Covid diagnosis in children soars in hospitals in São Paulo

Since the beginning of the year, the rate of positive diagnosis for Covid-19 has skyrocketed in children’s hospitals in São Paulo, while that of influenza has been falling. Hospitalizations also show an upward trend, but at a much slower pace.

Many parents are taking advantage of the trip to hospitals or virtual consultations with pediatricians to clarify doubts about vaccination against Covid-19. In São Paulo, the city government plans to start vaccinating 11-year-olds next Monday (17).

In the three public children’s hospitals in São Paulo (Menino Jesus, Darcy Vargas and Cândido Fontoura), the increase in hospitalizations for SARS (severe acute respiratory syndrome) in the last week was 8% (from 37 to 40 hospitalized), but, according to the consolidated In the last six months, the total number of children hospitalized today is 82% higher than that recorded in July, according to an analysis by Info Tracker, a project by Unesp and USP that monitors data from the pandemic.

Due to the blackout of data in the official notification system of the Ministry of Health and the underreporting of cases from states and municipalities, there are no national data on the high rate of Covid in children.

In the largest pediatric hospital in the country that serves the SUS, Pequeno Príncipe, in Curitiba (PR), there were 102 confirmed cases for Covid in the first 12 days of the year, with eight hospitalizations, against 20 cases and two hospitalizations throughout the month of December. . The institution also recorded four cases of “flurona” (coinfection of influenza with Covid).

In the São Camilo Hospital Network, in São Paulo, there were 993 pediatric consultations for respiratory symptoms in the first ten days of the year. In the period, 39 children diagnosed with Covid were hospitalized. Last Wednesday (12), six were hospitalized.

At Hospital Sírio-Libanês, the positivity rate in Covid exams in children is 36%. A week ago it was at 21.4% and in December it was at 7%.

At Hospital Infantil Sabará, the rate of positive tests for Covid rose from 2% in mid-December to 20% last week. Now it’s at 28%. Influenza reached 62% in the week of Christmas, dropped to 40% at the beginning of the year and is now at 15%. A day, the hospital has admitted four to five children with Covid. This Wednesday (12), there were eight hospitalized, twice as many as a week ago.

“Fortunately, the average length of stay for these patients is low, an average of two days”, says infectious disease specialist Francisco Ivanildo de Oliveira Junior, quality manager at Sabará.

According to pediatrician Claudio Schvartsman, vice president of the Sociedade Israelita Albert Einstein, most hospitalizations refer to children with comorbidities, such as asthma and bronchitis, or with diseases that require the use of immunosuppressive medications.

As with other health services in the country, both hospitals are only testing for Covid children who go through the emergency room with more serious symptoms and who, in general, need hospitalization. “Due to the reduced availability of tests, we are having to rationalize”, says Oliveira Júnior.

In mild cases, according to him, the positive test will not influence clinical management. The orientation is for the family to behave as if it were Covid. “In this current epidemiological situation, flu syndrome without identification of the etiological agent is equal to isolation for Covid.”

At Hospital Albert Einstein, in two weeks, the positivity rate in Covid tests jumped from 12% to 32%. Seven children were hospitalized this Thursday (13), against five a week ago.

“This time, unlike the other waves, Covid is affecting the age group of young children. Fortunately, in most cases, the disease is behaving like a small or medium intensity cold. It lasts for three or four days and then it starts to improve”, says Schvartsman.

According to Oliveira Júnior, from Sabará, in addition to the classic respiratory symptoms, some children diagnosed with Covid have been presenting gastrointestinal manifestations, with vomiting, diarrhea and abdominal pain. Sometimes these signs appear on their own, without fever or other flu-like signs.

The orientation, says the doctor, is that, in the face of mild complaints and if the child is in a good general condition, parents should first use the telemedicine tool or contact the child’s pediatrician before going to the hospital. .

“They should go to the ER if there are warning signs such as prolonged fever that does not go down, respiratory discomfort, if the very young child is hypoactive [alheia ao que se passa ao seu redor], stop accepting power. Then, yes, they need face-to-face evaluation and eventual hospitalization.”

Schvartsman, from Einstein, says that the demand for telemedicine care is high and that many parents are taking advantage of the consultations to guide themselves on whether or not to vaccinate their children against Covid.

“In general, the justification for the doubt is that it is still a new vaccine and that the disease, in children, is usually mild. It is a half truth. In absolute numbers, it is not a small contingent of deaths, it is greater than mortality of other diseases for which there is also a vaccine. I always say that the cost-benefit ratio [da vacinação] pays off.”

Professor Cristina Diniz, 45, is one of the people who still have doubts about the childhood vaccine against Covid. She, her husband, their 15-year-old teenage daughter and their nine-year-old son contracted Covid on a trip to Bahia at the end of the year. Symptoms were mild. The couple and their daughter are vaccinated. “If my child has been infected, does he still need a vaccine? Is he not already immunized?”

According to pediatrician Talita Rizzini, coordinator of the pediatric service at Hospital Leforte at the Liberdade unit, even if the child has already had Covid, it is important that they get vaccinated due to mutations in Sars-Cov-2 and the possibility of the emergence of new variants. .

“Vaccination is very important because, with the antibodies formed, when the child comes into contact with the virus, the immune response is faster, which brings less seriousness to the case”, he says. The pediatric service had been suspended during the pandemic and will reopen this Saturday (15).