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Editorial
Since December 2019, an epidemic caused by the severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2) occurred unexpectedly in Wuhan, Hubei province, China
and quickly spread from Wuhan to other areas of China and other countries. The World
Health Organization named this new coronavirus disease COVID-19, resulting from the
combination of the words Corona, Viruses and Disease, with an indication of the year
2019, the year of its appearance. The General Directorate of Health of Portugal states
that the transmission of COVID-19 can occur through respiratory droplets, direct contact
with respiratory secretions, infected feces or contaminated surfaces and by air, through aerosol generators(1).
There are relatively few reported cases of COVID-19 infection in children, compared to the total number
of cases in the general population. In February 2020, 2.4% of the 75,465 cases in China (conrmed and
suspected) occurred in children, as well as in Italy with 1.2%(2) and 5% in the United States of America(3). Data
from the General Directorate of Health of Portugal, from March 29, 2020, show that 1% of children under 10
years old and 2.3% of adolescents between 11 and 19 years old were presenting COVID-19. At the moment,
there are no cases of death in this age group(1). One of the explanations for this disease not being prevalent in
children may be because they are less exposed to the virus and have less indications for testing for SARS CoV-
2 because, in most cases, they have mild symptoms similar to those of a common u. The function of innate
immunity to respiratory tract infection is greater in children than in adults, because the adaptive immune
response in children is superior and the protein that binds to the angiotensin-converting enzyme is less mature
in younger people, which makes such binding dicult. Thus, children's ability to trigger an acute inammatory
response to SARS-CoV-2 is weak, which can also contribute to a better outcome. Such particularities, however,
do not eliminate the possibility of serious cases and even death, especially in children with comorbidities(4).
1 Escola Superior de Saúde da Cruz Vermelha Portuguesa, Lisboa, Portugal.
The new coronavirus and the risk to children's health
José Manuel da Silva Vilelas1
https://orcid.org/0000-0002-9433-9018
Rev. Latino-Am. Enfermagem
2020;28:e3320
DOI: 10.1590/1518-8345.0000.3320
www.eerp.usp.br/rlae
Como citar este artículo
Vilelas JMS. The new coronavirus and the risk to children's health. Rev. Latino-Am. Enfermagem. 2020;28:e3320.
[Access ___ __ ____]; Available in: ___________________ . DOI: http://dx.doi.org/10.1590/1518-8345.0000.3320.
añodía
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www.eerp.usp.br/rlae
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Rev. Latino-Am. Enfermagem 2020;28:e3320.
Copyright © 2020 Revista Latino-Americana de Enfermagem
This is an Open Access article distributed under the terms of the
Creative Commons (CC BY).
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Corresponding author:
José Manuel da Silva Vilelas
E-mail: jvilelas@esscvp.eu
https://orcid.org/0000-0002-9433-9018
Regarding mother-fetus intrauterine vertical transmission, there is still no scientic evidence to demonstrate
its existence. COVID-19 was also not detected in breast milk(5). However, the main concern is whether an infected
mother can transmit the virus through respiratory droplets. Thus, breastfeeding during maternal COVID-19 infection
is not contraindicated by the Centers for Disease Control and Prevention and the Royal College of Obstetricians and
Gynaecologists, but precautions must be taken to prevent the spread of the virus to the newborn, including washing
your hands before touching it and wearing a face mask. In the case of breast milk extraction, the recommendations
for cleaning the breast pumps after each use must be strictly observed(6).
Although the immediate risk of COVID-19 in children is low, it is important to monitor the situation and its
evolution. At this stage, the concern about COVID-19 can make children and their families anxious. Several countries
have implemented social connement and distancing, which means maintaining a safe distance (approximately
one meter) from others and avoiding meeting spaces with more than ve people. In case of connement at home,
parents are often the best and closest resource for their children to seek help. Games and play can be strategies
for distraction and communication with children. Toys should be cleaned and disinfected with soap and water, a
disinfectant or sodium hypochlorite solution (10 ml/1 liter of water). This virus is inactivated after ve minutes(7).
The current outbreak of COVID-19 remains serious worldwide and has been designated as a Public Health
emergency and an international concern of the World Health Organization. It is highly contagious and, although the
number of reported sick children is small at the moment, they are also vulnerable to infection. The importance of
raising awareness and strengthening infection control measures can never be overemphasized.
References
1. Direção Geral de Saúde (PT). Norma nº 007/2020 de 29 março 2020. Prevenção e Controlo de Infeção por
SARS-CoV-2 (COVID-19): Equipamentos de Proteção Individual (EPI). [Internet]. 2020 [Acesso 7 abr 2020]. p.
1-24. Disponível em: https://www.dgs.pt/directrizes-da-dgs/normas-e-circulares-normativas/norma-n-0072020-
de-29032020-pdf.aspx
2. Livingston E, Bucher K. Coronavirus Disease 2019 (COVID-19) in Italy. JAMA. 2020 March 17. doi:10.1001/
jama.2020.4344.
3. Centers for Disease Control and Preverntion (US). Severe outcomes among patients with Coronavirus Disease 2019
(COVID-19). MMWR Morb Mortal Wkly Rep. 2020 March 26; 69(12):343–6. doi.org/10.15585/mmwr.mm6912e2.
4. Hon KL, Leung CW, Cheng WT, Chan PK, Chu WC, Kwan YW, et al. Clinical presentations and outcome of severe
acute respiratory syndrome in children. Lancet. 2003;361(9370): 1701-3. doi: 10.1016/s0140-6736(03)13364-8.
5. Wei M, Yuan J, Liu Y, Tao Fu, Xue Yu, Zhi-Jiang Z. Novel Coronavirus infection in hospitalized infants under 1 year
of age in China. JAMA. 2020;323(13):1313-4. doi:10.1001/jama.2020.2131
6. Royal College of Obstetricians and Gynaecologists (UK). Coronavirus (COVID-19) Infection in Pregnancy.
Information for healthcare professionals. [Internet]. 2020 [cited 2020 April 7]. p. 1-50. Available from: https://www.
rcog.org.uk/globalassets/documents/guidelines/2020-04-03-coronavirus-covid-19-infection-in-pregnancy.pdf
7. Cao Q, Chen YC, Chen CL, Chiu CH. SARS-CoV-2 infection in children: Transmission dynamics and clinical
characteristics. J Formos Med Assoc. 2020;119(3):670-3. doi: doi.org/10.1016/j.jfma.2020.02.009.
