COVID-19 Is More Serious When Children Get a Second Viral Infection

The recent study shedding light on the severity of COVID-19 in patients under 5 when they contract a second infection like RSV or influenza, provides a sobering perspective. This revelation, while not unexpected, explains why COVID-19 is more serious when children get a second infection and underscores the complexity of this challenging illness season.

According to a recent study, children with COVID-19 plus an additional infection, such as RSV, are more likely to be hospitalized than their counterparts with COVID-19 alone.

The report, which will appear in the Pediatrics issue for February 2023, was published online on January 18. More than 4,300 hospitalized U.S. children with COVID-19 were examined between March 2020 and February 2022. It was discovered that children of COVID-19 patients under the age of 5 who also had another virus, such as rhinovirus or enterovirus, were substantially more likely to develop serious respiratory illness.

Dr. Mark Kline, chief academic officer and physician-in-chief at Children’s Hospital of New Orleans, explains, “This research verifies what many of us have experienced.” A growing number of hospitalized children with COVID-19 were also infected with other viruses, such as RSV, influenza, and rhinovirus/enterotoxin, over the past year.

The news might not surprise Kline or his parents. According to specialists, including White House COVID-19 response coordinator Ashish Jha, this may appear to be just another alarming headline amid a difficult season marked by a “tripledemic” of COVID-19, RSV, and influenza cases.

What does the new research reveal, and how should exhausted parents respond? Three specialists weigh in.

Why Do Children Contract Multiple Viruses Simultaneously?

Dr. Michael Harris, M.D., a pediatric emergency department physician at Northwell Health’s Cohen’s Children Medical Center in New York, explains that COVID-19, influenza, and RSV are all extremely contagious.

These can affect people of any age, but youngsters’ social and intellectual environments raise their risk.

“Kids tend to interact with other children more than adults,” adds Dr. Harris. “They attend child care and school. They engage in physical sports.”

Also, children have had less exposure to viruses throughout their lifetimes, so their immune systems are typically weaker. Dr. Sharon Nachman, M.D., chief of the division of pediatric infectious diseases at Stony Brook Children’s Hospital, explains that when a child is ill, their immune system is impaired as it attempts to fight off one virus, making them more susceptible to another illness.

Dr. Nachman claims that due to COVID-19-related school and daycare closures and decreased socialization, many children were not exposed to common diseases such as influenza and RSV. As a result, the immune system has not been “trained” on how to combat numerous viruses; as a result, more children are contracting many infections simultaneously.

“These viruses never disappeared. We just weren’t receiving them because we weren’t seeing each other “Dr. Nachman explains.

Does This Research Explain Why Sick Season Seems Worse Than Normal This Year?

The research spans from March 2020 to February 2022, but might it explain why nearly half of the parents reported that their child was already sick by October? Or why the CDC issued a health caution in early November regarding increased respiratory activity, particularly among children?

Experts concur.

Dr. Kline explains, “This is certainly a contributing factor to the increase in hospitalizations for respiratory illness during the previous few months.”

Dr. Nachman also notes that safeguards, such as masking and social isolation, have effectively prevented the spread of influenza and RSV over the past two years. With people returning to their pre-pandemic behaviors, there is an increased risk of disease.

“We did a fantastic job protecting everyone for a good reason…

We are no longer protecting everyone,” Dr. Nachman argues. “Now, no one is masking.”

When Should Your Kid See the Emergency Room?

In recent weeks, the number of pediatric hospitalizations for the respiratory disease has decreased, and Dr. Harris hopes this trend continues. But parents must know when to take their child to the emergency room for further evaluation. According to Drs. Nachman and Harris, a high temperature is normally not a reason to take a kid to the emergency room unless your child’s healthcare physician specifies differently for health concerns.

Dr. Nachman suggests looking for respiratory difficulties.

“If you remove a child’s shirt and observe the gap between their ribs sucking in and out, they are having difficulty breathing,” she explains.

According to Dr. Nachman, a diminished appetite is normally acceptable, but unwillingness to drink or inadequate diaper output are red flags. When in doubt, follow your instincts.

“I tell parents, ‘You are my finest detective. You are familiar with how your child seems when they are somewhat ill and how you feel when they are severely ill. Call me if you feel the urge to speak with me on the phone, “Dr. Nachman adds.

How To Safeguard Your Children

As the cold/flu/RSV season fortunately continues, there are actions parents may take to safeguard their children. Initially, Dr. Nachman advocates returning to fundamentals.

“Healthy dietary habits, including water, fruits, and vegetables, and healthy sleeping patterns are essential,” she explains. “It assists the body in producing the correct hormones at the appropriate moment. It helps tune up the body’s immunological system. I acknowledge that it is difficult, but the sooner we begin these difficult duties, the greater the lasting impact.”

Dr. Harris hopes that individuals will also remember the core lessons they learned throughout the pandemic.

“I believe that we should have been following common sense for the past two decades. If your children are ill, they should stay home,” Dr. Harris affirms. “Wearing masks. If you are in a crowded location such as a bus, subway, or airplane, there is a good probability that someone has something you don’t want, whether it’s COVID, the flu, or a cold—I don’t think any of us want any of these viruses.”

Dr. Kline concludes by encouraging parents to immunize and boost their children against COVID-19 and influenza. Children older than six months are eligible for the COVID-19 vaccine and bivalent booster, however CDC data indicates a wide range of vaccination rates among children. Depending on the state, only 2% to 40% of children aged six months to 4 years had gotten their first dosage.

Even if you take precautions, your child may likely become ill.

“The good news is that every virus your child contracts today will strengthen their immune system as they age,” Dr. Nachman explains. Even while we would prefer that our children did not contract any of these viruses, it will help their immune systems in the future.

Dr. Nachman stresses that this is not an excuse to completely disregard measures or host “chicken pox” parties for respiratory infections. Nonetheless, it may help you feel slightly less guilty when your child brings something home.

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