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Children who test positive for Covid and another respiratory virus could have serious illness, study says

When Covid-19 patients younger than 5 years old also test positive for another respiratory virus, they tend to get sicker and develop more severe illness, suggests a new study.

Among hospitalized children under age 5, testing positive for Covid-19 and another respiratory virus at the same time is associated with about twice as likely to have severe respiratory illness than those who test negative for other viruses, according to the study. published this Wednesday (18) in the journal Pediatrics.

The study comes amid a difficult respiratory virus season in the United States, where circulating respiratory syncytial virus (RSV), coronaviruses, influenza and other viruses are overwhelming children’s hospitals.

The findings demonstrate the impact that respiratory viruses have on pediatric hospitals and how “ongoing surveillance” of the circulation of Covid-19 and other illnesses can help predict future increases in hospitalizations, researchers from the Centers for Disease Control and Prevention wrote. (CDC), the US, and several US universities and health departments.

Caring for young children with overlapping respiratory illnesses was something Jenevieve Silva experienced firsthand during the Covid-19 pandemic.

“The height of illness was from September to mid-November, when our household just couldn’t rest,” she said.

The mother of eight, who lives in San Jose, Calif., said her twins “have been hit with the virus” since they started preschool in May 2021.

Last October, the twins tested positive for Covid-19 and developed what their pediatrician suspected was another respiratory viral infection, possibly respiratory syncytial virus, around the same time.

“Based on what the pediatrician told us, she said, ‘I really believe they have these overlapping viruses,’” Silva said, adding that the boys’ symptoms included shortness of breath, cough, fatigue and fever, with one twin having a fever. 40 degrees for four days straight.

Warm baths and Vick VapoRub massages on the back and chest helped ease the pain, but watching her boys battle these respiratory ailments was “brutal,” Silva said.

“They looked so fragile – they looked sick, like something deeper than just viruses at the same time,” she said. “It was hell. I mean, it was really bad.”

‘I can’t be the only mother dealing with virus after virus’

The boys recovered, are “very well” and have gained healthy weight, Silva said, but she fears they may have developed asthma after their illnesses.

Since October, when they had co-detection, “the doctor said it looks like this might have triggered their asthma. And now, ever since, when they get a cold, they have asthma symptoms – violent coughing episodes, sometimes vomiting,” Silva said.

“I can’t be the only mom dealing with virus after virus,” she said, adding that for other parents, she has a message of hope: “Be patient. Listen to your doctor”.

The new study included data from 4,372 children hospitalized with Covid-19. Among those who were tested for other respiratory viruses, 21% had co-detection, meaning that another respiratory virus was also detected in the test results. The data came from the U.S. Centers for Disease Control and Prevention’s Covid-19 hospitalization surveillance network, called Covid-Net, with data from 14 states.

The researchers consider that focused on co-detection, not co-infection, as the test does not necessarily show that a child has been actively infected with both viruses just because the test came back positive.

Overall, “this study found that respiratory virus co-detections were rare in the first year of the pandemic, RSV and rhinovirus or enterovirus co-detections increased during the predominantly Delta period, and influenza co-detections were rare during the first 2 years of the pandemic.” , the researchers wrote in the study.

The data also showed that children with cosensions were more likely to be younger than 5 years old, receive greater oxygen support, and be admitted to the intensive care unit (ICU). No significant associations were observed among children aged 5 years and older.

Specifically for children under age 2, testing positive for respiratory syncytial virus during COVID-19 was significantly associated with severe illness.

More research is needed on the precise impact that two respiratory viruses can simultaneously have on the body, said researcher William Schaffner, a professor in the Division of Infectious Diseases at Vanderbilt University Medical Center and medical director of the National Foundation for Infectious Diseases, who was not involved in the study. new study.

“But we think that being attacked by two viruses, especially if you are under five years old, was clearly shown by this study, tends to make your illness more severe, more likely to be prolonged in the hospital, more likely to be in the hospital. pediatric intensive care unit,” said Schaffner. “And clearly, having your lungs, your throat and your body – usually your immune system – attacked by two viruses simultaneously understandably can make some children more seriously ill.”

Basic care helps prevent respiratory diseases

‘The pandemic has taught us how contagious these viruses are’

Lead researcher Asuncion Mejias, an associate professor of pediatric infectious diseases at Nationwide Children’s Hospital, said hospitalized children she treated for Covid-19 and co-detection of other respiratory viruses often require increased oxygen support and ICU treatment.

“Coronavirus is a very pro-inflammatory virus, so it really weakens your immune response,” Mejias said. “And when you still haven’t recovered and you get a second hit, in this case RSV or rhinovirus, you develop a more serious illness.”

Overall, Schaffner said these new study findings are yet another reason why it remains important to make sure children are up to date on their Covid-19 shots, as well as being vaccinated against the flu.

Mejias agreed, stressing the importance of safe practices to prevent the spread of the virus to children too young to be vaccinated.

“The pandemic has taught us how contagious these viruses are,” Mejias said of respiratory pathogens.

“If someone is sick, try to avoid contact,” she said. “These viruses are not only transmitted through saliva and secretions, but also through the hands. So hand washing and all these measures are very important.”

Source: CNN Brasil

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