A recent study has suggested that Covid infection may increase stroke risk in children. A small study conducted in the US and published in the journal Pediatric Neurology, reviewed medical charts and diagnosis codes to identify 16 hospital patients who had an ischemic stroke between March 2020 and June 2021 soon after the surge of Covid pediatric cases. “It may be that hyper-immune response that comes later that’s causing kids to clot,” said MaryGlen J. Vielleux, a pediatric neurology resident at University of Utah Health and lead author of the study. “Overall, kids have a relatively low risk for stroke, but there is a rare but real risk after Covid,” Vielleux said. (Also read: Long Covid in kids: How common it is, symptoms, treatment and all you want to know)
According to Dr. Kishore Kumar, Founder Chairman & Neonatologist, Cloudnine Group of Hospitals, Bangalore, says that while most children recovered from Covid infection without any major problems, a minority of them got symptoms and signs described as MIS-C (short for Multi Inflammatory System – Children ) and newborn babies got affected due to pregnant moms getting infected with MIS-N (Multi Inflammatory system – Newborn) disease.
Dr Kumar says MIS-C and MIS-N are multi-inflammatory-systemic diseases be it in children or in the newborn and the symptoms are triggered by covid-19 infection causing an inflammatory cascade leading the manifestations of the disease – in children as a result of “direct infection” and in newborn as a result of indirect infection – with moms having had covid-19 during infection and the antibodies/inflammatory markers from the mothers crossing through placenta triggering inflammation in newborn babies.
“Either way the manifestations are multi-system not accounted for by any other diseases or known infections,” says the expert.
“Covid-19 virus has variable characteristics, including its capacity for transmission and rate of infection as well as its short and long-term impacts. While some people hardly ever have any incapacitating symptoms, others continue to struggle with illnesses even after they have recovered . Even children who were affected by the Covid-19 virus have reported a range of experiences. Although the majority of them were not affected as severely as adults, Covid-19 can cause a number of additional diseases in children, even if they had little or no symptoms beforehand. Some conditions are not serious and might go away by themselves. While some are more serious and may require medical attention,” says Dr Amit Gupta, Senior Consultant Paediatrician & Neonatologist, Motherhood Hospital, Noida.
Here are ways Covid has affected children’s health:
1. Gut bleeding, leg pains, tummy pains
“The commonest we have seen is the manifestations of the blood – children suddenly developing either excessive clotting or poor clotting due to raised inflammatory markers causing manifestations due to clots – like leg pains, tummy pains persisting despite all tests to the cause of these pains being negative and finally we realize it is mini clots in the blood vessels supplying the various organs – including increased incidence of pancreatitis or bleeding manifestations from poor clotting including gut bleeding,” says Dr Kishore Kumar.
Multisystem inflammatory syndrome, a rare complication in children caused by Covid-19 can cause inflammation of some organs and tissues, including the brain, heart, lungs, blood vessels, kidneys, digestive system, skin, and eyes.
“Coronavirus, like other viral illnesses like some types of flu, has the potential to directly infect and harm the heart’s muscle tissue. Additionally, the body’s immune system response may indirectly harm and inflame the heart. If your child exhibits symptoms like a fever after contracting COVID-19 that have no apparent reason, along with one or more of the symptoms like abdominal pain, skin rash, vomiting, diarrhea, bloodshot eyes, you should consult your paediatrician,” says Dr Amit Gupta
3. Heart issues
“Another common thing we have seen is the heart being affected in various ways. Many children showed dilatation of the blood vessels supplying blood to the heart – some resolving after a few weeks, some persisting for a few months – requiring careful monitoring and treatment as required. Some children even developed myocarditis – ie., inflammation of the heart. Most of these resolved over a period of months,” says Dr Kumar.
4. Respiratory issues
“Due to the fact that Covid-19 typically affects the lungs, persistent respiratory symptoms are common. Chest pain, a cough, and increased difficulty breathing during exertion are a few of them. Some of these signs can last for three months or more. Lung function testing may be required for children 6 years of age and older with persistent symptoms. To rule out complications like blood clots, children with exercise-induced breathing issues that don’t go away may require heart tests,” says Dr Gupta.
5. Brain issues like headaches, convulsions, hallucinations
“Many children developed manifestations of the brain – head aches, convulsions, and few had hallucinations – again most of them resolving over a few weeks,” says Dr Kumar.
6. Behavioral issues and mental health
“A child’s mental health and behavior may be impacted by having Covid-19. Events related to Covid-19 like isolation, treatment, medication, absence of play time with friends and school activities may exacerbate symptoms in kids who already have mental or behavioral disorders . Some children also might get irritable and moody. Your child’s pediatrician can examine your child for indications of depression, anxiety, and other mental health issues, and can also suggest when your child might require additional help,” says Dr Gupta.
7. Persistent fever
“Another common manifestation we saw was persisting fever in children with cough – not responding to antibiotics and cough medicines – many of them requiring steroids to control cough – a lot of children behaved almost like children with asthma,” says Dr Kumar.
8. Loss of appetite, energy
“Lot of children didn’t have any specific symptoms but had loss of appetite, loss of energy and tiredness lasting for a few weeks to a couple of months,” says Dr Kumar.
“Adults who have had Covid-19 frequently complain about confusion, difficulty memorizing and concentrating. Teenagers and children may have the same symptoms. Your youngster can appear more forgetful or have problems focusing. They can require more repetition and breaks while learning because they read more slowly. As stress can make these symptoms worse, make sure your child gets adequate sleep and assists them in controlling it. Your child may benefit from a team-based therapy, take regular intervals between study sessions and rehabilitation plan if post-Covid mental exhaustion doesn’t get better or interferes with daily activities,” says Dr Gupta.
9. Physical exhaustion
“Children have been observed to get tired easily and an overall drop in energy levels after getting infected by Covid-19 virus. Over time, things normally get better. A gradual increase in physical exercise can be suggested by your child’s paediatrician. If symptoms don ‘t go better after trying this, they could suggest seeing a physical therapist or other expert,” says Dr Gupta.