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Children who get COVID-19 can suffer severe illness, leading Utah doctor warns

Dr. Andrew Pavia urges parents to get their young children vaccinated once eligible.

People who subscribe to the myth that children can’t get COVID-19 “should walk in our shoes every day,” the chief infectious diseases physician at Utah’s largest children’s hospital said Friday.

Doctors there are treating between eight and 12 children a day who have COVID-19. Of those child patients, three to five are typically in the ICU each day, Dr. Andrew Pavia, director of epidemiology at Intermountain Primary Children’s Hospital, said Friday during a weekly COVID-19 community briefing hosted over Facebook Live.

Pavia said between 5% and 8% of children who get COVID-19 still show symptoms months later, he said. But there are many other concerns parents should have if their children contract the coronavirus.

“Being infected may mean you miss many days of school,” Pavia said. “It may mean you infect family members, who are more vulnerable, who may actually get very sick or die from it.”

Pavia on Friday urged parents to consider getting their children vaccinated once eligible. The same day, the Food and Drug Administration cleared kid-size doses of Pfizer’s COVID-19 vaccine for children 5 to 11 years old.

On Tuesday, the Centers for Disease Control and Prevention will make more detailed recommendations on which children should get vaccinated, with a final decision from the agency’s director possible by the end of next week.

Long-term COVID-19 effects in children

One long-term effect of COVID-19 that doctors are particularly worried about in children is multi-system inflammatory syndrome, or MIS-C.

The syndrome causes serious inflammation of many organ systems. The organs that are most hard-hit typically include the liver and the heart, “and it’s heart damage that scares us the most,” Pavia said.

In some cases, MIS-C can affect the nervous system, causing such neurologic symptoms as confusion, seizures and even strokes.

“Although a rare complication, this is the one we fear the most, and that has caused most of the heartbreak that we’ve seen,” Pavia said.

Utah has seen around 120 children diagnosed with MIS-C since the pandemic began 19 months ago. “We’re seeing an increase now, which is reflecting the increase in infections that we saw after school started,” Pavia said.

Outcomes such as MIS-C only happen in few cases, Pavia said.

“But it doesn’t have to happen,” Pavia said. When deciding on whether or not to get children vaccinated, he continued, “you’re rolling the dice with a rare but severe outcome.”

ICUs remain crowded

One in three children with MIS-C end up in the ICU, Pavia said. Like most such units throughout Utah, Primary Children’s ICU is operating between 93% and 100% capacity, Pavia said.

“Our big problem, like every hospital in the state, is a nursing shortage,” Pavia said, noting that the children’s hospital is typically about 10 nurses short of “the very best nurse-to-patient care ratio.”

Of all Utah ICU patients, 39.6% are being treated for COVID-19. It’s also where heart surgery patients and people who have suffered major trauma are treated.

“My hat’s off to everyone in the hospital who’s working so hard, but this is really not sustainable,” he said of overcrowding and staffing shortages.

Pavia said he’s anticipating some relief when young children will be eligible to get vaccinated against COVID-19, which could be as soon as Nov. 8.

Once that happens, Intermountain locations will be dispensing both the child-sized dose and the standard formulation for adults and teens.

“We would love to get the whole family vaccinated,” Pavia said.