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Explained: Why a new Covid-related disease among children has Europe worried

Coronavirus (COVID-19): UK's Paediatric Intensive Care Society said it had observed an "apparent rise" in the number of children, of all ages, with a "multi-system inflammatory state requiring intensive care".

By: Explained Desk | New Delhi | Updated: May 2, 2020 10:24:00 am
Explained: Why a new Covid-related disease among children has Europe worried Children’s drawings of rainbows supporting the National Health Service (NHS) during the coronavirus outbreak are displayed in a window of 10 Downing Street in London, Wednesday, April 29, 2020. (AP Photo: Matt Dunham)

Children in the UK are reportedly falling ill with symptoms of high fever and swollen arteries, and doctors believe it could be coronavirus-related. On Monday, the Paediatric Intensive Care Society (PICS) said it had observed in the last three weeks an “apparent rise” in the number of children, of all ages, with a “multi-system inflammatory state requiring intensive care”. A report in The Associated Press estimated 10-20 such cases so far.

“There is a growing concern of a SARS-CoV-2 related inflammatory syndrome emerging in children in the UK or that there may be another unidentified infectious pathogen associated with these cases,” PICS stated.

The National Health Service (NHS) has issued a nation-wide alert, and asked doctors to urgently report any cases with similar symptoms. Not just the UK, doctors in Italy and Spain have also alerted authorities of similar cases.

What is multi-system inflammatory state?

This rare illness causes inflammation of the blood vessels, which leads to low blood pressure. It affects the entire body as it causes a build-up of fluid in the lungs and other organs. This condition is similar to Kawasaki disease. Patients suffering from it require intensive care to support the lungs, heart and other organs, according to The Guardian.

What are the symptoms?

Children were showing abdominal and gastrointestinal symptoms as well as cardiac inflammation. According to PICS, there were also overlapping symptoms of toxic shock syndrome and atypical Kawasaki disease.

Toxic shock syndrome (TSS) is a rare life-threatening condition caused when certain bacteria enter the body and release harmful toxins. If not treated in time, the condition could be fatal. Symptoms include high temperature, flu-like symptoms including headache, sore throat, cough, diarrhea, dizziness or fainting, difficulty breathing and confusion. Some patients suffering from TSS may need ICU admissions.

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Kawasaki disease is an acute inflammatory disease of the blood vessels and usually occurs in children below the age of five. The inflammation caused by the disease affects many parts of the body but has a more serious effect on the heart since it causes inflammation in the coronary arteries that are responsible for supplying blood to the heart. This results in enlargement or in the formation of aneurysms that can lead to heart attacks. Symptoms include fever, changes in extremities, rashes, redness of the cornea, red and cracked lips, a red tongue and lymph node enlargement of the neck.

Is this disease related to Covid-19?

Only some of the children with these symptoms tested positive for Covid-19. Therefore, it remains unclear if and how the inflammatory syndrome is related to the virus.

Is there cause for concern?

In a letter published in the Health Service Journal (HSJ) on Monday, Simon Kenny, the NHS’s national clinical director for children and young people was quoted as saying, “Thankfully Kawasaki-like diseases are very rare, as currently are serious complications in children related to Covid-19, but it is important that clinicians are made aware of any potential emerging links so that they are able to give children and young people the right care fast.”

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The Guardian reported that some doctors have suggested that the illness may be “post-infection inflammatory response”, where the immune system goes into overdrive. This also explains why some children with this illness could have tested negative for the virus. They could have already recovered from the virus before the inflammation set in or the tests simply did not detect the virus.

Another syndrome associated with an over-stimulated immune system response is the cytokine storm syndrome. It is suspected that some Covid-19 patients, even young ones, can develop this response leading to sepsis, multiple organ failures and even death.

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