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05/14/2020 19:32
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Connection with Covid-19? Doctors report severe inflammation in children
Bergamo – There are worldwide reports of severe inflammation in children associated with a crown infection.
Now, a study of Bergamo, the center of the pandemic in Italy, sheds light on the characteristic features of the rare inflammatory disease that is similar to the so-called Kawasaki syndrome.
As doctors reported in “The Lancet,” this could be related to Covid-19, but doctors emphasize that only a small proportion of younger patients are affected.
Crown infection is usually mild in children. But in some cases, the condition appears to lead to symptoms reminiscent of Kawasaki syndrome, a rare childhood disease.
This syndrome leads to an overreaction of the immune system, which is likely caused by bacteria or viruses.
Adults already know that corona virus can also cause an overreaction. A direct connection between Kawasaki and Covid-19 has not yet been established.
However, there are now reports from various countries of children with inflamed blood vessels, rashes, and fever, symptoms that at least resemble Kawaski’s disease.
Kawasaki type symptoms
Doctors at the Papa Giovanni XXIII Hospital in Bergamo have compared the cases of children who showed such symptoms between February 18 and April 20 with the cases of Kawasaki in the region from five years before the pandemic began. .
In total, there were 19 Kawasaki cases between January 2015 and mid-February this year. Ten children with symptoms similar to Kawasaki’s have been treated in the two months since, which according to the study authors corresponds to a 30-fold increase, and the doctors themselves point out that it is difficult to draw valid conclusions based on such small numbers. .
Eight of the ten children who were hospitalized after February 18 tested positive for Sars-CoV-2 on an antibody test. All of the children in the study survived, but those who became ill during the pandemic showed more severe symptoms than those of the previous five years.
Cardiac complications occurred in six of the children and five showed signs of toxic shock syndrome. Furthermore, more of them had to be treated with steroids than in the group before the pandemic broke out.
Another difference: Children who became ill during the crown wave were on average older than those who had been previously diagnosed with Kawasaki. Due to these differences, the authors advocate classifying inflammatory disease as a “Kawaski-like syndrome”.
Virologist Christian Drosten points to good treatment capacity
In fact, the Italian study, as a similar summary from Great Britain, shows different courses that only partially correspond to a typical Kawasaki syndrome, but often represent the so-called atypical Kawasaki syndrome, emphasizes Johannes Hübner, deputy director of the children’s clinic from the University of Munich, in an independent classification
“An atypical Kawasaki syndrome shows some very nonspecific symptoms that we see in many viral infections, such as fever and a rash.” Also, the connection to Covid-19 is unclear or not secure in some of the reported cases.
“We have never heard of such a backlog of cases in Germany,” summarizes Hübner, who is also president of the German Society for Pediatric Infectious Diseases (DGPI).
The DGPI is currently in the process of establishing a suspicious case notification system and will closely monitor the situation. “Right now, the situation in Germany is certainly not worrying,” said the doctor.
Berlin virologist Christian Drosten made it clear Thursday on the NDR podcast that he sees no reason for the scaremongering. It is a rare phenomenon that international pediatrics is now beginning to discuss. Drosten also referred to good treatability.
Important information about the immune system.
Russell Viner, president of the British Royal College of Pediatrics and Child Health, also says: “Although the article suggests a possible emerging inflammatory syndrome related to Covid-19, it is important, for both parents and health workers, to reappear. emphasize that children in general are minimally affected by Sars CoV-2 infection. “
However, understanding the phenomenon in children could provide important information about immune responses to Sars-CoV-2 that may be relevant to adults and children, Viner said. “In particular, if it’s an antibody-mediated phenomenon, it can affect vaccine studies and also explain why some children take Covid-19 seriously while most are unaffected or asymptomatic.”
Cover photo: 123rf.com/bondd