Covid-19 in Children
In a recent article in a local New Jersey publication, N.J was listed as one of the three hardest-hit states for Covid-19 in children. With the onset of school, September and October have traditionally been the busiest time for pediatricians treating sick children. This year, many parents are extremely anxious and concerned for the well being of their children and keeping them safe from contracting and spreading Covid-19.
Much has been learned about the Covid-19 over the last several months and new research is emerging every day. Covid-19 is highly contagious, but not very virulent. In other words, Covid-19 is easy to catch and easy to spread, but the manifestations of the virus are, in general, not very serious, especially in children. The Covid-19 virus itself does not cause many symptoms, except for cold-like symptoms, but how your immune system reacts to the virus is actually much more important. Some people will experience a severe immune reaction (known as a “cytokine storm”) after exposure. Excess pro-inflammatory cytokine activity is the root cause of many acute and chronic medical problems.
Originally, it was touted that children were safe from Covid-19. More recently, however, it was identified that some children were experiencing a multi-system inflammatory syndrome after having Covid-19 that resembles Kawasaki Disease . In an effort to help ease some anxiety and help prepare parents to send their children off to school, we will discuss the facts of Covid-19 in kids:
Fact 1: COVID-19-related hospitalizations among children (below 18 years of age) represent a minimal number of the total hospitalizations.
Fact 2: Children with covid-19 related illness, like adults, may have elevated levels of cytokines, and reduced levels of white blood cells called lymphocytes. They saw that by the time the children had recovered, the immune system changes had gradually returned to normal.
Fact 3: There is a difference in the transmission pattern of COVID-19 in different age groups. Research from the Netherlands found that the virus is mainly spread from adult family members to children. Child to child transmission or child to adult transmission is less common. 
Fact 4: You can make the case that because children tend to have a more resilient and balanced immune system than adults, they are much less likely to have a severe cytokine storm. Healthy children, in general, can handle more immune system stress than adults.
Fact 5: There is no evidence that “quick fix” vitamins, cleanses and immunity drinks will boost your immune system. In fact, many parents begin giving their children Elderberry extract during the school year to boost the immune system. However, according to a study by the Andrew Weil Center for Integrative Medicine, they found that elderberry increases immune cell release of tiny chemicals called cytokines. Specifically, elderberry increases the release of a cytokine called IL-1B, which is a part of the inflammatory reaction to COVID-19 that can result in acute respiratory distress. For this reason, to minimize the possibility that elderberry could aggravate the inflammatory “cytokine storm” associated with the more severe COVID-19 infections, it is recommended to stop elderberry at the first signs of infection (fever, cough, sore throat) and/or if you test positive for the virus.
Fact 6: In a study published by Dr. David Meltzer, MD, PhD, chief of hospital medicine at University of Chicago Medicine, individuals with untreated vitamin D deficiency were nearly twice as likely to test positive for COVID-19 relative to their peers with adequate vitamin D levels. This corroborates with news reports that there are more instances of COVID-19 in the African American and Hispanic population. Dr. Meltzer surmises that “The fact that Chicago has such a large African American population, Hispanic population, and is located in a northern area where people don't get much sun exposure for most of the year, I think those all mean that there are areas where vitamin D deficiency is more likely here."
Fact 7: Continued research and clinical experience is ongoing and therefore we do not have all of the answers. However, whether you are age 5, 27, 65, or 95 you will give you and your children the best chance at staying healthy and surviving covid-19 by abiding to the following suggestions:
- Avoid sugars, excessive carbohydrates, fried foods, processed foods, and other toxins which promote the production of inflammatory cytokines
- Keep your weight down. Being overweight is frequently associated with high levels of insulin (as a consequence of insulin resistance). Insulin resistance is the root cause of many chronic inflammatory disorders. Insulin resistance will increase pro-inflammatory cytokine levels.
- Get at least 8 hours of sleep. Lack of sleep distorts all bodily functions, destroys circadian rhythm, lowers anti-oxidant defenses, impairs hormonal function and consequently increases your risk of excess inflammatory cytokines.
- Supplement with therapeutic dosages of vitamin D (somewhere between 2,000 and 10,000 IU each day)
- Take a balanced multivitamin that contains zinc. Adequate zinc levels can reduce viral replication of covid-19.
- Quercetin at 250mg three times each day helps transport zinc into your cells which may be beneficial in reducing viral replication of covid-19.
- Go outside! The fresh air and sunlight are vital to your family’s health.
 Davis, Tom. “Rare Coronavirus Syndrome In Kids: NJ Among 3 Hardest-Hit States.” Wayne, NJ Patch, Patch, 16 Aug. 2020, patch.com/new-jersey/wayne/rare-coronavirus-syndrome-kids-nj-among-3-hardest-hit-states.
 Stewart, Kim. It's Not Kawasaki ... It's PIMS-TS in Children with COVID-19. 2 Sept. 2020, todayspractitioner.com/uncategorized/its-not-kawasaki-its-pims-ts-in-children-with-covid-19/.
 Children and Schools. www.rivm.nl/en/novel-coronavirus-covid-19/children-and-covid-19.
 COVID-19 FAQ. integrativemedicine.arizona.edu/COVID19/FAQ.html.
 David O. Meltzer, MD. Association of Vitamin D Status and Other Clinical Characteristics With COVID-19 Test Results. 3 Sept. 2020, jamanetwork.com/journals/jamanetworkopen/fullarticle/2770157.
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