What is known about the new ‘COVID-related’ illnesses effecting children?

Katherine Johnston (13 May, 2020)

Child dies at Evelina as ‘cluster’ of cases thought to include Southwark are recorded

8631The Evelina London Children's Hospital (pictured)

Evelina Children’s Hospital has recorded its first death from a new illness linked to COVID-19, as it emerges more than 40 seriously ill children have been admitted for treatment – with a cluster of cases thought to be centred around Southwark and Woolwich.

Little is known about the illness; a set of hyper-inflammatory symptoms with the hallmarks of toxic shock syndrome or the rare Kawasaki disease.

A report published in medical journal The Lancet this month outlines the ‘unprecedented cluster’ of eight cases seen in just ten days in April, from across the south-east, all of whom were rushed to Evelina.  One, aged just fourteen, passed away after six days in intensive care.  The other patients are all recovering.

The News understands the majority of cases seen by the hospital are responding well to treatment. Their symptoms recorded included fever, conjunctivitis, diarrhoea, abdominal pain, rashes, headaches and vomiting. Some have tested positive for COVID-19 but others have not.

All were previously fit and well before becoming ill. Five of the eight were boys, and six were from Afro-Caribbean backgrounds. In total, more than 40 cases have been seen by Evelina alone since March, with Great Ormond Street and other hospitals across the country reporting cases too.

In response to the situation, on April 26, the Paediatric Intensive Care Society issued an alert to doctors, from NHS England, warning of the rise in cases of severely ill children with the hitherto unknown illness.

“In the last three weeks, there has been an apparent rise in the number of children of all ages presenting with a multi-system inflammatory state requiring intensive care across London and also in other regions of the UK.

“There is a growing concern that a COVID-19 related inflammatory syndrome is emerging in children in the UK, or that there may be another, as yet unidentified, infectious pathogen associated with these cases.”

Since then, cases around the world have been reported, with New York’s state governor Andrew Cuomo announcing at least 73 children have been diagnosed, and three have died in this ‘entirely new chapter’ of the Coronavirus pandemic.

As yet little is known about the illness – it doesn’t even have a name – and cases are still very rare. Its link to COVID-19 is also still untested.

Health secretary Matt Hancock told reporters at the Downing Street press conference two weeks ago that he was ‘very worried’ by the reports.

 Chief medical officer, Prof Chris Whitty, said that it was ‘entirely plausible’ that the illness was caused by COVID-19 ‘at least in some cases’.

Researchers from Evelina London, Guy’s and St Thomas’ and Imperial College are now collecting data and blood samples to learn more about the condition and find the best treatments.

Currently, doctors are focusing on anti-inflammatory treatments, ranging from aspirin and steroids, intravenous immunoglobulin infusions and immune-modulatory drugs more often used for severe forms of arthritis, inflammatory bowel disease and other rare immune conditions where the body is attacking itself.

A spokesperson for Evelina London said: “If parents are worried about their children’s health they should seek advice which includes their GP, 111 or if they are concerned their child needs urgent review or treatment, they should take them to their nearest emergency department.

“The children we have seen have been significantly unwell and not getting better as would normally be expected from simple childhood infections.

“The main concern has been very high fevers which are not settling down.”

Always go straight to hospital or phone 999 if your child:

  • Becomes pale, mottled and feels abnormally cold to the touch
  • Has pauses in their breathing (apnoeas), has an irregular breathing pattern or starts grunting
  • Severe difficulty in breathing becoming agitated or unresponsive
  • Is going blue around the lips
  • Has a fit/seizure
  • Becomes extremely distressed (crying inconsolably despite distraction), confused, very lethargic (difficult to wake) or unresponsive
  • Develops a rash that does not disappear with pressure (the ‘glass test’)
  • Has testicular pain, especially in teenage boys

Contribute
Nigel Knowitall says:

Southwark, and Woolwich were the first area’s of London to have COVID-19 cases, so it looks as though this disease in children surfaces about a month after the child has been exposed to COVID-19, possibly by either parent. All of the children with this new disease have shown anti-bodies for the virus, so the link is there.

Maybe COVID-19 has somehow mutated with the virus that causes Kawasaki Syndrome so although the child is not affectected with any breathing problems or other, nothing is done at the time. Then after a month a delayed reaction triggers the symptoms now appearing in children.

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