Children hospitalized for Covid-19: should we be worried?

“This evening there are 64 children hospitalized in pediatric intensive care for a serious covid, this is twice the maximum recorded in November or December with 30 children on a given day”. The sentence, pronounced this Tuesday by the Minister of Health, Olivier Véran, during the debate on the bill establishing the vaccination pass has, at first glance, something to worry some parents at a time when we are talking about ‘an active circulation of the virus among the youngest, and in particular at school. Corn “we must especially not panic the parents” insists Fabienne Kochert, president of the French Association for Ambulatory Pediatrics.

This figure deserves to be put into perspective, in several ways. On the one hand, because “When we talk about resuscitation, this does not necessarily mean that the child has been placed on artificial ventilation, we are talking about intensive care when the child requires a little oxygen”. Thus, among hospitalized children, thes infants under three months of age who test positive for Covid-19. However, these patients do not have severe forms of the disease, said the Directorate General of Care Provision (DGOS).

On the other hand, are counted among these figures, the children of which “Sars-CoV-2 was not the cause of the hospitalization “, but we discovered “looking for him after.” This is the case, for example, of the discovery of an asymptomatic Covid case during emergency hospitalization for another medico-surgical or traumatic pathology.

The pediatrician evokes “four major groups” among children with Covid-19 currently hospitalized, not necessarily in intensive care. Firstly, “30 to 40% would represent babies under three months old who arrive at the emergency room with a fever and potentially a flu or a urinary tract infection, to whom we do a PCR test which turns out to be positive without us really knowing which is at the origin of the symptoms, but which sometimes deserve to be placed on oxygen “.

The second, somewhat larger group concerns patients with “table of respiratory distress, with which one detected a co-infection, that is to say that they are at the same time carrier of the RSV at the origin of the bronchiolitis in the youngest and of Sars-CoV-2 , and who need oxygenation “.

“A small group then concerns children with comorbidities, sickle cell disease in particular or suffering from chronic respiratory diseases, neurovegetative pathology or cancer, under immunosuppressive treatment and therefore already fragile, but who are also carriers of Sars-CoV. -2 “, continues the president of the French Association of Ambulatory Pediatrics.

Finally, “we note in a small tremor of the famous PIMS which on all the children carriers represent a small portage”, she insists, hammering that there is “no drastic increase in severely ill children in intensive care ” and stressing that “when we go from 0 to 1 we increase by 100% but that does not mean that we go from 500 to 2000”. This point, she concedes, “asks to be clarified on the days and weeks to come because once the portage of PIMS is documented, it on the other hand is directly linked to Sars-CoV-2”.

Christèle Gras-Le Guen, epidemiologist and president of the French society of pediatrics and epidemiologist abounds on these different points. “In the 64 children in intensive care, there must be a significant proportion of patients with bronchiolitis because they are unstable and need respiratory support”, explains the one who took part on Tuesday in a meeting between pediatricians who did not reveal “no worrying or alarming signal in the different regions of France”. To explain this increase in the number of children with Covid in hospital, the latter recalls that“currently the virus is circulating so much that there are more positive children, it is logical and this had already been observed in previous ones”.

And to conclude: “we must stop the anxiety-provoking messages which are undoubtedly intended to convince children to be vaccinated, it is deleterious for the mental health of children as well as parents (…) there are a few rare severe forms of Covid in carriers of underlying chronic illnesses but keep in mind that there are many more hospitalizations for bronchiolitis than for Covid “.

On the side of the DGOS, it is also specified that this increase in hospitalizations would probably be due to contamination “intra-family more than school taking into account the holidays”. As for the variant, it would seem that it is Delta which still dominates for these severe forms.