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>> Hello, my name is Hamid Bassiri. I'm one of the infectious disease specialists here at
the Children's Hospital of Philadelphia and I also have a background in immunology.
We know that while children generally do well with COVID-19 that they are just as susceptible
as adults. Even healthy children without any underlying comorbidities or other medical
conditions can still contract disease. Sometimes that disease can be severe.
Clinically, I can tell you that I've seen a variety of different sequelae of actually
getting disease. Certainly, there’s the acute complications of COVID-19 where children can come
in and have respiratory distress, need help with oxygenation and breathing, and I've seen kids do
well with that. I've seen kids, unfortunately, need things like a nasal cannula to help them
with a little bit of oxygen, and occasionally some kids who land in our intensive care unit
who really suffer from the more severe disease. In addition to the acute presentation of COVID-19
and the respiratory distress that you see, there's also a variety of post-acute sequalae of
SARS-CoV-2. One of the other things we see clinically, and this happens in children
regardless of whether they actually come into the hospital and need to stay in the hospital
or even in children who develop some very, very mild symptoms, is this concept of the long-haul
syndrome or the post-acute sequelae of SARS-CoV-2 in children, or PASC.
PASC takes a number of different forms, and in different children, it can manifest itself very
differently. And again, it can, it can just, the spectrum can encompass some mildly annoying stuff,
which kids can do well with and eventually resolve, but it can also involve some pretty
debilitating type of phenomenon that can really affect the lives of our children.
So, that could include anything from not being able to sleep, not being able to
breathe as well as they used to previously. Any exertion, any running around making them
incredibly fatigued, not just because they're tired, but much, much more fatigued than they
would have been at any other time. The inability to concentrate and focus, which really affects
their learning in schools and after school. The occasional joint pains that come and go,
abdominal pains that come and go that, again, interfere with the actual ability of our children
to do what they're supposed to be doing — playing, learning, and really developing as time goes on.
And then one of the more severe post-acute sequelae of SARS-CoV-2 is a syndrome that myself
and a group of us collaboratively have been studying, this syndrome is called the multi-system
inflammatory syndrome in children, or MIS-C. And what MIS-C is, is a hyperactivation
of the immune system. So, children can get acute COVID-19, in many instances the acute
COVID-19 that they get is actually asymptomatic. So, they're not coughing. They're not having
breathing difficulties or anything else. And they actually resolve that portion of their disease
fairly nicely. And then several weeks later, sometimes generally between four and seven weeks
later, they develop a hyperinflammatory syndrome. So, what does that mean?
Well, they develop pretty high-spiking fever that can last for a few days. And in addition to that,
some of the children develop rashes, redness of their eyes, and can start to have
more fatigue, malaise, weakness. And the virus, or the sequalae of the virus, can actually affect
their heart function, which can be not just severe, but potentially life-threatening.
So, we've seen a number of those children here at the Children's Hospital of Philadelphia,
and we formed a group to try and actually study what is happening with our immune system.
Why is it becoming hyperactivated?
We and others around the world have started to really just scratch the surface of that.
I don't know that any one of us has an answer as of yet.
So, I think there are many really good reasons to consider vaccination of children,
both for preventing disease in them in the acute sense, in the post-acute sense,
and with respect to decreasing the transmission and the number of susceptible hosts that the virus actually has in the community.
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