Babies are dying of COVID-19 in Brazil: Myth, Symptoms, Trends, and Reasons

8 min readMay 29, 2021

By Tint Tha Ra Wun

The Coronavirus disease of 2019 (COVID-19/ SARS-CoV2) has infected more than 160 million people and has caused the deaths of more than 3.3 million lives worldwide. It is one of the deadliest viruses that our human species had been evolved on Earth, impacting the lives of millions of people in the modern world.

The COVID-19 virus has caused an impact on all age groups, most severely on seniors who have serious underlying medical conditions (heart or lung diseases or diabetes) with a higher risk of complications. However, today, we would like to explore how it is imposing a thread on our future generation: the babies. Specifically, we would like to discuss the cases of COVID-19 for babies in Brazil and identify the myths, symptoms, trends, and other factors related to this issue.

Myth: Children are at ZERO risks for COVID-19

There is a common misconception that children are at zero risks for COVID-19.

Indeed, COVID-19 is not as severe in children as in adults. Research has suggested that children younger than ages 10 to 14 are less likely to become infected with the virus that causes COVID-19 compared to people age 20 and older.

However, this does not mean that babies do not get infected. Although COVID-19 in babies tends to be milder compared to adults or asymptomatic, some children can become severely ill with COVID-19. Children with underlying conditions, such as obesity, diabetes, asthma, congenital heart disease, genetic conditions, or conditions affecting the nervous system or metabolism, might be at higher risk of serious illness with COVID-19.

Younger age means inexperienced.

Babies under age 1 might be at higher risk of severe illness with COVID-19 than older children. Newborns can become infected with the virus that causes COVID-19 during childbirth or by exposure to sick caregivers after delivery.

Symptoms of COVID-19 in children

Although the details have not been understood, children react differently to the COVID-19. This is likely due to the differences between the kids’ and adults’ immune systems and how they interact with the COVID-19 virus.

Let us explore some of the symptoms of COVID-19 in children. Most of these symptoms are similar to adults but the effects are less severe and cold-like. Most children also recover between one to two weeks.

According to this Mayo Clinic article, possible symptoms include:

· Fever or chills

· Nasal congestion or runny nose

· Cough

· Sore throat

· Shortness of breath or difficulty breathing

· Fatigue

· Headache

· Muscle aches or body aches

· Nausea or vomiting

· Diarrhea

· Poor feeding or poor appetite

· New loss of taste or smell

· Belly pain

Note: The bolded symptoms are those symptoms not commonly found in COVID-19 adult cases.

Trends of COVID-19 in children in Brazil

Often believed to be rare, COVID-19 has killed an estimated 1,300 babies in Brazil since the start of the pandemic. As reported in this article from April 15th, 2021, data from Health Ministry suggest that more than 800 children under age 9 have died of COVID-19, including about 500 babies. The experts predict the death trolls could even be higher due to the underreported cases because of a lack of widespread testing.

Moreover, Dr. Fatima Marinho of the University of São Paulo, a leading epidemiologist who is a senior adviser to the international non-governmental organization Vital Strategies, estimated that the virus has killed 2,060 children under 9, including 1,302 babies.

Dr. Marinho made this prediction based on her research on an excessive number of deaths from an unexplained respiratory syndrome during the pandemic. She found out that there have been 10 times more deaths from an unexplained respiratory syndrome over the past year compared to previous years.

Additionally, she has seen a rise in cases of the multisystem inflammatory syndrome (MIS-C) among Brazilian children. Many children who have been reported for the MIS-C also tested positive for COVID-19 antibody test, suggesting these children have previously infected with the virus.

According to the same Mayo Clinic article, the symptoms of MIS-C include:

· Fever that lasts 24 hours or longer

· Vomiting

· Diarrhea

· Pain in the stomach

· Skin rash

· Fast heartbeat

· Rapid breathing

· Red eyes

· Redness or swelling of the lips and tongue

· Feeling unusually tired

· Redness or swelling of the hands or feet

· Headache, dizziness, or lightheadedness

· Enlarged lymph nodes

Moreover, the emergency warning signs of MIS-C include:

· Inability to wake up or stay awake

· Difficulty breathing

· New confusion

· Pale, gray, or blue-colored skin, lips, or nail beds — depending on skin tone

· Severe stomach pain

Note: The bolded symptoms are symptoms similar to those of COVID-19 in babies.

As denoted from the most recent data reported from the Ministry of Health, from April 1 last year to February 13, Brazil recorded 736 cases and 46 deaths of children and adolescents from pediatric multisystem inflammatory syndrome (P-SIM).

The graph below shows the number of cases for P-SIM associated with COVID-19 in Brazil by age.

Note. MIS-C and P-SIM/ SIM-P all refers to the same multisystem inflammatory syndrome.

Reason: Why this is happening?

Brazil has a significant number of children hospitalized for COVID-19 compared to other nations. As denoted from this article, this year alone, according to the latest epidemiological bulletin of the Ministry of Health, 617 babies (less than one year), 591 children from one to five years old, and 849 from six to 19 years old were hospitalized due to the disease. However, compared to the total number of cases in the country, this representation may seem quite low.

There are many factors to consider when we think about COVID-19 in babies and death rates, specifically in Brazil. There possibly are many reasons: insufficient testing, inaccessibility to vaccines, failed economic system and socioeconomic vulnerabilities, and late and misdiagnoses.

Some professionals in the country have indicated that the complications are due to Brazil’s failed healthcare system.

Renato Kfouri, president of the Scientific Department of Immunizations of the Brazilian Society of Pediatrics, pointed out that it is because of Brazil’s failed healthcare system. Across the country, oxygen supplies are dwindling, there is a shortage of basic medicines and in many ICUs across the country, there is simply no more beds.

This opinion was also supported by Dr. Christos Christou, president of Médecins Sans Frontières or Doctors Without Borders in English. In a briefing with the reporters in April, Dr. Christou remarked that the Brazilian government’s “failed response” to the pandemic had led to thousands of avoidable deaths. More than one year into the Covid-19 pandemic, the failed response in Brazil has caused a humanitarian catastrophe. Each week there is a grim new record of deaths and infections — the hospitals are overflowing, and yet there is still no coordinated centralized response.

Another professional in the country pointed out the late diagnosis and misdiagnoses as a reason. According to Dr. Marinho, children are not usually tested for coronavirus, since they are, in practice, much less susceptible to developing the most severe symptoms of the disease (and many are asymptomatic). Moreover, their symptoms can be easily confused with those of other diseases, impairing the diagnosis.

As denoted from this BBC Brazil article, “Pediatrists should pay attention to children with shortness of breath and fever, and if diarrhea and/or abdominal pain and/or cough occur when thinking about COVID-19. Cough was uncommon during hospitalization, but it was an alarm signal for death for children. Abdominal pain and diarrhea were the most frequent symptoms in children older than one year,” says Dr. Marinho.

In addition, another cause of death of children in Brazil, which is still being investigated, is the so-called multisystem inflammatory syndrome (MIS-C), which can compromise the brain, causing encephalitis, or important organs such as the heart and kidneys. The symptoms of MIS-C are previously discussed in the Trends of COVID-19 in children in Brazil of this article.

However, it is the comorbidities and socioeconomic vulnerabilities that have the greatest weight in the death of children by COVID-19 in Brazil. An observational study developed by Brazilian pediatricians led by Braian Sousa, linked to the School of Medicine of the University of São Paulo (USP), and supervised by Alexandre Ferraro, identified comorbidities and socioeconomic vulnerabilities as risk factors for the worst outcome of COVID-19 in children.

According to the researchers, having more than one comorbidity increased the risk of death by almost ten times. Compared to white children, indigenous, brown, and East Asian children had a significantly higher risk of mortality. There is also a regional effect (higher mortality in the North) and a socioeconomic effect (higher mortality in children from less socioeconomically developed municipalities). Based on these ethnic, regional, and socioeconomic effects that shape the mortality of children hospitalized with COVID-19 in Brazil, the team proposed that there is a syndemic (interaction between health problems and socio-economic context) between COVID-19 and non-communicable diseases, driven and fostered by large-scale sociodemographic inequalities.

Similar findings were made by Professor Paulo Ricardo Martins-Filho of the Federal University of Sergipe (UFS), one of the most published researchers on COVID-19 in Brazil. He and his team developed a study to estimate the incidence and mortality rates of COVID-19 in Brazilian children and analyze its relationship with socioeconomic inequalities. Again, they concluded that there were important regional differences and a relationship between mortality rates and socioeconomic inequalities.

Limitations

While conducting this research, the first and foremost challenge that we encounter was the lack of well-established data, specifically on the COVID-19 case numbers by age. Most of the data sources are either incomplete or unreliable, making it difficult to find facts to draw conclusions.

Although Brazil, having the second-highest number of COVID-19 cases in the world, the proper report on the COVID-19 related information is scarce. For example, in the United States, which records the highest number of COVID-19 cases in the world, the Centers for Disease Control and Prevention release more updated information on an hourly and daily basis. However, there is no such update available for Brazil, thus making it challenging to find data for one of the most important public health issues in today’s world.

However, we tried to use facts and data from reputable news sources, such as NYTimes, BBC, and NBCNews as well as reports from Brazil’s limited official COVID-19 database to support the facts and data stated in this article.

Now: Where To?

In conclusion, COVID-19 has caused misery in today’s world, affecting the lives of millions of people on Earth. It is interesting to see how this virus imposes adverse public health threads on different age groups. With the increase in cases and deaths among babies, certainly, this pandemic can also have a huge impact on the lives of our future generations.

It is time that the Brazilian government starts preparation and make implementations to control the spread of COVID-19 in babies and to prevent late diagnoses. Moreover, the public should also pay close attention and remain focused on this deadly dangerous virus as well as take every precaution to reduce the worst outcomes of this pandemic.