Why did Covid kill so many young children in Brazil? Doctors are at a loss


RIO DE JANEIRO – The mother frightened her little one’s unbreakable fever and took the little girl, Letizia, to the hospital. Doctors had disturbing news: It was Covid-19.

Mother Ariane Rock Marinhero said they were reassured, noting that the children were not showing serious symptoms.

Less than two weeks later, on February 27, Letizia died in a hospital intensive care unit in Maringa, southern Brazil, after days of labored breathing.

“It happened quickly, and I was gone. It was my everything,” said Ms. Marinheiro, 33.

Covid-19 is Destroys BrazilAnd, in disturbing new wrinkles that experts are working to understand, it appears to be killing infants and young children at an unusually high rate.

Since the start of the epidemic, 832 children aged five or younger have died from the virus, according to the Brazilian Ministry of Health. Comparable data is scarce because countries track the impact of the virus differently, but in the United States, which has a much larger population of Brazil and a higher number of deaths from Covid-19, 139 children aged four and under have died.

Dr Fatma Mariño, an epidemiologist at the University of São Paulo, said the official number of child deaths in Brazil is likely to be much lower than the number, because a lack of widespread testing means that many cases go undiagnosed.

Dr Marinho, who leads the child death count study based on both suspected and confirmed cases, estimates that more than 2,200 children under the age of five have died since the start of the epidemic, including more than 1,600 children under a year old. .

“We are seeing a huge impact on children,” said Dr. Marinho. “It’s a ridiculously high number. We haven’t seen this anywhere else in the world.”

Experts in Brazil, Europe and the United States agree that the number of child deaths from Covid-19 in Brazil appears to be particularly high.

“These numbers are surprising. This is much higher than what we see in the US Medical Campus,” said Dr. Sean O’Leary, vice chair of the Infectious Diseases Committee at the American Academy of Pediatrics and a specialist in infectious diseases of children at the University of Colorado Anschutz. Here in the United States, those numbers are a little higher. “

There is no evidence available on the effect of virus-that variants Scientists say It leads to more severe cases of Covid in young and healthy adults and leads to a higher number of deaths in Brazil – among infants and children.

But experts say the variable seems to be the case Which leads to high death rates among pregnant women. André Ricardo Ribas Freitas, an epidemiologist at São Leopoldo Mandic College in Campinas, who led a recent study on the effect of the variable, said that some women with Covid give birth to stillbirths or premature babies who are already infected with the virus.

“We can actually confirm that the P.1 variable is more severe in pregnant women,” said Dr. Ribas Freitas. “Often times, if a pregnant woman has the virus, the baby may not survive or both may die.”

Experts said the lack of timely and adequate health care for children once they fell ill is likely a factor in the death toll. Experts in the United States and Europe said early treatment was key to recovering children with the virus. Dr Marinho said that in Brazil, weary doctors were often late in confirming that children had been infected.

“Children are not tested,” she said. “They get sent away, and when these kids come back in really bad shape, it’s suspected Covid-19.”

Dr. Lara Shekerdemian, chief of critical care at Children’s Hospital of Texas, said the mortality rate for children who contracted Covid-19 was still very low, but that children who lived in countries where medical care is not equal were more at risk.

“A child who might need a little oxygen today may end up on a ventilator next week if he doesn’t have access to the oxygen and steroid that we give early in the disease process,” said Dr. Schkerdimian. “So what might end up just being hospitalized in my world could result in a child needing medical care that they cannot get if there is a delay in getting care.

a A study published in the Journal of Pediatric Infectious Diseases In January I found That children in Brazil and four other countries in Latin America have developed more severe forms of Covid-19 and more cases of polymorphic syndrome, which is a rare and severe immune response to the virus, compared to data from China, Europe and North America.

Even before the pandemic began, millions of Brazilians living in impoverished areas had limited access to basic health care. In recent months, the system has been overburdened as large numbers of patients have flooded into critical care units, resulting in chronic bed shortages.

“There is a barrier to access for so many,” said Dr. Anna Luisa Pacheco, a specialist in pediatric infectious diseases at the Heitor Vieira Dorado Foundation for Tropical Medicine in Manaus. “For some children, it takes three or four hours by boat to get to the hospital.”

Childhood cases have soared amid the broader explosion of infection in Brazil, which experts attribute to President Jair Bolsonaro’s arrogant response to the pandemic and his government’s refusal to take strong measures to boost social distancing. The underdeveloped economy has also left millions without sufficient income or food, forcing many to risk infection while searching for work.

Some children who have died from the virus already have health problems that make them more vulnerable to infection. However, Dr Marinho estimates that they account for just over a quarter of deaths among children under the age of ten, and this indicates that healthy children also appear to be at risk of contracting the virus in Brazil.

Her mother said Letizia Marinheiro was one of those children. Ms Marinheiro said that a healthy baby girl, who had just started walking, had not been sick before.

Ms Marinheiro, who was injured with her husband Diego, 39, thinks Letizia might have survived had her illness treated more urgently.

Ms Marinero said: “I think they did not believe that she could be so sick, and they did not believe that this could happen to a child.”

And I remembered begging for more tests. Four days after the baby was hospitalized, she said, the doctors had not fully examined Letizia’s lungs.

Ms Marinheiro is still not sure how her family got sick.

She kept Letícia – the first child the couple had desperately wanted for years – at home and away from everyone. Mr. Marinheiro, the hair salon product supplier, has been careful to avoid contact with clients, even as he continues to work to keep the family afloat.

For Ms. Marinheiro, the sudden death of her daughter left a huge hole in her life. As the pandemic takes hold, she says, she hopes other parents give up on the risk-taking of the virus that kept Leticia away from her. In her city, she watches families throwing birthday parties for children and officials press for schools to reopen.

She said, “This virus cannot be explained.” “It’s like playing the lottery. We never think this will happen to us. It’s only when he takes someone from your family.”

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