source site Children may require unique surveillance during the pandemic. While Covid-19 is known to threaten the older age, the question whether children are silent carriers remains unanswered. Only 2.4% of reported cases in China and 1.2% in Italy. It seems that children are infected by adults but it is unclear yet if children infect adults. The disease is less severe in children compared to adults with similar symptoms.1 Between 2-16% of children with Covid-19 were reported asymptomatic,2 with rates reaching 27% (in Israel3 So far, no reports identified transmission from an asymptomatic child. But are the children truly asymptomatic?
seehttps://dareloyoun.org/cases-and-treatments/signs-and-symptoms-of-poor-vision-in-children/ The variability of an asymptomatic report may be attributed to the extent of epidemiologic questioning. The asymptomatic children tend to be younger posing a further challenge in identifying epidemiological information.4 While young children are less likely to report pain symptoms, observational measures are routinely used.5 A similar approach should be used for retrieving covid-19 symptoms. The retroactive report is challenging. This may improve if parents could actively monitor and record symptoms in realtime. Australian symptom checker question about evident breathlessness symptoms such as: grunting and skin discoloration. Taking into account the asymptomatic cases we believe that active monitoring for mild change in behaviors will eventually reveal more symptoms. There is a consensus about remote assessment for adult covid-19 patients in the primary care setting.6 These recommendations could be modified and applied to children.
https://helenhighly.com/egg-film-review-at-tribeca-film-festival-2018/https://www.griffinsautorepair.com/diagnose-car-problems-sound-smell/ For example, asking the parents to note if their child has:
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https://www.saratogafamilydentistry.com/testimonials/maria-vasquez/go here Change in daily activities: things that the child did yesterday and is unable to do today.
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click here Difficulty to speak: speaks less, shorter sentences, unusual pausing
see url Cough, drooling, runny nose, unusual skin color
follow In conclusion: Children may be underdiagnosed due to mild and under-reported complaints. Active surveillance maybe useful for the population at risk and/or before opening quarantines.
https://www.saratogafamilydentistry.com/high-quality-equipment https://www.saratogafamilydentistry.com/high-quality-equipment References:
- Lu X et al. SARS-CoV-2 Infection in Children. NEJM 2020. doi: 1056/NEJMc2005073
- Livingston E and Bucher K. Coronavirus Disease 2019 (COVID-19) in Italy. JAMA 2020. doi:10.1001/jama.2020.434
- https://www.timesofisrael.com/silent-spreaders-almost-a-third-of-infected-kids-under-9-are-asymptomatic/
- Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and Epidemiological Features of 36 Children With Coronavirus Disease 2019 (COVID-19) in Zhejiang, China: An Observational Cohort Study. Lancet Infect Dis 2020. doi: 10.1016/S1473-3099(20)30198-5
- von Baeyer CL, Spagrud LJ. Systematic review of observational (behavioral) measures of pain for children and adolescents aged 3 to 18 years. Pain. 2007;127(1-2):140–150. doi:10.1016/j.pain.2006.08.014
- Greenhalgh T, Choon Huat Koh G, Car J. Covid-19: a remote assessment in primary care. BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m1182