The crisis of coronavirus disease (COVID-19) pandemic is the
greatest challenge we have faced since World War II [1].
Although children are less commonly infected, and severity
of disease in children is usually mild, no one is completely
immune to this disease [2]. Most of the reported cases of
COVID-19 infection in children show a complete recovery in
one to two weeks; however, those with serious underlying
medical conditions are at a higher risk [3].
The reason behind the lower
prevalence of COVID-19 among children compared to adults is
still unclear. Latest studies suggest that less exposure,
less vigorous immune response, and incomplete functionality
of Angiotensin-Converting Enzyme II (ACE2) in children – as
the potential receptor for SARS-CoV-2 – are responsible for
the significantly fewer severe cases in children [4].
Generally, children with mild symptoms and no risk factors
should be managed at home [5]. Obstructed or absent
breathing, central cyanosis, and cold skin are emergency
signs that need immediate airway management and oxygen
therapy to the target SpO2
³
94% [6]. The children with moderate and severe symptoms,
along with the children with mild symptoms but with
underlying risk factors, are recommended to seek hospital
admission, and emergency treatment should be started
according to the disease severity [5,7].
Due to a possible transmission from
asymptomatic patients, children should avoid playgrounds and
use a face mask in public settings. Current evidence
suggests that SARS-CoV-2 is not transmittable by breast milk
[8]. However, in the case of suspected or confirmed COVID-19
positive mother, feeding the expressed breast milk by a
healthy caregiver is more favorable than direct
breastfeeding [9]. The mother should use a mask and maintain
strict hand hygiene to prevent transmission during the
breast milk expressing by using alcohol-based hand rubs or
soap and water. Proper disinfection should also be applied
to the equipment by a healthy person.
Lockdown, along with school and
playground closures, and more time spent in front of screens
like video games and television, can affect children’s
mental health, and the lack of physical activity could
result in overweight. To overcome this issue, children
should be encouraged to achieve the 60-minute daily goal of
physical activity, recommended by WHO, by sticking to
in-door exercises [10]. Also, the quality and quantity of
food should be considered seriously by the families, as the
children eat unhealthier foods and the underprivileged
children are undernourished due to the discontinuation of
mid-day meal facility. Therefore, close supervision on
physical health, nutrition, and mental health should be
performed. Compared with the other groups of society,
children are more vulnerable and are in need of great
support [11]. It is our duty to provide support to children
and families to assist them in overcoming the current
situation.
Funding:
None; Competing Interests: None stated.
REFERENCES
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full.pdf. Accessed April 13, 2020.
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al. Clinical characteristics and intrauterine vertical
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Lancet. 2020;395:809-15.
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html. Accessed April 21, 2020.
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World Health Organization (WHO). Global strategy on
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people. Available from: https://www.who.int/
dietphysicalactivity/factsheet_young_people/en/.
Accessed April 21, 2020.
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World Health Organization (WHO). Environmental health
in emergencies: Vulnerable groups. Available from:
https://
www.who.int/environmental_health_emergencies/vulnerable_groups/en/.
Accessed April 21, 2020.