVID-19 is not public. A month ago, the Ministry of Public Health (MSP) created a platform to access data on the pandemic, but it provided incomplete information and has already stopped working. The MSP also did not answer the query made by this newspaper.

No studies have been conducted in the country on prolonged COVID in children and the perception of doctors is varied. Pediatric infectologist Rina Silva says that in her consultation one in 25 children has post-COVID-19 sequelae. Instead, pediatrician Carlos Cepeda estimates that at least two out of ten of his patients show signs of prolonged COVID.

Silva explains that, although more than 200 symptoms associated with prolonged COVID have been described in children, the most common are fatigue, tiredness, shortness of breath, cough, digestive, neurological and, as in the case of Paula, joint manifestations.

Sarah says that one day her daughter woke up very upset. She had a fever, joint pain, and swollen glands in her groin, armpits, and even one of her collarbones.

After seeking care in Machala, the city where they reside, Paula’s situation did not improve and the fever continued, so they proceeded to take her to a hospital in Guayaquil where they did all kinds of tests except for COVID-19.

Days later they took her to a second medical center where they found that Paula had coronavirus. “From that moment on, our viacrucis began,” says Sarah.

Paula was hospitalized for 23 days in the hospital, of which 20 she had a temporary fever that came and went. When she was discharged and returned to Machala, she relapsed, they returned to Guayaquil and had to hospitalize her for six more days. Her recovery was slow.

Although he had ups and downs, the infection apparently cleared up, but what remained constant was the pain and swelling in the joints. So the doctors started a treatment for arthritis, which her mother has, the difference was enormous; her daughter began to improve.

Pediatrician Carlos Cepeda says that at least two out of ten of his patients show signs of prolonged COVID and that, having limited information on the sequelae of COVID-19 in the pediatric population, it is still not known for sure what the symptoms are. Specific effects and possible consequences of the pandemic on children.

“We try to associate and have criteria for diagnosis and attribute symptoms to either COVID-19 or another pathology to work on their respective diagnoses,” he says.

The pulmonologist Fabián Romero specifies that in pediatric patients who have been diagnosed with COVID-19, preventive monitoring should be carried out from the fourth week to six months after infection to treat a possible prolonged COVID in time.

Currently, the specialist attends to between 15 and 20 patients for post-COVID follow-up and recommends that, for this follow-up, a timeline should be made from the infection and comprehensive follow-up with different medical tests to rule out other pathologies.

“Even if the patient has had mild COVID, they need a check-up with an intentional search for symptoms to explain certain discomforts,” Romero points out, referring to intentional search for specific questions based on symptoms related to persistent COVID.

“When one intentionally asks if they have presented tiredness or shortness of breath or a persistent cough and we have this epidemiological link to the past infection, we have a high suspicion that we are dealing with a post-COVID patient,” he details.

Also, for parents or caregivers of children, the specialist recommends that they be meticulous and monitor the illness of minors daily to identify possible discomfort after the acute phase of contagion.

For this reason, it suggests being cautious and paying attention to signs such as easy tiredness, shortness of breath or a feeling of suffocation and bodily discomfort.

The fear of contagion and a long emotional process

Although today Paula is a girl with a great development, her mother says that the situation was not always like this, mainly during the first year of confinement. Sarah comments that, during those months, her daughter felt a lot of anxiety at not being able to share with other children, since her age difference with her siblings is wide. The oldest is 25 and the next is 23 years old.

But in front of her house lives a contemporary cousin of Paula with whom they shared a lot of time together before the pandemic and, due to the confinement and Paula’s discomfort, they could not continue doing so.

When Paula turned ten, Sarah recalls, she asked her mother as a birthday present to invite her cousin to her celebration. Her relatives agreed and since then the girls began to frequent her visits.

Sarah indicates that this was a great all-round help in her little girl’s recovery. “The emotional part of her rose, she was much more animated and that helped her physical recovery; there I began to notice her much better, ”she recalls happily.

For child psychologist Valeria Veintimilla, accompaniment is another key factor for the emotional development of children during this pandemic.

She highlights that face-to-face activities are essential when dealing with this pandemic, mainly in children, because they need social interaction to develop their social and motor skills.

“Being so much time at home they have no way of letting off steam and verbalizing as when they shared with their classmates at school and this emotional burden manifests itself in the form of anxiety or even depression,” he says.

For this, the neurologist López suggests that it is extremely important to identify when there is a problem. “Parents sometimes can’t assimilate it and see it as a passing problem. But that temporary problem can be a little more complex over time, ”he rescues.

The specialist emphasizes that the important thing is that a child, however simple his problem may be, “must be intervened and guided by a health professional, be it his psychiatrist or psychologist, who will focus more on the problem and give a corresponding treatment” .

As for the fear of getting infected, Veintimilla points out that it is something that has affected people a lot during this pandemic. This happens with Paula who, according to her mother, is very terrified by the idea of ​​reinfection.

That is why her daughter is extremely careful, protects herself a lot and is meticulous when she has to go somewhere. “When visitors come to the house, she always wears a mask and puts alcohol on everything; she is very careful and self-care ”, indicates her mother.

Veintimilla comments that several children have developed terror about it and, “being so uncertain, it generates a lot of anxiety in children because they do not know what is going to happen and how it will work if they contract the virus. Many are afraid that their parents or they will get infected.

In addition, he points out that in the case of children or adolescents who have suffered the loss of a loved one or have experienced traumatic events during their journey through the disease, as is the case of Paula, “there is also a strong affectation in the emotional part and psychological”.

“These are events that children and adolescents have not finished processing. They accumulate (their emotions) and fail to have that space of containment and relief, which affects them a lot emotionally, ”she details.

Although it is no longer mandatory to wear a mask in the country, Sarah says that with her family they have reached an agreement that none of them will stop wearing a mask outside the home.

“We are going to continue using it until we see that the pandemic has completely ended,” he specifies and comments that today, after having traveled this long and winding road, he feels somewhat calm, because he has the most important thing with him: his family. whole. (I)

Source: Eluniverso

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