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At least 197 Brazilian children and adolescents presented, until the end of August, a series of health problems that, together, may characterize a new disease potentially associated with COVID-19, Pediatric Multisystemic Inflammatory Syndrome.
According to the Ministry of Health, of the total number of children, 140 were under 10 years old when they fell ill. Also according to the folder, the syndrome could have caused the death of at least 14 patients from 0 to 19 years in the period from May to August of this year.
The reported deaths were registered in eight states: Pará (3); Rio de Janeiro (3); Ceara (2); Paraíba (2); Bay (1); Pernambuco (1); Piauí (1); and São Paulo (1). The coordinator of Child Health and Breastfeeding, Janini Ginani, recalled that the deaths in question are “under investigation”, since several other syndromes can overlap, making diagnosis difficult.
According to the latest balance, until August 26, the highest number (41) of notifications of the new syndrome came from Ceará. They are followed by Pará (24); Rio de Janeiro (22); Federal District (19); São Paulo (19); and Bahía (11). Cases were also registered in Alagoas (9); Espírito Santo (8); Minas Gerais (5); Paraíba (6); Pernambuco (9); Piauí (6); Rio Grande do Norte (9); and Rio Grande do Sul (9).
Yesterday (8), however, the government of Pernambuco announced that 16 cases of the syndrome in the state, including one death.
| PHEW | TOTAL NUMBER OF CASES | NUMBER OF DEATHS |
|---|---|---|
| Acre | – | – |
| State | 9 | – |
| Amapá | – | – |
| Amazon | – | – |
| Bay | eleven | one |
| Ceara | 41 | two |
| federal District | 19 | – |
| Holy Spirit | 8 | – |
| Goias | – | – |
| Maranhao | – | – |
| Minas Gerais | 5 | – |
| South Mato Grosso | – | – |
| Mato Grosso | – | – |
| by | 24 | 3 |
| Paraíba | 6 | two |
| State | 9 | one |
| Piauí | 6 | one |
| Parana | – | – |
| Rio de Janeiro | 22 | 3 |
| Rio Grande do Norte | 9 | – |
| Rondônia | – | – |
| Roraima | – | – |
| Rio Grande do Sul | 9 | – |
| St. Catarina | – | – |
| Sergipe | – | – |
| Saint Paul | 19 | one |
| Tocantins | – | – |
| Brazil | 197 | 14 |
Supervision
Although it is characterized by different symptoms, the syndrome is usually associated with persistent fever, accompanied by hypotension, conjunctivitis, spots on the body, diarrhea, abdominal pain, nausea and vomiting, among others. In some cases, the patient may also develop respiratory symptoms and heart dysfunction. Also, there is always a marked anti-inflammatory activity in the body.
The first cases of the new syndrome began to register in Europe in April this year. The reports soon multiplied, prompting the World Health Organization (WHO) to issue an alert to draw the attention of pediatricians around the world.
On May 20, the ministry issued, in association with the Brazilian societies of Pediatrics and Rheumatology, a first statement on the subject. The folder requested the attention of health professionals so that the syndrome could be quickly identified. However, the symptoms can be confused with those of other syndromes, such as Kawasaki.
On July 24, when the country registered 71 confirmed cases of covid-19 and three deaths, the ministry implemented a national monitoring system for the syndrome through a form available in the official communication system of the portfolio.
Last week, when participating in a meeting of the External Commission to Combat Covid-19 of the Senate, the director of the Department of Strategic Programmatic Actions, of the Ministry of Health, Antonio Rodrigues Braga Neto, highlighted the need to “qualify the service to children ”, clarifying that notification, although important, is not mandatory.
“We still do not have mandatory notification. What we have is a recommendation, “said Neto. “We understand that mandatory notification is a tool of epidemiological interest that will facilitate the analysis of these cases,” added the director, highlighting that, worldwide, there are still many doubts about the syndrome.
“It is a new and very recent disease. What we have to guarantee is the capillarity of the information. [Garantir] That a child who comes to primary care three days ago with fever and any of the other symptoms, such as nausea, headache or conjunctivitis, and who has laboratory abnormalities and sepsis has been excluded, is referred to specialized care ”.
During the meeting, the coordinator of Child Health and Breastfeeding, of the Ministry of Health, Janini Ginani, stressed that most of the children and adolescents affected by the syndrome are male, between 0 and 9 years old and did not have pre-existing chronic diseases. -existing.
“The cases have been more prevalent in the age group up to 10 years. Among children aged 0 to 4, 41 were men and 34 were women. Among those aged 5 to 9 there were 39 and 26, respectively, ”explained Janini.
“We have seen a difficulty regarding discrimination in these cases. What is possibly a sepsis is reported as a multisystem inflammatory syndrome. We are trying to separate these causalities; Improve surveillance to understand how this syndrome has developed in the country, also qualifying surveillance and [o registro] deceased. “
UTI
A researcher from the D’OR Institute for Research and Education and the Federal University of Rio de Janeiro (UFRJ), pediatrician Arnaldo Prata presented, during the meeting, data from a study of 79 children and adolescents hospitalized in 19 intensive care units (UCI), public and private, from five states (BA; CE; PA; RJ and SP).
For him, although the number of cases of the syndrome is small, it is necessary to be alert, since 87% of children hospitalized in the ICU tested positive for covid-19. Of them, 13% had a clinical picture associated with the syndrome.
“That is, among children from 0 to 19 years old, multisystemic inflammatory disease can affect 10% and 15% of those who become ill and need to be hospitalized for covid-19,” Prata emphasized.
UTI
A researcher from the D’OR Institute for Research and Education and the Federal University of Rio de Janeiro (UFRJ), pediatrician Arnaldo Prata presented, during the meeting, data from a study of 79 children and adolescents hospitalized in 19 intensive care units (UCI), public and private, from five states (BA; CE; PA; RJ and SP).
For him, although the number of cases of the syndrome is small, it is necessary to be alert, since 87% of children hospitalized in the ICU tested positive for covid-19. Of them, 13% had a clinical picture associated with the syndrome.
“That is, among children from 0 to 19 years old, multisystemic inflammatory disease can affect 10% and 15% of those who become ill and need to be hospitalized for covid-19,” Prata emphasized.
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