Hospital admissions up among kids below five years

NEW DELHI, FEB. 18:  More children below five  years were admitted to hospitals in India during the third Covid wave as compared to the first and second wave due to the reopening of schools, said the latest ICMR study.

Most children who died were infants, said the study, which analysed the National Clinical Registry for COVID-19, a platform which collects real-time Covid data, set up by the Indian Council of Medical Research (ICMR) in collaboration with the Union Health Ministry, AIIMS, and the ICMR-National Institute of Medical Statistics.

The study, which studied the impact of Covid in the three waves on the children, confirmed that Covid-19 was milder in children than adults, and the pattern was consistent across all three waves. The other reason children were hospitalised more during the third wave, which was termed milder as compared to the first and second wave, was the unvaccinated status of the below 18 years population, said the study, published in the Indian Journal of Pediatrics.

The study said of the 1,244 enrolled hospitalised Covid-19 patients aged between 0–18 years, 98 and 124 were infants and neonates, respectively. Of 1,244 Covid-positive children, 67 (or 6.2%) died during hospital stay, and the reason mainly was altered sensorium (unconscious); WHO ordinal scale ≥4 at admission (severe case in need of hospitalisation with oxygen support) and malignancy (cancer).

The proportion of deaths was highest in the age group of one month to 1 year (12.5%), followed by neonates (7.2%), five to nine years (6.4%), 10–18 years (5.7%), and then one to four years of children (2.4%). “Mortality rates were similar across the three waves of the pandemic, though a significant shift towards the under-five group was observed in the third wave,” said the study, which was held to evaluate the factors associated with mortality of a multi-centric cohort of hospitalised Covid-19 children from 42 hospitals across India.

Only 68.6% of children were symptomatic at admission, with fever being the most common symptom – similar tosymptoms in adults. Diarrhoea, rash, and neurological symptoms were also noted. Gastrointestinal symptoms were seen among children between 1 and five years of age. Most children stayed in the hospital for four to six days. Of the 1244 admitted children, 260 (21%) had at least one co-morbidity.

The most common co-morbidity among children over one year old was hematologic disorders and malignancy, while cardiac disease was more common among infants. Neonates did not report any co-morbidity.

In the three waves, children admitted with co-morbidities and mortality were not significantly different. Still, during the third wave, a change was seen among those under five. The study also said that oxygen supplementation was required by 23.8% of patients, while non-invasive and mechanical ventilation were required by 4.1% and 6.3%, respectively.

Covid third wave impact

Mortality rate among children (below 18 years of age) were similar across three waves of Covid pandemic, though a significant shift towards the under-five group was observed in the third wave,” said the study

More children were hospitalised during the third wave owing to the unvaccinated status of the below 18 years population, said the study.

Another major cause was the reopening of schools during the third wave. 

The third wave was termed milder as compared to the first and second wave

The proportion of deaths was highest in the age group of one month to 1 year

12.50%

This is followed by neonates (7.2%), five to nine years (6.4%), 10–18 years (5.7%), and then one to four years of children (2.%).

-TNIE