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European Doctors Warn Rare Kids' Syndrome May Have Virus Tie
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LONDON
— Doctors in Britain, Italy, and Spain have been warned to look out for
a rare inflammatory condition in children that is possibly linked to
the new coronavirus.
Earlier
this week, Britain’s Paediatric Intensive Care Society issued an alert
to doctors noting that, in the past three weeks, there has been an
increase in the number of children with “a multi-system inflammatory
state requiring intensive care” across the country. The group said there
was “growing concern” that either a COVID-19 related syndrome was
emerging in children or that a different, unidentified disease might be
responsible.
“We
already know that a very small number of children can become severely
ill with COVID-19 but this is very rare,” said Dr. Russell Viner,
president of the Royal College of Paediatrics and Child Health. He said
the syndrome was likely caused by an overreaction of the body's immune
system and noted similar symptoms had been seen in some adults infected
with the coronavirus.
The
cases were also reported to have features of toxic shock syndrome or
Kawasaki disease, a rare blood vessel disorder. Only some of the
children tested positive for COVID-19, so scientists are unsure if these
rare symptoms are caused by the new coronavirus or by something else.
Health officials estimate there have been about 10-20 such cases in
Britain and NHS England said it is urgently investigating the reports.
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Viner
said that although doctors were considering other potential causes for
the syndrome, including other viruses or new medications, “the working
hypothesis is that it's COVID-related.”
Spain’s
Association of Pediatrics recently made a similar warning, telling
doctors that in recent weeks, there had been a number of school-age
children suffering from “an unusual picture of abdominal pain,
accompanied by gastrointestinal symptoms” that could lead within hours
to shock, low blood pressure and heart problems.
“It
is a priority to recognize these (symptoms) to urgently refer these
patients to a hospital,” the pediatric association said.
In
Italy, Dr. Angelo Ravelli of Gaslini Hospital and a member of the
Italian Paediatricians' Society, sent a note to 10,000 colleagues
raising his concerns. He and his team reported an unusual increase in
the number of patients with Kawasaki disease in regions of Italy hit
hard by the pandemic, noting some children had COVID-19 or had contacts
with confirmed virus cases.
“These
children do not respond to traditional treatment,” he said, adding that
some were given a high dose of steroids. Those who developed toxic
shock syndrome needed help breathing and were admitted to intensive care
units, Ravelli said.
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Kawasaki
symptoms include a high temperature that lasts for 5 days or more, a
rash and swollen glands in the neck, according to Britain's National
Health Service.
Dr.
James Gill, an honorary clinical lecturer at Warwick Medical School,
said while the reports were concerning there was still no solid evidence
that the rare syndrome was caused by COVID-19.
“Regardless
of source, multi-system inflammatory diseases are exceptionally serious
for children and already stretched intensive care teams, so keeping an
extra eye out for new symptoms arising in the patients we see is always a
good thing,” he said.
Some possible cases have also been reported in France and Belgium.
Dr.
Sonja Rasmussen, a University of Florida pediatrics professor, noted
one similar case in the United States involving a 6-month old girl in
California who was diagnosed with Kawasaki disease and then COVID-19.
That report, from Stanford University, doesn’t clarify whether both
illnesses happened coincidentally or if COVID-19 might have somehow
caused Kawasaki disease, said Rasmussen, who co-authored a recent JAMA
Pediatrics article about COVID-19 and children.
“We’ll
need more information published in the peer-reviewed literature to
better understand this association. However, Kawasaki disease is a
relatively rare condition, so seeing these cases makes us concerned that
Kawasaki disease could be a rare complication of COVID-19,” she said.
“We need to remain vigilant when we see children with findings that
aren’t typical for COVID-19.”
To
date, children have been among the least affected group by the
coronavirus. Data from more than 75,000 cases in China showed they
comprised 2.4% of all cases and mostly suffered only mild symptoms.
The
World Health Organization said it was attempting to gather more
information on any new, coronavirus-related syndrome in children from
its global network of doctors but had not received any official reports
about it.
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Aritz Parra in Madrid, Andrea Foa in Genoa, Italy and AP Medical Writer Lindsey Tanner in Chicago contributed to this report.
