COVID-19 and Children: From an Epidemiological Perspective

Öz

COVID-19, caused by SARS-CoV-2, has rapidly progressed globally started from early days of 2020 and was disseminated to 187 countries and territories by April. As of May 3, 2020, COVID-19 has led to a total of 3,507,442 cases and 245,241 related deaths, globally. Turkey, was successful to delay the first COVID-19 case until March 10, yet, case numbers increased fast, reaching to the top 7th rank in the list of countries with the highest case numbers. It is fortunate that the case-fatality ratio was relatively low, with a somewhat stable course around 2.5%. Somewhat stable course of new case numbers, with an apparent decrease through the end of April led to onset of normalization attempts in the country. The future course of the pandemic will be mainly determined by compliance of the general public with personal hygiene, mask use and social distancing. Globally, COVID-19-related morbidity and mortality rates are lower among children than in adults. Underlying mechanisms for this difference has not been clarified, yet, may be linked to lower exposure rates among children, their immune response may be different and/or higher rates of asymptomatic cases may have lower admissions/testing among children. However, it is important to emphasize that children are prone to SARS-CoV-2, too and all relevant preventions should be ensured. This issue should also be considered in evaluating potential risk of infection transfer from asymptomatic youngsters to the elderly and/or to those with chronic diseases. Data on COVID-19-related case numbers and deaths have not been published so far for children. This requires urgent consideration for related reporting and novel research activities on health burden of COVID-19 on Turkish children. Success in combating the COVID-19 pandemic requires concurrent efforts for clinical management of patients together with epidemiological studies of available national data and establishment of specific research to provide evidence for national and international preventive interventions. Learnings from this pandemic will provide direct evidence for management of future pandemics, and all related parties should be motivated to prepare detailed reporting of ongoing efforts and their outputs.

Anahtar Kelimeler

• COVID-19,
• Child health,
• Epidemiology,
• Prevention,
• Morbidity,
• Transmission

COVID-19 ve Çocukların Etkilenimi: Epidemiyolojik Açıdan Değerlendirmeler

Öz

SARS-CoV-2 virüsünün neden olduğu COVID-19 hastalığı, 2020 yılının ilk günlerinden itibaren hızla yayılarak, Nisan ayı sonunda 187 ülke ve bölgeye yayılım göstermiş; 3 Mayıs 2020 itibarı ile dünyada 3,507,442 vaka ve ilişkili 245,241 ölüme neden olmuştur. Türkiye, ilk vakanın görüldüğü 10 Mart 2020 tarihinden sonra vaka sayılarındaki hızla artma sonucu 50 gün içinde vaka sayısı en yüksek 7. ülke konumuna yükselmiş, ancak bu arada ölüm sayılarını göreceli olarak aşağı sınırlarda (%2.5 civarında) tutmayı başarmıştır. Nisan ayının sonuna doğru vaka sayılarında düzleşme ve aşağı doğru gidiş ile gündelik yaşamdaki kısıtlamaların azaltılması konusundaki çalışmalar başlamıştır. Toplumun kişisel hijyen, sosyal mesafenin korunması ve maske kullanımına uyum düzeyine bağlı olarak salgının ülkemizdeki süreci değişiklik gösterebilecektir. Dünya genelinde çocukluk çağında COVID-19 vaka ve ölüm sayıları, yetişkinlere kıyasla daha düşüktür. Bunun altında yatan nedenler çocukların enfeksiyonla daha az karşılaşmaları, bağışıklık sistemi cevaplarının yetişkinlerden farklı olması ve/veya asemptomatik olmaları nedeniyle daha az hastane başvuru/test yapılması kaynaklı olabileceği konusunda yayınlar olsa da sonuçları henüz kesinlik kazanmamıştır. Öte yandan, COVID-19 pandemisinin çocukların yaşamı için de bir risk olduğu kesindir ve bu konuda yeterli önlemler alınmalıdır. Bu paralelde asemptomatik ve sağlıklı görünümdeki çocukların enfeksiyonu taşıma konusundaki tehlike hem topluma yönelik kısıtlamalar planlanırken hem de özellikle yaşlı ve kronik hastalığı olan kişilerin bireysel korunmasında dikkate alınmalıdır. Türkiye’deki vaka sayıları içinde çocuklara ait yüzdeler ve ilişkili risk faktörleri konusunda yayınlanmış bir bilgi henüz yoktur. Bu konuda yapılacak çalışmalara ivedikle ihtiyaç duyulmaktadır. Pandemi dahilinde bir yandan salgına bağlı hastalık yükü ile başa çıkarken, bir yandan da verilerin detaylı inceleme ve analizlerinin yapılması, literatüre katkı sağlayacak çalışmalar ile ulusal ve uluslararası mücadele planlarına katkı sağlanması değerlidir; bu pandemide öğrenilenlerin detaylı olarak yapılması bundan sonraki pandemiler için kanıta dayalı hazırlık sürecine doğrudan katkı sağlayacaktır ve desteklenmelidir.

Anahtar Kelimeler

• Bulaş,
• COVID-19,
• Çocuk sağlığı,
• Epidemiyoloji,
• Korunma

Kaynakça

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