KARACHI: Recently, Pakistan witnessed a high mortality rate of children owing to COVID-19. As a result, paediatricians had revised treatment guidelines in line with the study's findings.
Fourteen per cent of total juvenile COVID-19 patients, or one in seven children, who contract moderately to severe COVID-19, died ascribed to the virus.
According to a World Health Organization-sponsored multi-centre research in Pakistan, this mortality rate is many times higher than in countries in the West. Their findings were publicised at a seminar in Islamabad.
Faculty from Aga Khan University led the study, incorporating the National Institute of Cardiovascular Diseases and National Institute of Child Health in Karachi, the Children's Hospital in Lahore, and the Benazir Bhutto Hospital, Rawalpindi. Over 1,100 youngsters who had tested positive for the virus and were taken to the healthcare facilities for treatment were enrolled in the study. Between March 2020 and December 2021, data on newborns, infants, babies, and teenagers up to the age of 18 was gathered.
Children with underlying health issues including malnutrition, cancer, or cardiovascular disease were shown to have a greater risk of dying from COVID-19, with one in every five young patients with comorbidities, or 19.5 per cent, dying. Even youngsters who had previously been healthy were at risk, with one out of every eight youngsters in Pakistan dying from the pathogen.
Children's fatality rates from COVID-19 had been determined to be around 1% in similar research from Western countries. Delegates at the seminar noted that the study's fatality rates were high for various reasons. For instance, because the individuals came from health facilities, they were more likely to have moderate to severe COVID-19. Second, one-third of the youngsters in the research had health complications.
The study's initial findings revealed that a multi-system inflammatory syndrome, or MIS-C, was the primary cause of death from COVID-19. After a youngster had been infected with the virus for a few weeks, MIS-C develops. According to the study, it caused vital organs such as the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs to inflate. Another prominent cause of fatal consequences from the infection was respiratory illnesses. More information about all of the study's causes of death and the most critical factors that helped the infants survive are now being accumulated.
The majority of deaths in the study occurred in 2021 rather than 2020, implying that later strains of the virus may be more lethal than the strain that initiated the outbreak in Pakistan.
While overall mortality from COVID-19 in children was low compared to adults, it seems evident that COVID-19 was not a benign condition in children, according to the study's primary investigators in Pakistan, Dr Qalab Abbas, Dr Fyezah Jehan, and Dr Shazia Mohsin. The virus continually develops; therefore, specialists should stick to the most recent treatment recommendations. Paediatricians across the nation were proposing three potentially life-saving revisions to treatment recommendations for severely ill children.
Specialists from the Pakistan Paediatric Association spoke at the event, recommending steroids in severely unwell children early on, followed by intravenous immunoglobin. They also recommended using prone ventilation, which entails a patient lying on his stomach while linked to a ventilator, and either a Continuous Positive Airway Pressure Machine or a high flow nasal cannula, to manage youngsters with COVID-19 who had respiratory issues.
According to presenters at the symposium, the World Health Organization had yet to propose that children under the age of 12 be vaccinated. They did, however, point out that the findings of this study contribute to the body of data supporting immunisations for younger children with comorbidities.
"The majority of child deaths in our study took place between the ages of 1 and 9," said Dr Abbas, Dr Mohsin and Dr Jehan. "As we conduct further analysis from our data and compare it to our partner sites in India, Ethiopia and South Africa, we will be able to provide more specific guidelines on how vaccination policies could be amended."
Over 5,000 youngsters from Pakistan, India, Ethiopia, and South Africa participated in the World Health Organization-sponsored research.
The event's chief guest was Dr Faisal Sultan, Special Assistant to the Prime Minister. The conference was attended by representatives from the World Health Organization, UNICEF, and Pakistan's Expanded Programme for Immunization.