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Since the start of the coronavius pandemic, 420 babies have died from covid-19 in Brazil, a figure roughly ten times higher than in the United States, the country with the highest number of deaths from the disease, according to official data.
According to the United States Centers for Disease Control and Prevention (CDC), 45 children under one year old died after being infected with the virus.
In babies aged one to five, the gap between the two countries is also evident: Brazil has recorded 207 deaths by covid-19, while the United States had 52.
The Brazilian figures are also higher than those of the United Kingdom, which has recorded only two deaths from coronavirus in babies under one year old, and those of Mexico, where 307 children between zero and four have died.
France, on the other hand, has only recorded four deaths of children under the age of 14 with the new coronavirus.
At the same time, the United States is currently the country with the highest number of deaths from covid-19 with 529,000, followed by Brazil (270,000) and Mexico (191,000), according to data from Johns Hopkins University. .
The death rate from the virus in the United States (161.28 per 100,000 population) is also higher than that in Brazil (128.12 per 100,000 population).
It can therefore be said that, since the start of the pandemic, Covid-19 has killed proportionately more people in the North American nation than in Brazil, according to the official data provided.
Birth rates are also important in this equation.
The two countries have virtually the same rates, according to the World Bank: 1.77 children per woman in the United States and 1.74 children per woman in Brazil.
In 2019, 3.5 million births were registered in the United States and 2.9 million in Brazil, considering that the American population is 328.2 million, while the South American country has 210 million d ‘inhabitants.
In summary, Brazil has higher number of baby deaths and young children from covid-19, although they have fewer births than in the United States, where, in turn, more people are dying from the virus.
But, what is behind these high numbers babies and children killed by covid-19 in Brazil?
The reasons
Besides the figures that highlight the high infant mortality in Brazil, the South American nation also records a significant number of children hospitalized with covid-19.
This year alone they were hospitalized with illness 617 babies under one year old, 591 children aged 1 to 5 and 849 aged 6 to 19, according to the latest epidemiological bulletin from the Ministry of Health.
Experts interviewed by BBC News Brazil say there is no single answer to the problem.
The lack of control in the management of the pandemic and the absence of an adequate diagnosis, associated mainly with comorbidities (associated diseases) and socio-economic vulnerabilities, including the appearance of a syndrome associated with covid-19 in children, help explain the tragic situation in Brazil.
It should be noted that if the deaths are more numerous in Brazil, compared to other countries of the world, the mortality in this age group is still “very low”, according to the scientific community.
In fact, 420 babies represent only 0.15% of the total 270,600 deaths from covid-19 in Brazil.
So, the probability that a baby (or a child) developing severe symptoms of covid-19 and dying from the disease is rare, but “not zero,” Fatima Marinho, epidemiologist and senior consultant at Vital Strategies, told BBC News Brazil.
“Deaths in this age group are rare, but it is necessary to end this myth that children do not die from covid-19,” he adds.
Marinho points out that deaths from covid-19 among babies and children in Brazil they can be even older taking into account deaths from Severe Acute Respiratory Syndrome (SARS).
“We can say that 48% of those who died from unspecified SARS have a high probability of death from covid-19 due to clinical and epidemiological criteria,” he says.
According to Marinho, preliminary data from a survey conducted by Vital Strategies and the Federal University of Minas Gerais (UFMG) in three regional capitals showed that 90% of unspecified SARS cases turned out to be covid-19, after the investigation.
She points out that covid-19 tends to progress differently in children and adults.
As young children are not normally tested for the coronavirus because in practice they are much less likely to develop the more severe symptoms of the disease (and many are asymptomatic), your symptoms may be confused easily with those of other diseases, altering the diagnosis.
“Pediatricians should pay attention to children with difficulty breathing and fever, and if they have diarrhea and / or abdominal pain or cough, (they should) consider covid-19,” Marinho says.
Doctors remember that the probability of death in newborns it is higher than in older children one year because its immune system, responsible for the defense of our body, is still “in training”.
In addition, another cause of infant mortality in Brazil, which is still under investigation, is the so-called “multisystem inflammatory syndrome”, which can involve the brain, causing encephalitis or important organs such as the heart and the organs. kidneys.
In the UK, 1 in 5,000 children infected with coronavirus have developed this immune system reaction, according to UK government data.
Symptoms, including high fever, low blood pressure, and abdominal pain, usually appear about a month later contact with the coronavirus.
The vast majority of children infected with the coronavirus do not develop this inflammatory process or do not recover with treatment.
But in some cases, the syndrome can turn into a serious illness and lead to death.
It happened with a patient of pediatrician Jessica Lira, who works in the ICU at Albert Sabin Children’s Hospital in Fortaleza.
The girl was two years old and developed encephalitis, an inflammation of the brain that appears to have been caused by the coronavirus infection.
“He died of brain death. The conversation was difficult, the parents were very angry, it was difficult for them to understand how it evolved. They did not know that covid-19 could lead to such a situation,” said Jessica said in a recent interview with BBC News Brazil.
Socio-economic comorbidities and vulnerabilities
Socio-economic comorbidities and vulnerabilities are the factors that weigh the most in the deaths of children from covid-19 in Brazil.
A study by Brazilian pediatricians led by Braian Sousa, linked to the Faculty of Medicine of the University of So Paulo (USP), and under the supervision of Alexandre Ferraro, identified comorbidities and socio-economic vulnerabilities as factors risk of worst outcome of covid -19 in children.
“Individually, most of the included comorbidities were risk factors. Having more than one comorbidity almost tenfold the risk of death. Compared to white children, Aboriginal, Métis and East Asian children had a significantly higher risk of mortality, ”say researchers in the study published on the medrxiv platform.
“In addition to the impact of co-morbidities, we have identified ethnic effects, regional and socio-economic factors that determine the mortality of children hospitalized with covid-19 in Brazil. By combining these results, we propose that there is a link (interaction between health problems and the socio-economic context) between COVID-19 and non-communicable diseases, driven and promoted by large-scale socio-demographic inequalities. . ”
“Our results also identify risk groups among children who should be prioritized for public health measures, such as immunization,” the researchers conclude.
A total of 5,857 patients under the age of 20 were studied, all hospitalized for covid-19.
Professor Paulo Ricardo Martins-Filho, of the Federal University of Sergipe (UFS), finds similar hallazgos.
He and his team developed a study to estimate incidence rates and Mortality from Covid-19 in Brazilian children and analyze its relationship with socio-economic inequalities.
And they concluded that there are significant regional differences and a relationship between death rates and socio-economic inequalities.
“Most children who die have comorbidities, especially cancer patients or those who are overweight and obese. There are also those who have lung and heart problems. But this is not a rule. We are seeing healthy babies and children dying from covid, something that was not present in the first wave, ”said Lohanna Tavares, pediatric infectious disease specialist at the Infection Control Commission at Albert Sabin Children’s Hospital from Fortaleza, to BBC News Brazil.
Pediatricians believe the deaths of these healthy children may be linked to external factors, such as malnutrition and other illnesses, such as dengue, for example, but this correlation has not yet been investigated.
Tavares reinforces another factor that has contributed to the increase: the lack of assistance.
“Hospital beds and access to pediatric care are less important for children than for adults. Several pediatric hospital wards have been filled with adult beds, ”he adds.
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