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'Covid Generation': Do children born in a pandemic get sicker?

2022-05-28T03:55:36.905Z


Doctors are blunt: the immune system of minors who came into the world between masks and social distance is not weaker. If they now suffer more colds it is because they are more exposed


In the convulsive 2020, 341,315 children were born in Spain, children who spent their first months of life completely cloistered in their homes, with very few outings on the streets, without visits or social contacts or half seeing the world, with faces around them covered by a mask.

They, and those who came later, in 2021, are the generation that was born in a pandemic and, although the covid did not hit them – the infection is very mild in the smallest – they do carry the weight of these two years of intermittent social restrictions.

The scientific community, for example, has begun to study whether the so-called covid generation has neurodevelopmental problems (speech or play).

And now that the health crisis is more stabilized and the restrictions have fallen,

parents also see how the mucus and recurrent colds return.

Much more than months ago.

But does this mean that children born in a pandemic get sicker?

Doctors are blunt: there is no evidence to suggest that these minors have a weaker immune system.

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If they fall ill more often now, it is because there are no social restrictions, they are exposed more and there are more pathogens circulating than during the hard phase of the pandemic, the voices consulted agree.

There is no evidence that the immune system of a child born during the coronavirus health crisis is different from that of another born before 2020, says Alfredo Tagarro, coordinator of the Respiratory Infections working group of the Spanish Society of Pediatric Infectious Diseases: “ What is clear is that the exposure of children to pathogens in a pandemic has been different from what we were used to.

And, although it is true that we have an overload of care in the emergency room due to banal pathology [not serious], what this suggests is that these children have been coming into contact with circulating viruses”.

Federico Martinón-Torres, Head of Paediatrics at the Hospital of Santiago de Compostela, agrees: "The fact that they have stopped being exposed to certain pathogens that have stopped circulating should not be confused with the fact that their immune system has not matured properly."

And he asks for caution with the interpretations of the current situation: “We must be cautious because, although non-pharmacological measures have impacted the transmission of agents other than Sars-Cov-2 that could be blocked by the mask and distance, this is not so with all pathogens.

It makes no sense to think that children have stopped having their immune system stimulated because it is more complex than all that: a child, even with masks, is exposed to a multitude of antigenic encounters throughout the day,

The end of social restrictions and the return to pre-pandemic life dynamics, however, has returned to the streets viruses that had been missing during the worst of the pandemic, such as influenza or respiratory syncytial virus.

"It's nothing strange or unexpected," says Martinón-Torres, and it is what can be seen now at the consultation, agrees Carlos Rodrigo, clinical director of the Pediatric Service of the Germans Trias i Pujol Hospital in Badalona: "Children have to catch a series of infections systematically in the first years of life.

Just having caught them several times gives them immunity to face them.

During the pandemic, due to the protection measures and not having gone to daycare, the children have not caught anything.

But they have to do it."

For ISGlobal pediatrician and epidemiologist Quique Bassat, there are no alarm signals either: hospitals are in a normal situation, without a barrage of pediatric infections, and the controversy is more circumscribed to a perception of parents "due to lack of habit," he explains. : “This is like when they return to the nursery after the summer: we have been quiet for a while because it was the time for masks and less contact between the children.

But when you take it off and it comes back together, you're back to before."

The fact of having delayed contact with some common viruses, experts point out, may even be positive.

“It is better to catch one of these viruses [such as influenza or syncytial] after a year and a half than after three months,” says Rodrigo.

As you age, your immune system becomes more mature and is better able to respond to external threats.

In any case, says Óscar de la Calle, a member of the Spanish Society of Immunology, "children have very good defenses against common pathogens."

“When they are born, they have an immature immune system: they do not produce antibodies (the ones they have are from the mother) and they develop them in the first year of life.

But, to counteract this, they have an innate immune system – the one that protects from immediate contact with germs – more powerful than that of adults, ”he explains.

And that's what makes viral infections often very mild, like covid.

The Hygiene Hypothesis

There is a controversial scientific theory —the “hygiene hypothesis”—, which suggests that progressive exposure to certain pathogens in childhood helps the development of the immune system: this would explain, its defenders argue, why it has increased so much in recent decades the incidence of autoimmune and allergic diseases, for example, in developed countries, where hygiene measures and more aseptic environments have prevented contact with numerous germs;

or why children in rural environments, in contact with animals and more exposed to other pathogens, have fewer allergies.

Regarding the extreme hygiene that the pandemic installed, the experts consulted point out that there is no evidence that this phenomenon has influenced the immune system of children.

Martinón-Torres recalls, in fact, that this theory is just that, “a hypothesis”.

And he insists: "Children have not stopped being exposed to pathogens and their immune system has matured in the usual way."

If now the cases of influenza or respiratory syncytial virus are increasing, for example, it is because for two years, the children have not been exposed to that particular pathogen "and a larger pool of susceptible subjects is generated."

Toni Soriano, pediatric infectologist at Vall d'Hebron Hospital, agrees that "an immunosuppressed generation has not been born" and, with the return to normalcy of viral cycles, the usual rhythm of childhood infections will normalize.

However, he adds: "It strikes us that in Africa not so many cases of covid have been reported in other parts of the world and it would be interesting to assess the theory of hygiene here."

On the other hand, whether there is any long-term effect of the pandemic's restrictive measures on the response to infections remains to be seen.

The dynamics of the last two years, Martinón-Torres values, may have influenced the microbiome, for example, and changed the response to infections.

Or maybe not: "This is purely speculative and needs to be proven."

In the case of the alert for a rise in unidentified hepatitis diagnoses in young children, what is happening is still being studied, but the pediatrician at the Hospital de Santiago warns that "the adenovirus that has been found in a high percentage of cases, it was circulating during the pandemic as well.”

“It is true that perhaps the combination of several factors, such as no exposure to various pathogens, previous exposure to Sars-Cov-2, the change in the child's flora, may have generated a cocktail that has led to this increase in cases.

The other alternative is that we have now seen all the cases that we should have seen spread out in previous years.

But all this is also speculative.”

Source: elparis

All news articles on 2022-05-28

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