More than 2,600 kids in Shelby County have COVID-19. How are they being treated?

Corinne S Kennedy
Memphis Commercial Appeal

While early indicators show COVID-19 hospitalizations could be dipping in Shelby County, pediatric hospitalizations have been at frightening highs in recent weeks, as new infections among children remain at levels previously unseen during the pandemic.

On Sept. 1, Methodist Le Bonheur Healthcare had a then-record high 322 COVID-19 patients hospitalized across its network. The largest increase in the system in the preceding days had been at Le Bonheur Children’s Hospital, which has seen a spike in pediatric coronavirus cases in recent weeks. 

As of Monday, there were 2,647 active pediatric cases in Shelby County, down from 3,199 on Sept. 7. While the decline is encouraging, the figure is up from about 1,100 pediatric cases in Shelby County in early August. 

Dr. Sandy Arnold, division chief of pediatric infectious diseases at Le Bonheur, said on Sept. 8 there were 12 admitted pediatric COVID-19 patients, down from 30-something a few days before. However, many of the admitted children are seriously sick.

Dr. Sandra Arnold speaks to the press during a press conference dealing with pediatric cases of COVID-19 at Le Bonheur Children's Hospital on Friday, Aug 13, 2021.

“I don't know if this is a real trend towards cases decreasing or if it's just a blip,” she said. “Seven of those 12 kids are in the ICU. So there's still lots of sick kids around. But hopefully, things are trending in the right direction. But they need more than a few days of that before we can say.”

Infections among people 17 and younger comprise about 40% of all active cases in Shelby County as of Monday, according to the Shelby County Health Department. The youngest confirmed COVID-19 death in Shelby County is 10 years old, and three Shelby County residents 17 and younger are confirmed to have died due to complications from the virus. Additional children from the wider region have died in local hospitals. 

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Dr. Steve Threlkeld, director of infection prevention for the Baptist Memorial Health Care System, said the delta variant is a factor in the increased pediatric cases. While the return to school and the fact that many children are not yet able to be vaccinated play a role in the spread of pediatric cases, those issues are not new. 

“That all by itself is a big part of the situation…. we have, as a society, become less worried about the virus... we’ve become used to it... we see more people dying of it now,” he said. “We’ve become a bit numb, as a society, to it. Kids wake us up from that numbness. I think when kids get sick, people appropriately pay more attention to it. And we've certainly had a dramatic increase.”

Pediatric COVID-19 treatment

Arnold said effective COVID-19 treatment for pediatric patients is largely the same as in adults. If they are within the first 10 days of illness, children admitted to Le Bonheur get remdesivir, which, though not a miraculous drug, is one of the only antiviral drugs used for COVID-19, she said. 

For kids who get seriously ill, they are given steroids like dexamethasone, also used in adults, and sicker kids receive immunomodulatory therapies like tocilizumab, when available. There’s a national shortage due to all the COVID-19 patients nationwide. 

Pediatric COVID-19 care can be hit and miss, Arnold said. The surge in children’s cases is relatively new, so hospitalists are still learning what works and what doesn't in kids. They’re trying to give treatments as early as possible.

Especially for teens who exhibit symptoms closer to adults. Most of the children who get seriously ill are teenagers, Arnold said.

“We’re basically treating these bigger kids like adults,” she said. 

The older teens who end up on ventilators are, by and large, those who are obese or who have neuromuscular disease who don’t produce good coughs and can’t clear their lungs. Younger kids and babies tend to have different symptoms. 

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Threlkeld said that it is by no means only children or adults with comorbidities who are dying of complications related to COVID-19, but those health complications are more prevalent among people who get seriously ill or die. 

Symptoms of COVID in kids: What parents should look for

Arnold said physicians are starting to see more symptomatic COVID-19 infections among children. They have similar symptoms to adults — for children who are under 12 and cannot yet be vaccinated. 

“Anything from flu-like symptoms with fever and body aches and coughs, sore throat, runny nose, to also some kids have gastrointestinal symptoms. Seems like maybe more of the runny nose and sore throat,” for children, she said. “It usually takes a few days from the beginning for them to become ill enough to come to the emergency room. And some of the bigger kids, the teenagers who are actually getting really sick... some of them have a more mild illness with fever and cough...they don't start having the shortness of breath or real difficulties until (day) 7,8 or9.”

Many COVID-19 and multisystem inflammatory syndrome (MIS-C) symptoms can seem similar to other illnesses. 

In general, whether parents are worried about COVID-19 or MIS-C, Arnold said kids should be taken to an emergency room if they’re having trouble breathing. By and large, mild fever and diarrhea can be treated at home.

However, dehydration, especially when smaller kids are not eating and drinking anything, is also cause to take a child to the hospital, Arnold said.

Corinne Kennedy covers economic development, healthcare and soccer for The Commercial Appeal. She can be reached via email at Corinne.Kennedy@CommercialAppeal.com.