RIO DE JANEIRO, BRAZIL – Half of Brazilian children and adolescents who died from Covid-19 in 2020 were up to 3 years old, indicates a study published by the Oswaldo Cruz Foundation (Fiocruz). Newborns and children totaled 602 or 49.8% of the 1,207 deaths by Covid-19 last year under the age of 18.
The data from the Ministry of Health’s Infant Mortality Information System (SIM) show that 9% of deaths from the disease were among newborns up to 28 days old, and almost a third (28%) occurred among children in their first year of life.
One of the study’s authors, researcher Cristiano Boccolini from the Health Information Laboratory of the Institute of Communication and Scientific and Technological Information in Health (Icict/Fiocruz) says that the higher concentration of deaths up to 2 years (45% of the total among victims under 18) may be linked to the fact that immunity is only fully formed in the second year of life.
Another possible factor, he said, is that in Brazil about half of children under 6 months are not breastfed, which can help immunity, particularly if the mother already has antibodies. Therefore, children who are not breastfed are more vulnerable and could explain the increase in deaths in this age group.
The two conditions – incomplete immunity and absence of mother’s milk – would add to the degree of exposure of each family to the virus as a risk factor.
Boccolini reiterates that the asymptomatic form of Covid-19 is more common among children and adolescents, who have a better prognosis when infected, but he recalls that this public is not immune. In addition, from other countries’ experience, children may be more at risk than at the start of the pandemic due to the emergence of more transmissible variants, such as the Delta.
“In some countries, such as the United States, the spread of the delta variant has increased the number of new cases of Covid-19 and this increase is exposing more and more children to the virus. Children’s wards are overwhelmed in many places, and this can happen in Brazil too,” says Boccolini.
To tackle this issue, the specialist says that vaccination among adults must advance faster and pregnant and lactating women should remain a priority. “Another important recommendation is that mothers with Covid-19 continue breastfeeding their babies, if they are physically able to do so. The benefits of breastfeeding far outweigh the risk of infection. Health care, such as hand hygiene and the use of type PFF2 and N-95 masks, should be reinforced in these cases,” he says.
The World Health Organization recommends the universal use of masks starting at age 12. Among younger children, mask use should be supervised and assessed on a case-by-case basis. Children under 5 should not be forced to wear masks, according to the W.H.O.