Updated: July 18, 2020 7:26:57 am
Over the last few months, several hospitals in Delhi have reported children with Covid-19 reporting symptoms similar to those associated with a rare illness called Kawasaki disease — such as rashes and inflammation.
Kawasaki disease is a syndrome of unknown cause that leads to fever and mainly affects children under the age of 5. It is a form of vasculitis where blood vessels become inflamed throughout the body. The fever typically lasts for more than five days, and does not respond to usual medications.
One of the country’s top children’s hospitals, Kalawati Saran in Delhi, has reported five-six cases of children presenting with fever, rashes, respiratory and gastrointestinal issues — some of the symptoms of Kawasaki disease. They had all tested positive for Covid-19.
“These are the most common symptoms which have been described all over the world. While other viruses can also lead to this syndrome, but as we are in the middle of the pandemic, it is likely that the disease is related to Covid-19. We are not exactly saying they were infected with Kawasaki, but they had Kawasaki-like symptoms. The children had unexplained tachycardia and some of them were in a state of shock. All these positive cases were managed in the Covid care area,” said Dr Virendra Kumar, head of the department of paediatrics, Kalawati Saran hospital, adding that one of the patients died.
In May, a report released by the WHO stated that clusters of children and adolescents from Europe and North America had required admission to intensive care units with a multisystem inflammatory condition (MIC) with some features similar to those of Kawasaki disease and toxic shock syndrome.
“This is not a direct effect of the virus but an abnormal immune response induced by it. This multisystem inflammatory syndrome also causes a lot of digestive issues, like there are children who are presented with just pain in the abdomen, vomiting and loose motions. If you do not recognise the symptoms early, then they may have a fatal outcome. Some children may also have kidney failure,” said Dr Rachna Sharma, in-charge of the paediatric intensive care unit at BLK hospital, which has seen two such cases over the last few months.
Sir Ganga Ram hospital has seen six such cases, in which four were found to be infected with Covid-19 while the other two had not developed any antibodies against the disease. On Thursday, the hospital attended to a two-and-a-half-year-old boy from Najafgarh with persistent fever and respiratory issues. “The child had cold extremities and was exposed to the virus three-four weeks ago. His blood pressure had dropped significantly and all the parameters were pointing towards Kawasaki-like symptoms. This syndrome dysregulates the immune system and can affect the heart, intestine, liver and kidney. Three of the six such cases required ICU admissions,” said Dr Dhiren Gupta, paediatric intensivist at the hospital.
Experts further highlighted that timely intervention and identification of symptoms play a crucial role. For instance, a 13-year-old boy was presented with high-grade fever and rashes to doctors at BLK hospital. As the fever persisted, parents got anxious and got the Covid test, which came positive. He started having increasing fever spikes with pain in the abdomen, vomiting and poor oral intake.
“The child became drowsy and his blood pressure dropped. His hands and feet became cold and bluish. The disease had progressed from a simple fever to a more serious situation where the disease had affected his heart and kidney. His blood reports for corona were showing signs of severe disease. In this Covid multisystem inflammatory syndrome, the heart is usually affected in 50-60% of the cases and the child goes into a shock,” said Dr Sharma.
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