Largest pediatric hospital in SP sees a jump of healthy children with severe Covid

A new fact has caught the attention of doctors at Hospital Infantil Cândido Fontoura, the largest public pediatric institution in the state of São Paulo: an increasing number of young children, without previous comorbidities, who have had serious complications from Covid.

Like other children’s hospitals, Cândido saw the number of hospitalizations explode in January. There were 112 suspected cases, of which 39 have already been confirmed for Covid – against 4 in January 2021. Last December, there was no hospitalization for Covid.

Of the total of 5,113 visits to the hospital’s emergency room (ER) last month, 2,220 were for flu-like symptoms. This Friday (4), there were 14 children hospitalized with Covid and nine suspects. Half of them had no previous comorbidities.

“From ten days ago, we started to have healthy children [saudáveis] that evolved with a certain severity. We hadn’t seen this until then”, says pediatrician Mario Palumbo Neto, the hospital’s technical health director.

The intensive care physician Marina Favoreto Finardi, coordinator of the ICU, has the same perception.

“It seems to have changed the parameter of acute Covid conditions. Before, they were milder or in children with complicating comorbidities. Now we are seeing younger children, under one year old, with no history of previous diseases, who quickly progressed to severe pulmonary conditions, with very low oxygenation”, he explains.

Due to the severity of the cases, the average length of stay also increased: it went from seven days, on average, to up to three weeks. “The recovery of these patients is not fast as we see in other cases of respiratory diseases”, says Finardi.

The boy Heitor, 1, for example, has been hospitalized in the hospital’s ICU since January 18 due to complications from Covid. Before the infection, he was a healthy child, with no comorbidities.

He arrived at Cândido Fontoura’s ICU already intubated, transferred from another hospital. “But he had a good pulmonary response, he was extubated, but he got worse after 24 hours and was intubated again”, explains the intensivist.

There are two other very similar cases. Heloisa, ten months old, also without previous illness, was discharged from the ICU after the acute phase of Covid, went to the infirmary, but, on the seventh day of the infection, it got worse and went back to intensive care. She’s intubated.

​Christopher Dark, two months old, was hospitalized with Covid in another hospital in São Paulo that did not have a pediatric ICU. He had two cardiac arrests, according to mother Rariellen Adga, 22.

“The doctor said that I needed to find a place in a hospital with more support. But we had been trying for 24 hours through the state’s bed regulation system and nothing. When we already had the paperwork to file a lawsuit, a spot here.”

The baby arrived at Cândido Fontoura’s ICU intubated and remained there for 17 days. On Friday (28), he was extubated and, on Monday (31), transferred to the ward.

“It’s a great relief. He is already breastfeeding, he took my breast and I can keep him on my lap all the time”, says the mother, who has not left her son’s side since January 17th.

According to Palumbo Neto, it is still too early to formulate hypotheses about which factors would be related to these more serious cases of young children without comorbidities.

“It is difficult for us to know if this strain [ômicron] it is more harmful or more virulent to children than others. There is no data. What we observe is that before, during isolation, it was rare to get a diagnosis of Covid. The ones that arrived were not serious. Very rarely did a child go to the ICU.”

He explains that this increase may also be related to the general relaxation of the population of protective measures, which is also reflected in the rapid advance of the omni. “Everybody let their guard down because they’re vaccinated. Now everybody’s getting it and passing it on to the kids.”

Another possible bias, says the pediatrician, is the fact that the hospital, as the reference for Covid in children in the state network, may be concentrating more serious cases.

With the rise in cases and the return to school in the municipal network this Monday (7), the institution predicts a new spike in infections and has already expanded the number of beds. It went from a total of 40 to 61. Of these, 34 are infirmary beds and 27 are ICU beds.

“With the return of classes, we are fearful. Schools, children, there is more circulation of the virus, not everyone is vaccinated yet”, says the interim director of the hospital, Ana Maria Vasconcellos. The impact of returning to school, however, should be felt within seven to ten days.

12-year-old Kauê Vieira took the first dose, but before he could be immunized with the second, he began to show symptoms of Covid. On Friday (4), he was in the emergency room of Cândido Fontoura and had to receive a drip in his vein because he was dehydrated.

“On January 25, my test was positive. On Wednesday (2), it was Kauê’s turn to have a high fever, vomiting and diarrhea”, says his mother, Maria Vieira Gomes, who lives in Sapopemba. The eldest son, 21, had the same symptoms but was unable to be tested at the health facility.