Seven viruses of the coronavirus group are known to infect humans. All of it are of animal origin. Five of it came from birds (mainly bats), adapting and mutating, until they jump the species barrier, infecting humans and causing them disease, in most cases after using an intermediate host. Coronaviruses are known in pediatrics since the 1960s, and of the seven coronaviruses identified as infecting humans, four do not have a relevant expression in terms of disease, causing benign respiratory disorders such as rhinopharyngitis or bronchiolitis. The most worrying coronaviruses before the SARS-CoV-2 pandemic: In early 2000, the first human cases of a new coronavirus, SARS-CoV-1 (which causes severe acute respiratory syndrome 1) emerged in China. It came from a bat, passed to a mammal and ended up infecting man. In pediatrics, very few cases of this disease are described: Only 41 of a total of the 8 thousand cases that occurred; Of these 41 pediatric cases of SARS-CoV1, 26 were asymptomatic and no deaths were recorded. In 2012, cases of infection by another coronavirus emerged in Saudi Arabia, MERS-CoV (which causes Middle East espiratory syndrome), also with symptoms associated with severe respiratory infection. In pediatrics, only 38 cases were described: Of these 38, some of them asymptomatic, other with mild clinical manifestations; There were two deaths. According to data from the World Health Organization, the SARS-CoV-2 pandemic has already caused worldwide, from the beginning of 2020 to the beginning of December 2021: More than 265 million people infected, of which about 7.6 million are children under 14; And more than 5.2 million dead, of which 3,000 are children up to 14 years old. At this time, to fight the SARS-CoV2 pandemic, in addition to all the non-pharmacological measures that we now know to be effective and the drugs that have been discovered to be more or less effective in the treatment of severe disease, there are vaccines with proved efficacy in protecting against the most severe forms of COVID-19, avoiding the high number of deaths that the disease still causes among unvaccinated people. Since November 9, 2020, when Pfizer announced its new and effective vaccine, until today: There are more than 300 laboratories with vaccines candidates for approval by international health authorities; There are 154 vaccines in clinical development phase; And, for now, there are eight vaccines approved by the World Health Organization. There are also 24 other vaccines approved in different parts of the world, which are used locally (Cuba, Kazakhstan, China and Russia, among other countries). The effects of COVID-19 on pediatric age Children are also affected by COVID-19. In the US, for example: The proportion of children infected with SARS-CoV2 is equal to the proportion of children in the total population. However, the disease associated mortality is almost non-existent in these age groups. The proportion of deaths from COVID-19 in children is substantially lower than what this age group represents in the total US population. In Portugal, there has recently been an increase in the number of cases among children, which results directly of the large percentage of non vaccinated children. By August 2021, 144,000 children had tested positive for COVID-19, in a population of just over one million Portuguese infected since the beginning of the pandemic. In other words, about 10% of the total number of Portuguese people who had COVID-19 are children. Despite the benignity of the disease COVID-19 in pediatrics, there were more than 500 children hospitalized for this disease in Lisbon, either for pneumonia attributed to COVID-19 or for pediatric multisystem inflammatory syndrome (MIS-C) temporarily associated with SARS-CoV-2 or for one or more other causes. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
