A new study has found that when young children under 5 test positive for both Covid-19 and another respiratory virus, they tend to experience more severe symptoms. The research revealed that among hospitalized children in this age group, testing positive for both viruses increases the odds of severe respiratory illness by twice as much as those who only have Covid-19. This information was published in the journal Pediatrics.
This study has been conducted during a particularly difficult season for respiratory viruses affecting children's hospitals. The results highlight the impact respiratory viruses have on pediatric hospitals, and the researchers have suggested that by closely monitoring the different illnesses that are circulating, it will be possible to predict future increases in hospitalizations. A team conducted the study from the US Centers for Disease Control and Prevention and several universities and health departments across the United States.
Jenevieve Silva, a mother of eight from San Jose, California, has experienced the challenges of caring for young children with multiple respiratory illnesses during the Covid-19 pandemic. She recalls that the toughest time was from September to mid-November when her household struggled with illnesses. Her toddler-age twin boys have been frequently affected by viruses since they began preschool in May 2021.
Respiratory Viral Infection
Last October, Silva's twins tested positive for Covid-19 and then developed another respiratory viral infection, suspected by their pediatrician to be a respiratory syncytial virus (RSV), around the same time. Silva stated that their pediatrician believed the boys had overlapping viruses, and the symptoms they experienced included shortness of breath, cough, fatigue, and fever, with one twin having a fever of 105 degrees for four days.
Silva found that warm baths and massaging Vicks VapoRub on their chest and back helped alleviate her twin's symptoms. However, watching her boys struggle with these respiratory illnesses was difficult. She described them as looking frail and sickly as if something deeper than consecutive viruses was affecting them. She said it was a very difficult experience.
Silva's twin boys have recovered and are currently doing well, but she is concerned that they may have developed asthma due to their illnesses. Since October, when they had overlapping viruses, their doctor has suggested that it may have triggered asthma in them. Now, they experience asthma symptoms such as violent coughing and sometimes even vomiting whenever they get a cold. Silva said she knows she is not alone in this experience, and for other parents going through similar situations, she advises them to be patient and listen to their doctor.
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Codetection Case to Children
The new study analyzed data from 4,372 children who were hospitalized with Covid-19. Out of these children, 21% had a "codetection" of another respiratory virus in their test results, meaning that another respiratory virus was detected in addition to Covid-19. This data was obtained from the US Centers for Disease Control and Prevention's COVID-NET hospitalization surveillance network, which covers 14 states. The researchers clarified that they focused on "codetection" rather than "co-infection" since testing positive for both viruses does not necessarily indicate that a child is actively infected with both viruses.
The study found that codetections of other respiratory viruses were rare during the first year of the pandemic; however, codetections of RSV and rhinovirus or enterovirus increased during the Delta-predominant period. Meanwhile, codetections of influenza were infrequent throughout the first 2 years of the pandemic. The data also revealed that children with codetections were more likely to be under 5, require increased oxygen support, and be admitted to the intensive care unit.
There were no significant associations seen among children 5 and older. Specifically for children under 2, testing positive for RSV while having Covid-19 was significantly associated with severe illness. Dr. William Schaffner, a professor in the Division of Infectious Diseases at Vanderbilt University Medical Center, and medical director of the National Foundation for Infectious Diseases, who did not participate in the study, mentioned that further research is needed to understand the specific impact of two respiratory viruses on the body.
Vaccine Importance
He said that the study has demonstrated that, particularly for children under five years of age, being infected by two viruses at once tends to make the illness more severe, more likely to be prolonged in the hospital, and more likely to be in the pediatric intensive care unit. He added that having your lungs, throat, and immune system attacked by two viruses simultaneously would understandably make some young children more severely ill, as reported by CNN.
Dr. Asuncion Mejias, an associate professor of pediatric infectious diseases at Nationwide Children's Hospital, said that children she has treated for Covid-19 and other respiratory viruses often require increased oxygen support and treatment in the intensive care unit. She explained that Covid-19 is a proinflammatory virus, which weakens the immune response, and when a child is recovering from it and gets infected with another virus like RSV or rhinovirus, it leads to more severe disease.
Dr. Schaffner stated that these findings are more reasons why it is important to ensure that children are up-to-date on their Covid-19 and flu vaccinations. Dr. Mejias also added that it is important to practice safety measures to prevent the spread of viruses to children who are not yet vaccinated. She said that the pandemic had taught us how contagious these viruses are.
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