Italian Doctors Find Link Between Covid-19 and Inflammatory Disorder | Science



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Doctors in Italy reported the first clear evidence of a link between Covid-19 and a rare but serious inflammatory disorder that has required some children to undergo life-saving treatment in intensive care units.

The mysterious condition emerged last month when NHS chiefs issued an alert to doctors after hospitals admitted multiple children with a mix of toxic shock and symptoms seen in an inflammatory disorder known as Kawasaki disease.

On Tuesday, doctors at Evelina London Children’s Hospital announced the death of a 14-year-old boy, the first known death from the condition in Britain. Between 75 and 100 children are receiving treatment across the country. Typical symptoms include fever, rashes, red eyes, chapped lips, and abdominal pain.

Doctors suspected from the start that the coronavirus played a role in the new disorder by triggering an excessive immune reaction in children, but there was no evidence that the two were linked.

The latest evidence comes from doctors in Bergamo, the city with the highest rate of coronavirus infections and deaths in Italy. Medical records from the Papa Giovanni XXIII hospital showed that since the outbreak reached Bergamo, cases of Kawasaki-like illness have increased to about 10 per month compared to one every three months in the previous five years.

Of 10 children treated for the disorder between mid-February and mid-April, eight tested positive for antibodies to the virus. The two negative cases can be explained by faulty test results, doctors believe.

“Our study provides the first clear evidence of a link between Sars-CoV-2 infection and this inflammatory condition, and we hope that it will help doctors around the world try to familiarize ourselves with this unknown virus,” said Dr. Lorenzo D ‘Antiga, director of child health at the hospital. “I have no doubt that Kawasaki disease in these patients is caused by Sars-CoV-2.”

Writing in The Lancet, doctors caution that the “strong association” between the virus and the inflammatory condition must be kept in mind when governments ease their blocking restrictions. However, they emphasize that the disorder is very rare and does not affect more than one in 1,000 children exposed to the virus. A fraction of these require intensive care.

Dr. Annalisa Gervasoni, a pediatric specialist at the hospital, 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 on children, especially as countries around the world struggle with plans to begin to relax policies of social distancing. “

Kawasaki disease, which overwhelmingly affects babies, causes inflammation of the blood vessels and, in some cases, swelling of the heart. Rapid treatment can prevent life-threatening coronary aneurysms. The cause is not known, but studies suggest it is a post-infection inflammatory response that turns against the body.

The increase in cases points to a form of Kawasaki disease that affects school-age children more than babies and is specifically triggered by the coronavirus. Since the first cases were reported in Britain, dozens more have emerged in the United States, France, Spain, Italy, and Switzerland.


Health officials in Britain launched a surveillance study this week to monitor cases of the disorder, tentatively called PIMS-TS, for the pediatric multisystemic inflammatory syndrome temporarily associated with Sars-CoV-2.

Professor Russell Viner, president of the Royal College of Pediatrics and Child Health, said it remained the case that children were largely unaffected by Covid-19, but that surveillance for the new syndrome would shed light on who it affects. , how and what The longer term results are. “The vast majority of children with this condition have been well treated and are getting better and have gone home,” he said.

Dr. Liz Whittaker, clinical professor of pediatric infectious diseases and immunology at Imperial College London, said the cases followed the curve of the coronavirus outbreak and appeared to have peaked, though she could not rule out more as they rose. The restrictions. “We are not seeing many children who are not really okay with this condition,” he said. “It shouldn’t be a factor when we reopen schools.”

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