COVID-19 and Pediatrics: a look into the past and the future

Abstract

Globally, COVID-19 pandemic was devastating. Children were seemingly spared at the beginning of the pandemic, where by October 2021, according to the World Health Organization (WHO), those under the age of five accounted for 2% of the cases and 0.1% of global deaths. 1 However, the epidemiological scenario hás under gone major changes with an increase in cases among children and adolescents in 2022. Global data reveals that children under the age of five and between five and 14 years old currently account for 2.47% and 10.44% of the cases of respectively. 2 The highest mortality of the disease in pediatrics occurred in low and middle income countries, especially those under one year of age 3 reflecting once again how the income markedly affects child health, and it was not different with COVID-19, where the worst Access to medical care also determined mortality indicators. 4 Brazil accounted for about one in Five of these deaths in the pediatric age in the world and the vírus killed about two children under Five years of age per day, where as the Northeast region concentrated almost half of these deaths. 5 Pediatric manifestations of Covid were found to appear at a frequency of 25.24%, with mood swings (16.50%), fatigue (9.66%), and sleep disturbances (8.42%) being the main ones. 6 However, the hidden side of the pandemic was even more dramatic for our children. There were important osses of caring parents and grandparents leading to psychological suffering that is difficult to measure. With the absence of regular classes in school, there was also the loss of nutritional support offered by school meals and reduced physical activities. In addition, the occurrence of mistreatment, sexual violence, and associated teenage pregnancy accentuated theal ready existing social inequalities. 7 Vaccination has played an essential role in the fight against COVID-19, making it possible to reduces ever e illness and mortality rates, and contain the spread of the disease. 8 Children may play an important role in the transmission of this new respiratory disease by being a possible reservoir of the virus. 9,10 Children and adolescents safely were excluded from the initial clinical trials, and vaccination was only introduced laterin this group. 11 In Brazil, the inactivated vírus vaccine from the pharmaceutical company, Sinovac Biotech (CoronaVac) received approval for immunization of the pediatric population over three years of age, and the messenger RNA (mRNA) vaccine BNT162b2, developed in collaboration by Pfizer and BioNTech laboratories, was authorized for adolescentes, 12 to 18 years old. Subsequently, children aged five to 11 years old with a special presentation containing one-third of the standard dose and in September 2022, another pediatric presentation, corresponding to one-tenth of the adult dose, was used in children aged six months to three years of age. [11][12][13] The late introduction of vaccines in children combined with the emergence of new variants and subvariants with greater transmission capacity have res...

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