Children are increasingly the casualties of COVID

A growing number of young people are suffering from persistent health issues once they have recovered from a coronavirus infection, including life-threatening syndrome that can cause heart failure in children and even babies

Sarit Rosenblum|
Sarit Sapir was a 16-year-old high school student, basketball player and healthy, happy young person.
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  • And then three days before a family wedding in September last year, Sarit told her mother she was not feeling well. Her mother immediately took her to the doctor to be tested for COVID-19.
    The doctor told her there was no need for a test as Sarit had no coronavirus symptoms, and the family went to the wedding with 100 or so other people.
    6 View gallery
    Sarit Sapir, 16-year-old suffering from long-COVID
    Sarit Sapir, 16-year-old suffering from long-COVID
    16-year-old Sarit Sapir is still suffering from the after-effects of COVID
    (Photo: Jonathan Blum)
    But Sarit was infected with the virus. She then infected her mother and sent dozens of wedding guests into quarantine.
    "It was terrible," Sarit's mother says.
    "We were both sick in bed but in separate rooms because our symptoms were different and the doctor was worried that we had different variants of COVID-19, so he insisted we remain apart. We spent the Jewish New Year on the phone to each other," she says.
    Sarit was in bed for a month because her symptoms persisted. Even after she was cleared to emerge from quarantine, she found it hard to return to school; she was weak and breathless.
    "I'm an athlete," Sarit says. "I'm used to two-hour training sessions. But when I tried to go for a run I nearly fainted."
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    בית ספר יגאל אלון בגבעתיים
    בית ספר יגאל אלון בגבעתיים
    Elementary school children wear masks in class in Givatayim
    (Photo: Amit Huber)
    After finding her daughter practically passing out one day with dizziness and shortness of breath, Sarit's mother took her to Schneider Children's Medical Center in Petah Tikva to be examined by physicians specializing in post-COVID symptoms in kids.
    "They did multiple tests," her mother says. "They found she had a deficiency in vitamins and minerals and her lungs unable to oxidize properly. But at least we found we were not alone - there were many other kids with similar problems."
    Sarit's health challenges persist to this day.
    Health officials have warned coronavirus cabinet members of a surge in virus cases in children. Even Prime Minister Benjamin Netanyahu has expressed concern.
    "The public does not understand," Netanyahu told ministers recently. "We will see many young people die. Mass contagion will cause serious illness and death to the younger population."
    Health Ministry data shows that in November 2020, there were 400 cases of coronavirus in Israeli children under the age of two. By February 2021, that number had risen to 5,800. Reports coming out of other countries with high contagion rates point to the same phenomenon.
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    ים מגבעתיים
    ים מגבעתיים
    A teenager receiving the coronavirus vaccine in Givatayim, near Tel Aviv
    "There is no doubt that the British variant of COVID-19 is 'partial' to children and the contagion rate among them is higher than we've seen with earlier variants," says Prof. Eli Somekh, head of pediatrics at the Mayanei Hayeshua Hospital in Bnei Brak.
    Most hospitals have already opened dedicated pediatric COVID wards in response to the rising numbers of infected children. The Hadassah Medical Center in Jerusalem has also opened a dedicated pediatric intensive care unit.
    The vast majority of the hundreds of thousands of children infected by the virus in recent months have suffered mild symptoms and recovered. But because so many children fell ill, the number of those suffering from post-COVID complications is on the rise.
    In addition to the symptoms reported by adults who have recovered from the virus of shortness of breath, hair loss, brain fog, memory loss and fatigue, children who have had COVID have become increasingly ill from what has been temporarily named "a mysterious multi-systemic inflammatory syndrome."
    There have already been dozens of reported cases in Israel, while in the UK nearly 100 children have been hospitalized so far.
    Not much is known about this syndrome and it is believed to appear in only 1% of children who contact the virus. But as so many children have been infected by coronavirus, the number of those who have the syndrome is also on the rise.
    The children with this syndrome present with a high and persistent fever, stomach pains and difficulty breathing. Some report dry and chapped lips, swollen glands and a rash.
    These children require hospitalization and must often be placed on ventilators and medication for cardiac and blood system problems.
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    מתחם בדיקת בדיקות קורונה ב ירושלים
    מתחם בדיקת בדיקות קורונה ב ירושלים
    A child is tested for coronavirus in Jerusalem
    (Photo: AP)
    "We are now seeing more and more of these children," says Dr. Josef Benari, head of the pediatric ICU at Rambam Healthcare Campus in Haifa.
    "They arrive at the hospitals every day. We have had 50 to 60 of these cases who were treated in intensive care units, while others who were not at risk of heart failure were cared for in regular pediatric wards," he says.
    The first case of this kind in Israel was detected in April 2020, when two children were hospitalized at Rambam. One of them, an 11-year old girl quickly went into heart failure and had to be connected to an ECMO machine providing her with heart and lung support.
    "There are patients under the age of seven in other hospitals," Benari says, warning that even babies have been found to suffer from the syndrome.
    "This is a multi-system life-threatening inflammatory illness that we treat with steroids, though some studies suggest other medications. Happily, the prognosis is often good, and the children recover if the disease is diagnosed early," he says.
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    ד"ר יוסי בן ארי, טיפול נמרץ ילדים ברמב"ם
    ד"ר יוסי בן ארי, טיפול נמרץ ילדים ברמב"ם
    Dr. Joseph Benari, head of Pediatric Intensive Care at the Rambam Healthcare Campus in Haifa
    (Photo: Gil Nehushtan)
    There are currently 50 children being treated for what is now called long-COVID at the Sneider's children hospital after a rise in numbers identified during the third wave of the virus.
    "We have children waiting for months to be treated here," says Dr. Liat Ashkenazi-Hoffnung, who heads the outpatients department at Schneider.
    "We still understand very little about this phenomenon and are in the early stages of studying it. It is the only virus we know that causes such a reaction in children and I hope we will know more in the coming months," she says.
    "There is no doubt that this illness affects the neurological and blood systems," says Ashkenazi-Hoffnung. "Many of the children arrive for treatment after suffering from symptoms for months."
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    מחלקת קורונה ילדים בבית החולים הדסה
    מחלקת קורונה ילדים בבית החולים הדסה
    A pediatric coronavirus ward at Hadassah Medical Center in Jerusalem
    (Photo: Hadassah)
    Most of the children develop the syndrome up to eight weeks after recovering from COVID, but Ashkenazi-Hoffnung recommends that families wait at least six weeks before seeking further treatment, to ensure that symptoms are not related to an active virus and would subside after recovery.
    "We have limited tools to cure the children," she says. "We give them inhalers to help their breathing, anti-inflammatory medication or iron supplements."
    The most important thing, Ashkenazi-Hoffnung says, is to reassure children that they have a genuine medical issue and are not alone.
    "We have to tell the children this is not all in their heads. We tell them other children who are as smart and talented as they are suffering from the same thing too."
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