Covid-19 in Mumbai: In second wave, kids more symptomatic

Mumbai: Doctors treating Covid-19 patients have marked a distinct trend during the ongoing second wave of the pandemic -- the virus now appears to be impacting children more severely

Doctors treating Covid-19 patients have marked a distinct trend during the ongoing second wave of the pandemic -- the virus now appears to be impacting children more severely. Relatively unaffected during the first wave, children and adolescents are now showing more obvious symptoms such as prolonged fever and gastroenteritis, the doctors said.

In Mumbai, schools have remained closed since March 2020, but children are seen playing outdoors within housing society premises, as well as stepping out with elders.(Raj K Raj/HT file photo)

“During the first wave, most children remained asymptomatic, and a large number of them went untested because of that,” said paediatrician Dr. Bakul Parekh. “We tested children only when someone in the family had a history of Covid-19. A small number of children did have mild symptoms, which lasted only for a day or two.”

Over the last fortnight, Parekh, who runs a children’s hospital in Ghatkopar, has admitted six children between 1 and 7 years old to the hospital -- three with severe gastrointestinal infections and fever, and others with breathlessness and fever. “Those with gastrointestinal infections had to be put on intravenous fluids. The patients who were breathless required steroids and oxygen support,” said Parekh.

During the first wave, Parekh does not recall referring even a single child who needed hospitalisation.He links new mutations with the increased impact on children. “The available medical literature shows that the ‘double mutation’ found in Maharashtra (now called B1.617) can be one of the reasons behind it,” he said.

In Mumbai, schools have remained closed since March 2020, but children are seen playing outdoors within housing society premises, as well as stepping out with elders. This is increasing the risk of carrying the infection as well as getting infected, experts said. “Children are definitely more symptomatic now than what we saw in the first wave,” said Dr. Tanu Singhal, a paediatrician and infectious disease specialist at Kokilaben Dhirubhai Ambani Hospital. “The severity of their illness has gone up,” she said. According to Singhal, most of her patients are from the upper-middle class, who perhaps did not go out at all last year.

Mumbai has recorded 472,332 cases as of April 7, of which 77,495 are currently active, according to the BMC’s Covid-19 dashboard. Of the total cases, 27,233 infections were seen among children and adolescents-- 7,675 below nine years of age and 19,558 between 10 and 19 years of age. In Maharashtra, the total number of infections among children and adolescents is 299,185. Of these 95,272 are below 10, and 203,913 in the 11-20 age-group, according to a report issued by Maharashtra’s public health department on April 7.

As the number of cases rise, infection among children has also increased. However, the percentage of children and adolescents affected in the first wave and the second wave hover around 10% of total cases. What is striking is the change in symptoms, underline experts.

“Children are coming in with abdominal pain and severe diarrhea, which we didn’t see in the first wave,” said Dr. Soonu Udani, paediatrician and critical care specialist at SRCC Children’s Hospital.

“Some of them require intravenous fluids. In the first wave, most children were simply kept under observation, and in case of mild symptoms, they would respond to basic medication like paracetamol,” she said. Last year, of the paediatric patients who came to SRCC Hospital for other procedures and treatments, about 5% tested positive for Covid-19. “This time, we have about 30% to 40% of the children testing positive,” said Udani.

Doctors have observed some distinct changes in the presentations of adults, too. “Conjunctivitis is definitely more common now. Many adults are coming with post-vaccination Covid-19. The unusual thing is that they have developed antibodies, “ said Dr Sujeet K Rajan, a respiratory medicine specialist from Bombay Hospital.

Post-vaccination Covid-19 is being seen across the city, including among the health care workers who were first to be vaccinated. But experts say that their illness is truncated and extremely mild. “It is therefore important for people to get vaccinated as soon as possible. Even if they do get infected, these mild infections can be handled easily and these cases don’t put pressure on the health care system. Another important thing is not to let your guard down post-vaccination,” ” said Dr. Jalil Parkar, who consults at Lilavati Hospital.