Thread by @NohaAboelataMD

Protect the children! As they had back to school, a reminder that covid is not benign, even in children.

Very incomplete data set (>1.13 people have died in US and this only accounts for 996,981), but still we see 2,292 deaths in children 17 and under.🧵
https://t.co/La829oQzencovid.cdc.gov/covid-data-tra…

Covid is now a leading cause of death in all age groups and the only infectious cause in most. Most children with severe outcomes have no underlying condition or common ones like asthma, obesity or being born premature. Of course, death isn't the only bad outcome we worry about.

It's worth noting that we have a much bigger blind spot when it comes to understanding the disease process and progress in children because most of the research has focused on adults. Children are not small adults! We still have a lot to learn.
covid19treatmentguidelines.nih.gov/management/cli…

Don't forget about MIS-C, a very serious multi-system inflammatory condition that can happen several weeks after the initial COVID infection, even if that initial infection was mild. Many of these children need support in the ICU. Very difficult on child and family.

How common is MIS-C? We don't know because reporting from the local health jurisdictions to CDC is completely voluntary. But there have been 9,499 reported cases, including 79 deaths. Something tells me the geographic distribution is related to reporting, not true incidence.

The median age of patients with MIS-C was 9 years old, and half were between 5 and 13.

57% of children with reported MIS-C where race was known were Black or Latino. We do not know why this very significant disproportionality is happening. covid.cdc.gov/covid-data-tra…

Keep a close eye on children in the months-weeks after covid infection! Not just for MIS-C but also long and post covid. Long covid is likely happening at a similar rate in kids. Kids are supposed to have decades of quality life ahead of them and have more time for reinfections.

Children under 18 are 2.5 times more likely to be *newly diagnosed with diabetes* in the months after COVID infection compared to those without COVID, and even to those with other respiratory infections before the pandemic. This is not the flu!
https://t.co/75DMmKujapcdc.gov/diabetes/libra…

All children should have a physician visit BEFORE resuming sports/physical activity or within 2-4 weeks of a positive COVID test, whichever is sooner. We don’t want kids to return to sports prematurely, especially given the risk of myocarditis. AAP's Return to Play algorithm:

You can't get MIS-C, long covid, post covid events, etc. if you don't get covid. Avoiding infection and reinfection is the best strategy! Do what you can to assess and advocate for clean indoor air at school. Wear a high-quality mask, eat outside. Keep sick kids home.

When a child gets covid, please let them rest and fully recover, and keep a close eye on them in the subsequent weeks to months.

I really do worry that our younger generations will wonder why we didn't do more to protect them. We can and must do better by our children. 🙏🏾❤️

I review this topic and cover the current covid uptick in this week's People's Health Briefing.

One more thing to note: the vast majority of children will not require outpatient treatment for covid, but some could benefit. Make a treatment plan ahead of time with your pediatrician or specialist for high-risk children.