Pediatricians see no acute danger from delta variant

Image by Darko StojanovicThe delta variant of the coronavirus has been causing the seven-day incidence in Germany to rise again for weeks. However, the number of hospital admissions as another potential "leading indicator" for the pandemic is increasingly entering the debate as a parameter for political decisions. Against this background, children and young people are once again playing a major role. This is because a large proportion of schools will reopen in August. Particularly in the case of face-to-face teaching, the virus should then have an easy time spreading among people under 18. After all, almost without exception they are not yet protected by vaccination.

But how great is the risk for children and young people to become seriously ill? Answers and data from German children's hospitals provide information.

One thing is clear: Since the delta variant is known to be more contagious than the previously dominant alpha variant, this also leads to more infections in children and adolescents. Jakob Armann also confirms this to the Daily Mirror. He is a senior physician for pediatric infectious diseases and pediatric intensive care medicine at the Clinic and Polyclinic for Pediatric and Adolescent Medicine at the University Hospital of the Technical University of Dresden.

However, "There are no national or international data that the delta variant leads to more severe disease courses in children and adolescents or that the delta variant now preferentially affects children." The hospitalization rate of children and adolescents has been stable in Germany, but also in the United Kingdom, for example, since late summer 2020 and shows no changes due to the appearance of variants during this period, he said.

"There is no increase in severe - requiring intensive care - courses due to Delta in children and adolescents," says Armann. And he goes even further: Due to the currently low overall case numbers, he sees "practically no hospitalized children and adolescents" with a corona infection.

Armann at the University Hospital of Dresden is also where the data collected by the German Society for Pediatric Infectiology (DGPI) on Covid 19 cases in children and adolescents converge. They also confirm the picture Armann draws from Dresden University Hospital for all of Germany.

The most important facts about children with corona in the hospital:

  • In the first three weeks of July, only five children and adolescents were newly admitted to normal wards because of Corona infection.
  • The last case in which a child or adolescent had to be transferred to intensive care units because of severe course dates from early June.
  • The numbers peaked in late December. At that time, 77 children and adolescents were admitted to normal wards and 15 to intensive care units in one week.

Armann emphasizes, however, that the majority of children infected and hospitalized in the second and third waves were not there because of their infection - but for other reasons. Thus, there were and are only very few severe courses of Corona infection.

Robin Kobbe, a pediatrician and infectiologist at the University Medical Center Hamburg-Eppendorf (UKE), agrees with Armann. With regard to the delta variant, he tells the Daily Mirror: "That this variant is clearly more aggressive, cannot be said so far for children and adolescents."

However, he does not give the all-clear completely. He says there is no reason to assume that the significantly higher transmissibility is not also significant in younger age groups. "However, as the number of infections increases, more children will also become ill enough to require hospital treatment - that's foreseeable," Kobbe says.

However, Florian Hoffmann, a pediatric intensivist at the Children's Hospital and Children's Polyclinic at Dr. von Hauner's Children's Hospital, does not expect rising case numbers to increase the number of children and adolescents in intensive care units. "Delta is not becoming a children's disease," Hoffmann tells the Daily Mirror.

He, who is also secretary-general of the German Interdisciplinary Association for Intensive Care and Emergency Medicine, can also detect "virtually no inpatient cases at present." "And it is also not expected to come," Hoffmann said.

What can also be seen in the DGPI's registry is that more than a third of the children and adolescents treated as inpatients have so far been younger than a year old, and more than half of those have even been less than two months old. What does this mean? At least not that a particularly large number of very young children are becoming seriously ill. Instead, intensive care physician Armann has a simple explanation: "Most of these are infants who stay in the hospital as a precaution. But the risk of them becoming seriously ill is extremely low."

This also explains the statistic that around 20 percent of children and adolescents are in the normal ward without symptoms. Two out of three of the infected children and adolescents who had to be transferred to the intensive care unit also had concomitant diseases - in other words, they were not only infected with Covid-19.

And what about the sequelae? The impact of the delta variant of the virus on Long Covid Syndrome is difficult to assess reliably, says Armann. Kobbe expresses a similar opinion. This is mainly due to the fact that Long Covid does not start until twelve weeks after infection, and the delta variant was not dominant in either the United Kingdom or Germany as early as April, he says. "Personally, however, I do not assume that Delta will fundamentally change the situation," Armann said.

It is true that he also treats children and adolescents with suspected Long Covid in Dresden. But the numbers, like those of severe courses of corona infection in children, are manageable. "So far, there has been no increasing trend in recent weeks," Armann says.

This assessment of Long Covid in children is also supported by the statistics. Seventy-three percent of the more than 1670 patients were discharged fully recovered. About 25 percent were discharged with cough or fever. Only 0.4 percent of these children and adolescents were discharged with sequelae - the same number as died from Covid-19.



Image by Darko Stojanovic

 


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