Coronavirus may cause new inflammatory disease in children, medics say

Coronavirus may cause new inflammatory disease in children, medics say

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Health officials in the UK have warned that Covid-19 could be causing a new and rare inflammatory condition in children.

Britain’s Paediatric Intensive Care Society (PICS) said in a statement on Monday that it had been alerted to a small number of critically ill children presenting with “an unusual clinical picture” by the National Health Service (NHS).

The PICS noted that many — but not all — of the children with symptoms of the new inflammatory disease had been diagnosed with Covid-19.

The condition was likened to toxic shock syndrome and Kawasaki disease.

Toxic shock syndrome is a rare, life-threatening condition caused by bacteria getting into the body and releasing harmful toxins. Symptoms include a high temperature, a sunburn-like rash and flu-like symptoms such as a headache and sore throat. Kawasaki disease causes swelling of heart’s blood vessels and mainly affects children under the age of 5, according to the U.K.’s NHS. Symptoms include a rash, swollen glands in the neck, dry or cracked lips and red fingers or toes.

Symptoms of the condition

Common symptoms of the new inflammatory condition include abdominal pain, gastrointestinal symptoms and cardiac inflammation, PICS said.

“An early case report relating to Covid-19 presenting as Kawasaki syndrome has been published recently, and PICS is aware of a small number of children nationally who appear to fit the clinical picture described in the NHS England alert,” the organization added.

Speaking to BBC Radio 4’s “Today Programme” on Tuesday, Sanjay Patel, a consultant in pediatric infectious diseases at Southampton Children’s Hospital in England, likened the illness to sepsis — a life-threatening reaction to an infection — but added there were “most definitely” ways it could be treated.

“Over the last few years there’s been a huge narrative about sepsis, parents are on the lookout for cold hands and feet, difficulty breathing, lethargy, and it presents similarly to that,” he said. “These children will end up in hospital, frontline doctors will initially treat this as sepsis and these children initially don’t improve with antibiotics. It’s at that point that more investigations suggest this is an inflammatory condition that requires immune modulating treatment such as steroids and other drugs.”

‘Very worried’

The new coronavirus, which has infected more than 3 million people and caused 212,056 deaths globally to date, is widely understood to be less severe and cause fewer fatalities in children compared to adults.

However, speaking to U.K. radio station LBC on Tuesday, British Health Minister Matt Hancock said he was “very worried” about recent reports of children presenting with the new condition.

“We don’t know yet (if it can prove fatal),” he said. “It’s a new disease that we think may be caused by the Covid-19 virus — we’re not 100% sure because some of the people who got it hadn’t tested positive, so we’re doing a lot of research now but it is something we’re worried about. Although it is very significant for those children who do get it, the number of cases is small.”

He said the NHS had put out a call to doctors to be on alert for the condition and collate any information on children who were admitted to hospital with symptoms.

Meanwhile, Chris Whitty, England’s chief medical officer, told reporters at the U.K. government’s daily coronavirus press conference on Monday it was “entirely plausible” the new condition could be brought on by Covid-19.

“This is a very rare situation, but I think it’s entirely plausible that this is caused by this virus at least in some cases, because we know that in adults big problems are caused by an inflammatory process, and this looks rather like an inflammatory process,” he said at Monday’s press briefing.

Whitty emphasized, however, that it was not clear the coronavirus was definitely the cause of the new condition in children, noting that experts needed to look for other potential causes.

“Given that we’ve got a new presentation of this at a time with a new disease, the possibility that there is a link is certainly plausible,” he said. “But … the number’s very small, the key thing is if parents are worried, then phone up and get advice. It’s very rare.”

‘Absolutely tiny numbers’

NHS England’s National Medical Director Steve Powis said at the press conference that it was important to note the condition — which had only been reported over the last few days — was rare, but should not be ignored.

“It’s important for this and other conditions, although very rare — I must emphasize rare — that you come forward to seek treatment and diagnosis as quickly as possible,” he advised parents.

Patel also stressed on the BBC’s “Today Programme” Tuesday that the new condition was very rare.

“It’s really important to get this into perspective,” he said. “This has generated a huge amount of alarm, (but) we’re talking about a tiny number of cases. Less than 10 children in the U.K. have been admitted to intensive care units with this shock-like condition that we’re calling an inflammatory condition, and that’s out of about 11.5 million under-16-year-olds in the U.K., so that’s absolutely tiny numbers.”

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