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meThe blessing of this pandemic was that children previously seemed immune to it. However, worrying reports of children suffering from a new type of inflammatory syndrome that may be associated with a coronavirus infection have been on the rise for several weeks. Young patients often suffer from fever throughout the day from abdominal pain, diarrhea, rashes, and swelling of the hands and feet, and generally show strong inflammatory reactions, the symptoms of which are similar to those of the rare Kawasaki syndrome.
Due to the existing differences, doctors now refer to the new syndrome as Pediatric multisystemic inflammatory syndrome, in summary PMIS. At least 50 cases have been reported in Europe and around 100 children are affected in New York. So far, two children and two teenagers have died from the effects of the inflammatory disease. “In Germany, ten children and adolescents are sick, none of the children have died,” says Inge Krägeloh-Mann, president of the German Society for Pediatric and Adolescent Medicine.
It is still unclear if there is a direct connection to a Sars-CoV-2 infection, but the evidence is mounting. In a study published Wednesday in the Lancet, Italian doctors compared the number of Kawasaki patients treated before and after the pandemic began at the Bergamo hospital that was at the epicenter of the outbreak. In the five years prior to the Sars CoV-2 outbreak, 19 children with Kawasaki syndrome were treated there. From mid-February to mid-April 2020 there were ten children. The authors write that this corresponds to a thirty times higher frequency of Kawasaki disease.
In early May, a British medical team had already reported in the same magazine on an “unprecedented accumulation” of such cases in south-east England. Over a ten-day period, eight children were treated with toxic shock, such as can occur in Kawasaki syndrome. Usually one or two children a week would be diagnosed with such symptoms. The virus could only be detected in a part of the children by means of the PCR test. However, a large number of the children had antibodies against Sars-CoV-2 in their blood. Therefore, experts suspect that PMSI may occur after a SARS-CoV-2 infection.
The related Kawasaki syndrome has been known for almost eighty years, the causes of the rare disease are unknown. Cold virus infections, which are part of the Corona family, are discussed as possible triggers for the syndrome. “In this context, it is very possible that Sars-CoV-2 triggers a Kawasaki-like syndrome,” says Krägeloh-Mann, “the real question is whether the coronavirus causes these complications more frequently than other pathogens and whether the course is more serious”. is. Until now, the number of cases has been so small that you still have to be patient for a final evaluation.
The symptoms of the two related diseases presumably come from an overreaction of the immune system, which mainly affects the blood vessels and organs of the body itself. Kawasaki syndrome mainly affects children under the age of five, while PMIS, which tends to be more severe, mainly affects children over the age of five.
In Germany, Switzerland and Great Britain, monitoring projects were launched without delay, recording cases of outpatients and hospitalized Covid 19 patients and possible complications in children. Health authorities in several countries have or are in the process of providing information and guidelines to facilitate the diagnosis of pediatricians, and are requesting that suspected cases be reported. “Because the syndrome is so rare, global collaboration will be necessary to find the exact cause,” says Christoph Aebi, board member of the Swiss Society of Pediatrics.
Experts confirm that most children survive a corona infection without problems and generally show no symptoms or are only mild. “We watch the action very carefully. At the moment there is no reason to lift the relaxation that has been decided, “says Krägeloh-Mann.” Social interactions are extremely important to children, and PMIS is a very rare disease that is also treatable. “
