Haleemunnissa S, Didel Siyaram, Swami Mukesh Kumar, Singh Kuldeep, Vyas Varuna
Department of Psychiatry, All India Institute of Medical Sciences, Jodhpur, India.
Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, India.
Child Youth Serv Rev. 2021 Jan;120:105754. doi: 10.1016/j.childyouth.2020.105754. Epub 2020 Nov 28.
The COVID19 pandemic has forced the world to be closed in a shell. It has affected large population worldwide, but studies regarding its effect on children very limited. The majority of the children, who may not be able to grasp the entire emergency, are at a bigger risk with other problems lurking behind the attack of SARS-CoV-2 virus. The risk of infection in children was 1.3%, 1.5%, and 1.7% of total confirmed COVID-19 cases in China, Italy and United States respectively which is less compared to 2003 epidemic of severe acute respiratory syndrome (SARS), when 5-7% of the positive cases were children, with no deaths reported while another recent multinational multicentric study from Europe which included 582 PCR (polymerase chain reaction) confirmed children of 0-18 year of age, provide deeper and generalize incite about clinical effects of COVID19 infection in children. According to this study 25% children have some pre-existing illness and 8% required ICU (intensive care unit) admission with 0.69% case fatality among all infected children. Common risk factor for serious illness as per this study are younger age, male sex and pre-existing underlying chronic medical condition. However, we need to be more concerned about possible implications of indirect and parallel psychosocial and mental health damage due to closure of schools, being in confinement and lack of peer interaction due to COVID19 related lockdown and other containment measures. The effects can range from mood swings, depression, anxiety symptoms to Post Traumatic Stress Disorder, while no meaningful impact on COVID19 related mortality reduction is evident with school closure measures. The objective of this paper is to look at both the positive & negative effects in children due to COVID19 related indirect effects following lockdown and other containment measures. There is a need to gear up in advance with psychological strategies to deal with it post the pandemic by involving all stakeholders (parents, teachers, paediatricians, psychologists, psychiatrists, psychiatric social workers, counsellors), proposing an integrated approach to help the children to overcome the pandemic aftermath.
新冠疫情迫使世界仿佛被封闭在一个壳中。它影响了全球大量人口，但关于其对儿童影响的研究非常有限。大多数儿童可能无法理解整个紧急情况，在严重急性呼吸综合征冠状病毒2（SARS-CoV-2）病毒侵袭背后潜藏着其他问题的情况下，他们面临的风险更大。在中国、意大利和美国，儿童感染新冠确诊病例总数的比例分别为1.3%、1.5%和1.7%，与2003年严重急性呼吸综合征（SARS）疫情相比要低，当时5%-7%的阳性病例是儿童，且无死亡报告。而最近一项来自欧洲的多中心跨国研究纳入了582名经聚合酶链反应（PCR）确诊的0至18岁儿童，对新冠病毒感染在儿童中的临床影响提供了更深入且具有普遍性的见解。根据这项研究，25%的儿童有一些既往疾病，8%的儿童需要入住重症监护病房（ICU），所有感染儿童的病死率为0.69%。根据这项研究，严重疾病的常见风险因素是年龄较小、男性以及存在潜在的慢性基础疾病。然而，我们需要更加关注由于学校关闭、因新冠疫情相关封锁及其他防控措施导致的居家隔离和缺乏同伴互动所带来的间接和并行的心理社会及心理健康损害的可能影响。其影响范围可从情绪波动、抑郁、焦虑症状到创伤后应激障碍，而学校关闭措施对降低新冠相关死亡率并无明显的有意义影响。本文的目的是探讨因新冠疫情相关封锁及其他防控措施的间接影响给儿童带来的正面和负面影响。有必要提前准备好心理应对策略，以便在疫情结束后通过让所有利益相关者（家长、教师、儿科医生、心理学家、精神科医生、精神科社会工作者、顾问）参与进来，提出一种综合方法来帮助儿童克服疫情后遗症。
