Symptoms in Kids of Novel Coronavirus, COVID-19


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New paper released early due to importance.

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Coronavirus looks different in kids than in adults.

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A study released this week in the journal Pediatrics provides the clearest confirmation yet that coronavirus infections are, in fact, generally less severe in kids, with more than 90 percent of 2,143 children in the study in China having mild to moderate disease or even being asymptomatic.

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But it contains worrisome information about one subset — infants — and suggests that children may be a critical factor in the disease’s rapid spread.

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Pediatrics associate editors Andrea Cruz and Steve Zeichner, both physicians, say the study suggests “children may play a major role in community-based viral transmission.”

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The data suggests children may have more symptoms that make them contagious, like a runny nose, and that they may have more gastrointestinal symptoms, which raises concerns about the virus being in the feces for several weeks after infection.

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Adam Ratner, a doctor in pediatric infectious diseases at NYU Langone Health, said the clear takeaway from the study is that the novel coronavirus “is still something that has the ability to cause severe disease across the age spectrum.”

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Study: Coronavirus is not sparing children — and they may play a ‘major role’ in its spread..A new study shows coronavirus infections are less severe in kids, but they may spread it more readily than adults...The first thing to know is that children are getting infected across all age groups and genders. Among the patients studied, half were from Hubei Province, the epicenter of the outbreak, while the others were from bordering areas. They ranged in age from newborns to 18 with the median age being 7 years.
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So what does coronavirus look like in children?

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According to the analysis by Shanghai Children’s Medical Center researchers Yuanyuan Dong, Xi Mo and co-authors, mild cases (52 percent) were marked by the typical symptoms of a cold — fever, fatigue, cough, sore throat, runny nose and sneezing. Some patients had no fever and only digestive symptoms such as nausea, vomiting, abdominal pain and diarrhea.

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Those with moderate infection (39 percent) had pneumonia with frequent fever and cough, mostly dry cough, followed by a wetter cough. Some had wheezing but no obvious shortness of breath.
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Severe cases were rare (5 percent) as were those who required critical care (0.4 percent.) The severe cases began with early respiratory symptoms which were sometimes accompanied by gastrointestinal issues. Around one week the children have more difficulty breathing. Those cases sometimes quickly progressed to critical illness with acute respiratory distress or failure which in turn sometimes led to other organ dysfunction — heart failure or kidney injury.
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One boy, a 14-year-old, died on Feb. 7. No further details on the patient were revealed in the study.
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Of special interest to pediatricians is a group of seven infants (11 percent of the total number of infants in the study), and two children in the age 1 to 5 range (15 percent), who progressed to critical condition. The study suggests, the authors wrote, that “young children, particularly infants, were vulnerable.”.

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The luckiest group — 4 percent — did not have any symptoms at all even as nasal or throat swabs showed they were positive for coronavirus infection…..................

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The material on this site is for informational purposes only.
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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

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Coronavirus Tsunami Unlike Anything Before – fibrosis of lungs, death by sputum bolts


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First, see the PDF at bottom from Lancet: Mitigating effects of home confinement on children during the coronavirus outbreak.

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Then will see a summary of the Lancet report of how doctors treat the sickest coronavirus patients. So many die.

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It is now surely one of the most-read medical reports among caregivers in intensive care units around the world who are bracing for the novel coronavirus.

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Next, quoting Cuomo today, “I’m not urging calm. I’m urging reality.”

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An Italian doctor said: ‘Our hospitals are on their knees’: Italian doctor’s dire warning over coronavirus has driven his country’s healthcare system to brink of collapse.

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I truly fear for the safety of all when I hear people are already bored, fatalistic, saying “Well, it’s everywhere. There’s nothing I can do.” They don’t have a clue: A tsunami is coming and we are not the slightest prepared. No equipment. No masks. No gowns. No beds. Not the basics! No test kits for another two weeks…..maybe. There are things you must do to protect others. Don’t say, “It doesn’t matter, we will all get it.” Here is what’s coming.

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“more than 100 out of 120 people admitted with the virus also developed pneumonia.”

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We know from early stage COVID-19 autopsies published February 29, 2020, the two prominent lethal features are

  • severe fibrosis of distal lungs  – oxygen does nothing at scar tissue

  • sputum bolts that kill due to cytokine storm, an over-responsive immune system that kills with a surge of inflammatory cytokines that produce copious sputum.

  • “The influence of COVID-19 on the human body is like a combination of SARS and AIDS as it damages both the lungs and immune systems,”

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“…most important thing now is to take measures at an early stage of the disease to protect patients’ lungs from irreversible fibrosis,” Peng noted.”

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This Lancet article may wake you up if not too bored. It’s scares me like nothing I could imagine.

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From Lancet, February 24, 2020

Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study

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A summary, below, from The Washington Post, March 7, 2020, of a portion of the Lancet article, above:    .

How Doctors Treat the Sickest Coronavirus Patients

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It is now surely one of the most-read medical reports among caregivers in intensive care units around the world who are bracing for the novel coronavirus. The paper, published in the British medical journal the Lancet last month by a team of doctors working at the center of the outbreak, is the first study to characterize the clinical course, treatment and mortality of a group of critically ill patients infected by the new SARS-CoV-2 virus.

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The report is highly valuable, say clinicians in the United States and Europe, because it details the course of the disease in critically ill patients — that small but worrisome subset who end up in ICUs. The 52 patients were treated at the Jinyintan Hospital in Wuhan, China, during the first month of the epidemic, from the end of December through January.
The authors tracked the constellation of life-threatening symptoms, what drugs patients were given to try to combat the infection’s assault on the lungs, how supplemental oxygen was administered, and the outcomes — whether patients survived or died in the ICU.

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The grim conclusion: For patients infected with the novel coronavirus who became critically ill with pneumonia and entered their ICU, the doctors recorded “high” numbers of fatalities. Of the 52 people included in the sample, 32 died in the 28-day span of the study, revealing a death rate of 61 percent. Most died within seven days of being admitted to the ICU.
For comparison, mortality rates generally ranging between 30 and 40 percent are observed for patients who are sickened by ordinary seasonal flu and are fighting pneumonia and acute respiratory distress syndrome in ICUs.


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Specialists outside of China applaud the treatment given by the Chinese doctors to their patients in the study, saying that similar levels of care would be found in American and European critical care units.


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Like the doctors in China before them, health-care workers in South Korea and Italy are seeing their ICUs filling with critically sick patients. In Lodi, in northern Italy, one infectious-disease doctor told The Washington Post that coronavirus had hit “like a tsunami” at his hospital, where more than 100 out of 120 people admitted with the virus also developed pneumonia.

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Breathtaking. I am absolutely kicked in the gut sickened by what I know will be unfolding here. It is unlike anything we have seen before. As a physician, I cannot imagine how it is possible we will be even half prepared but even then, no respirators, not enough of a tsunami of respiratory therapists to handle the lungs that get blasts of sputum bolts and kill.

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We don’t have nowhere near enough critical care beds.

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We simply do not have the barest of necessities, already not enough masks and respirators, not to mention the flimsy gowns I’ve seen Health workers in Kirland Washington are wearing. I’ve not seen a single American Health worker wearing anything like the fully enclosed space suits even street workers wear in Wuhan.

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My mind is stunned reading what it was like there, what will get here soon, just like that and we will see what is unlike anything we have ever seen before in medicine; it is a tsunami and deadly serious.

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We’ve had 6 wasted weeks watching it come and did nothing. Test kits cannot be promised in two weeks, said Dr. Anthony Fauci on March 6. Contradicting the expert, trump on the same day said we had test kits now, but on Thursday March 5, Pence had already said we did not. 

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Just published is why seniors are more likely to die. Because they lost ability to turn off immune system when full blast no longer needed.

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Children can test positive to coronavirus but may have few to no symptoms.

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Lancet offers free public access on coronavirus. The Lancet resource center on coronavirus is here

Such as

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(Chinese translation | 附中文翻译, PDF)...

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China does not charge for healthcare due to coronavirus.

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Om Tat Sat Om

1 Om.svg.

 

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The material on this site is

for informational purposes only.

.
.
It is not legal for me to provide medical advice without an examination.

.
It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

~~~~~

For My Home Page, click here:  Welcome to my Weblog on Pain Management!

.

Please ignore the ads below. They are not from me….

.

.

The advertising below is not mine. In exchange, this blog is less expensive.

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