How Dangerous Is Covid-19 For Children?. According to the Robert Koch Institute, corona infections in children are mostly mild or unnoticed. At the same time, however, the experts agree that there is so far too little data to make a scientifically tenable statement about the COVID-19 risk in children. The reason for this is simple: Parents understandably do not bring their children to the doctor or hospital if things go slightly or unnoticed. Therefore, children are rarely tested. The proportion of patients who tested positive has so far been around 2 percent for children and adolescents and 6 percent for young adults up to the age of 20 (see sources, section 2). However, it is not currently possible to say with certainty whether this corresponds to the actual prevalence.
More frequent severe courses in children with previous illnesses
So it is currently not possible to answer with final certainty whether COVID-19 is actually almost always mild in children. But there is much to be said for it. Nevertheless, there are also difficult courses for children. According to the RKI, infants and toddlers are treated as inpatients for COVID-19 more often than other children and adolescents. Children with pre-existing conditions such as cardiovascular diseases or diabetes make up around a quarter of the children admitted to the hospital and half of all children who had to be treated in an intensive care unit because of COVID-19. According to the German Society for Pediatric Infectious Diseases (22), there was only one death associated with COVID-19 in this patient group in Germany until May 18.
Why is COVID-19 often symptom-free or mild in children?
This question cannot be answered at the moment, as the relevant research has not yet been possible. Experts suspect that the child’s immune system, which is not fully developed, enables a broader non-specific defense system than the “ready-made” immune system of adults. Another possibility would be that the child’s cells offer the virus fewer docking options because the corresponding binding sites (receptors) for the virus are not yet developed or are less strongly developed in the child’s cells.
Are children infected more easily than adults?
According to the current state of research, it looks like children are actually less likely to become infected with Sars-CoV-2 than adults. As with many other questions about corona infections, this question cannot currently be answered conclusively.
According to the RKI, studies come to very different results. In the majority of studies, however, the infection rate in children is significantly lower than that of adults. A study from China puts the infection rate in children under 15 years of age at a third of the risk for people between the ages of 15 and 64. The study “Changes in contact patterns shape the dynamics of the COVID-19 outbreak in China” was published by Science at the end of April.
How contagious are children to other children or adults?
The study situation is currently not clear on this question either. Germany’s leading virologist Christian Drosten published an evaluation of the laboratory tests at the Berline Charité at the end of April. According to this, the viral load of infected children is essentially as great as that of adults. Therefore, it could be possible that children are just as contagious as adults, Drosten concludes. At the same time, he admits that the number of children recorded in this analysis is very small. In his podcast, Drosten says “You should actually have ten times as many children, but we don’t have that many”.
Study in Baden-Württemberg: Children are not drivers of infections
The state of Baden-Württemberg had 2,500 children aged up to 10 years and one parent each tested for corona infections and antibodies. The complete results of this investigation by the university hospitals in Heidelberg, Freiburg, and Tübingen are not yet available. According to the state government, however, the interim results show that children are significantly less contagious and infectious than adults. The difference is significant, said Prime Minister Winfried Kretschmann (Greens) during a press conference on May 26th. And further: “We can rule out that children are drivers of the infection process”. These are reliable interim results with a stable trend “.
Professional societies: Children do not play a prominent role in the spread
In their joint statement “Children and adolescents in the COVID-19 pandemic”, 4 medical societies had previously assessed the study situation. They come to the conclusion that the risk of infection in children is significantly lower than that of adults. Accordingly, children do not play a prominent role in the spread of COVID-19. Rather, the infection in the family usually occurs through infected adults.
Do parents need to be concerned about the number of cases of Atypical Kawasaki Syndrome?
In the past few weeks, reports of severe inflammation in children with COVID-19 have created great concern among many parents. Accordingly, especially in the USA, Italy, Spain, France, and Switzerland, a noticeable number of children showed severe symptoms that resemble Kawasaki syndrome.
The German Society for Pediatric Infectious Diseases (DGPI) and the German Society for Pediatric Cardiology and Congenital Heart Defects (DGPK) point out in a joint statement that the reported cases do not always correspond to the typical clinical picture of Kawasaki syndrome. Therefore, in their opinion, the experts speak of an excessive inflammatory reaction with inflammation of the blood vessels (vasculitis). Such hyper inflammation syndromes were already well known before COVID-19. There is currently no evidence that infections with Sars-CoV-2 are the trigger for the corresponding symptoms.
At the same time, the experts point out that hyper inflammation syndromes can be treated “very well with cortisone or other immunosuppressants and immunoglobulins”. Therefore, there is no reason for parents to be concerned about the number of cases of atypical Kawasaki syndrome.
New evidence of a lower risk of infection for and by children
Update from June 17th
The University Hospitals of Freiburg, Heidelberg, Tübingen, and Ulm have now presented the first results of the study commissioned by the State of Baden-Württemberg on the risk of infection in children. According to the medical director of the children’s clinic at Ulm University Hospital, children are not to be seen as drivers of the wave of corona infections. However, the cause is still unknown, said Klaus-Michael Debatin on June 16 at a press conference. It may be because children have fewer binding sites (ACE receptors) to which the virus can dock. But it is also possible that the child’s immune system successfully combats SARS-CoV-2 in the nasopharynx.
For the study, the doctors tested around 2,500 children under 10 years of age and one parent each for SARS-CoV-2 and COVID-19 antibodies from April 22 to May 15. Of the 5,000 participants, only one parent-child pair was infected during the survey period. Antibodies could be detected in 64 people – 45 adults and 19 children.
Low number of infections in the families studied
The scientists summarize: “The preliminary analysis of the study shows that the most important results are that only a small number of infections occurred in the families examined and that children apparently not only contract COVID-19 less, which has been known for a long time, but also less often be infected by the SARS-CoV-2 virus. ”
The scientists point out that they could make statements about whether children infected their parents or parents infected their children. The study also did not examine how infectious children are in principle. Like many other studies in connection with Corona, the study has not yet been reviewed by experts.