In a study that could have relevance for India as it looks to open up and “live with the virus”, Italian doctors have reported the breakout of a rare Kawasaki-like disease in young children exposed to the coronavirus (SARS-CoV-2). The study could have implications on the decision to open up schools.
Kawasaki Disease is a rare condition that typically affects children under five. It causes blood vessels to become inflamed and swollen.
Only 19 children had been diagnosed with the condition in that area in the five years up to the middle of February 2020, but there were 10 cases between February 18 and April 20 this year, according to the study. Eight of the 10 children brought to hospital after February 18 tested positive for the coronavirus in an antibody test.
Children diagnosed after the epidemic broke out were older, had a higher rate of cardiac involvement, and features of a hyperactive immune breakout. There were no fatalities but the symptoms of those diagnosed during the epidemic were more severe than those diagnosed earlier, according to the study.
“The SARS-CoV-2 epidemic was associated with high incidence of a severe form of Kawasaki disease. A similar outbreak of Kawasaki-like disease is expected in countries involved in the SARS-CoV-2 epidemic,” the doctors reported in The Lancet.
Doctors from the Hospital Papa Giovanni XXII in Bergamo wrote: “We believe these findings have important implications for public health. The association between SARS-CoV-2 and Kawasaki-like disease should be taken into account when it comes to considering social reintegration policies for the paediatric population. However, the Kawasaki-like disease described here remains a rare condition, probably affecting no more than one in 1000 children exposed to SARS-CoV-2. This estimate is based on limited data from the case series in this region.”
Similar cases have been reported from New York and southeast England.
Dr Annalisa Gervasoni, co-author of the study and a paediatric specialist in Bergamo, said: “In our experience, only a very small proportion of children infected with SARS-CoV-2 develop symptoms of Kawasaki disease. However, it is important to understand the consequences of the virus in children, particularly as countries around the world grapple with plans to start relaxing social distancing policies.”
The increase could not be explained by an increase in hospital admissions, as the number of patients admitted during that time period was six-fold lower than before the virus was first reported in Bergamo.
Dr Lucio Verdoni, an author of the report, said: “We noticed an increase in the number of children being referred to our hospital with an inflammatory condition similar to Kawasaki disease around the time the SARS-CoV-2 outbreak was taking hold in our region.”
The doctors, however, cautioned that their report is based on only a small number of cases, and larger studies will be required to confirm the association.
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