Proportion of child Covid-19 cases rises in Karnataka

An increase in the proportion of child Covid-19 cases over the last three weeks has paediatricians and other medical professionals watching developments closely.

As per official data, pre-teens (children aged 0-9) represented an average of 3.5% of daily cases in the state in May. It rose to 4% in June and has now jumped to 4.4% in July. Among teenagers (aged 0-17), the proportion has remained a constant 8% to 9% statewide.

Paediatricians on the ground have also observed the increase. “In the last couple of weeks, we have started to see more children coming to the hospital with Covid-19,” said Dr Srikanta J T, Paediatric Pulmonologist, Aster CMI Hospital, and a member of the Third Wave Committee.

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He added that all evidence so far seemed to suggest that parents were passing on the infection to children. “There are a lot of factors to account for this: notably ‘revenge tourism,’ a delay in the arrival of testing results, and increased general mobility of the adult population,” he said, clarifying, however, that it was too early to tell if this represents the early beginnings of the third wave.

But why hasn’t there been a commensurate increase of infections among teens? Dr Bhaskar Shenoy, Head of Paediatrics at Manipal Hospitals (Old Airport Road), pointed out this is because traditionally pre-teens are more prone to infections than teens. “The immune response in children aged 10 and above is generally more robust,” he explained.

The issue has come at a time when the state’s genomic surveillance machinery is preparing to scale up sequencing of samples from children with Covid-19, even as medical professionals express concern that a new mutation of the novel coronavirus could be responsible for the increase in percentages.

“By all indications so far, it is still the baseline Delta variant which is causing infections in children,” said Dr Vishal Rao, a member of the state’s Genomic Surveillance Committee.

He added that this variant is still a concern because studies have not been conducted determining how it affects certain age groups, notably children. “We, therefore, need to closely monitor people aged below 18,” he added.

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The committee has been issued directions by the Indian SARS-CoV-2 Consortium on Genomics (INSACOG) to focus on paediatrics.

Meanwhile, Dr Srikanta pointed to the results of the fourth national sero-survey to suggest that not all was doom and gloom. The sero-survey has established that more than half or 59.4% of children in India had been infected with the virus and recovered (57.2% of pre-teens and 61.6% of teens).

“The third wave predictions are likely more prosaic than they need to be,” he added.

Concern about MIS-C

One of the concerns paediatricians have about a potential rise in children infected with Covid-19 is the associated problem of Covid-surving children developing Multi Inflammatory Syndrome in Children (MIS-C), whose worst clinical outcome is death.

Paedtricians explained that they are seeing one case of MIS-C for every 100 children infected with Covid-19. In July, 4,538 Covid-19 cases of children have been identified in Karnataka so far.

From March 12 (the start of the second wave) to July 23, there have been 61,894 recorded cases of Covid-19 infections in pre-teens and 1,56,798 cases among teens (10-19), according to the State Covid War Room.