Impact of the COVID-19 pandemic on children

A systematic review notes that children with COVID-19 have milder effects and better prognoses than adults. However, children are susceptible to "multisystem inflammatory syndrome in children" (MIS-C), a rare but life-threatening systemic illness involving persistent fever and extreme inflammation following exposure to the SARS-CoV-2 virus. As a vulnerable population, children and youth may be affected by COVID-19 pandemic policies implemented, including education, mental health, safety, and socioeconomic stability; the infection of the virus may lead to separation or loss of their family. As with many other crises, the COVID-19 pandemic may compound existing vulnerabilities and inequalities experienced by children. This was especially true when it comes to mental health.

Illness When a child is infected with COVID-19, they are more likely to have an asymptomatic case, or one that is mild to moderate in severity. The prevalence of long COVID in children is estimated at 1% vs 6-7% in adults. Children are more likely to experience gastrointestinal symptoms than adults. Children are less likely to become hospitalized than adults. Several explanations contributing to the milder COVID-19 symptoms experienced, in the acute phase, by children have been suggested, including:

a lower expression of ACE-2 (the receptor used by SARS-CoV-2 for cell entry) in the respiratory tract in younger children viral interference (e.g. by other coronaviruses) cross-reactive immune responses (e.g. antibodies, CD8+ and/or CD4+ T-cells reactive to other viral antigens than of SARS-CoV-2) some protection offered from an increased Th2-response The most common symptoms among children include fever symptoms, followed by a dry cough. Other commonly reported symptoms among children include nasal congestion or runniness, fatigue, and headache. Severe illness is possible. In some instances respiratory support (such as a ventilator) may be required. Some children have experienced multiple organ failure. Such severe or critical cases were most common among children with certain underlying conditions, such as for example, asthma or those with weakened immune systems. Overall, Children are associated with lower mortality rates than other age groups, when infected with COVID-19. Some children who become infected develop a rare condition known as MIS-C, short for "multisystem inflammatory syndrome in children". This causes a persistent fever and extreme inflammation. Other symptoms associated with MIS-C include severe abdominal pain and hypotension. Early into the pandemic, dermatologists reported an increase in chilblains-like lesions in children, especially on their feet, fingers, and toes. It has been informally referred to as "COVID toes". This was presumed related to COVID-19 infection, however confirming that a child has been infected can be difficult.

Education

School closures

By the end of March 2020, UNESCO estimated that over 89% of the world's student population was out of school or university due to closures aimed at mitigating the spread of COVID-19.

Gender disparity This disproportionately affected girls, with 111 million girls living in areas in which getting an education is already a struggle due to extreme poverty, economic vulnerability steep cultural and legal gender disparities. For instance, closures have forced over 4 million girls out of school in South Sudan, Niger, and Mali, some of the countries with low enrollment and completion rates for girls. Girls in refugee camps were already only half as likely as their male peers to enroll in secondary schools, and now school closures will affect them further as historically, school closures had caused a high proportion of girls to drop-outs and not return for reasons such as increased domestic and caretaker responsibilities. Additionally, several studies found that school closures increased girls vulnerability to physical and sexual abuse both by older men and by their peers, as girls were often are at home alone and unsupervised. Furthermore, frequency of transactional sex rose, due to families struggling to cover basic needs. As family breadwinners died and livelihoods were destroyed, many families either sold sex with their daughters, or sold them off as a child bride. There was concern that the Covid crisis could be similar to the Ebola crisis in Sierra Leone, in which adolescent pregnancy increased by up to 65% in some communities. At that time, "most girls reported this increase was a direct result of being outside the protective environment provided by schools. Many of these girls never returned to the classroom, largely due to a recently revoked policy preventing pregnant girls from attending school."

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