Thread by @DrEricDing

Doctors treating patients in India 🇮🇳 have marked a distinct trend during the 2nd wave—#COVID19 now appears to be impacting children more severely. Children and adolescents are now showing more obvious symptoms such as prolonged fever and gastroenteritis.🧵hindustantimes.com/india-news/in-…

2) During the first wave, most children remained asymptomatic, and a large number of them went untested because of that,” said paediatrician Dr. Bakul Parekh. “We tested children only when someone in the family had a history of Covid-19.”

3) Over the last fortnight, Parekh, who runs a children’s hospital in Ghatkopar, has admitted six children between 1 and 7 years old to the hospital -- three with severe gastrointestinal infections and fever, and others with breathlessness and fever.

4) “Those with gastrointestinal infections had to be put on intravenous fluids. The patients who were breathless required steroids and oxygen support,” said Parekh.
During the first wave, Parekh does not recall referring even a single child who needed hospitalisation.

5) He links new mutations with the increased impact on children. “The available medical literature shows that the ‘double mutation’ found in Maharashtra (now called B1.617) can be one of the reasons behind it,” he said.

6) “Children are definitely more symptomatic now than what we saw in the first wave,” said Dr. Tanu Singhal, a paediatrician and infectious disease specialist at Kokilaben Dhirubhai Ambani Hospital. “The severity of their illness has gone up,” she said.

7) “As the number of cases rise, infection among children has also increased. However, the percentage of children and adolescents affected in the first wave and the second wave hover around 10% of total cases. What is striking is the change in symptoms, underline experts.


8) “Children are coming in with abdominal pain and severe diarrhea, which we didn’t see in the first wave,” said Dr. Soonu Udani, paediatrician and critical care specialist at SRCC Children’s Hospital.

9) “Some of them require intravenous fluids. In the first wave, most children were simply kept under observation, and in case of mild symptoms, they would respond to basic medication like paracetamol,” she said.

10) “Last year, of the paediatric patients who came to SRCC Hospital for other procedures and treatments, about 5% tested positive for Covid-19. “This time, we have about 30% to 40% of the children testing positive,” said Udani.

11) Doctors have observed some distinct changes in the presentations of adults, too. “Conjunctivitis is definitely more common now. Many adults are coming with post-vaccination Covid-19. The unusual thing is that they have developed antibodies, “ said Dr Sujeet K Rajan