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After surpassing 4 million recorded cases and approaching 300,000 deaths worldwide, the covid-19 pandemic may have entered “a completely different chapter”, Andrew Cuomo, Governor of New York, the epicenter of the North American outbreak. The statements come at a time when the deaths of three children infected with the new coronavirus were registered in that city. All suffered a severe reaction, with symptoms similar to Kawasaki syndrome. In that state alone, 73 similar cases, with seriously ill children, were reported in the past week. “We thought that children could be vehicles for transmission … but we did not think that children would suffer,” said the governor.
It is important to understand if there is a relationship between the new virus and Kawasaki syndrome, something that science is still studying. The disease will be an extreme reaction of the immune system after a previous infection, in which the body’s own defenses attack it. Symptoms include fever, diarrhea, inflammation of the eyes, skin rashes all over the body, swelling of the feet and hands. In the worst cases there can be inflammation of the arterial walls, cut of the blood flow to the heart and death. The disease generally affects children under the age of five, but one of the fatalities in New York was a teenager. “It is the nightmare of all parents,” Cuomo lamented.
“We want to reassure parents, this seems to be unusual,” said Jane Newburger, director of the Kawasaki department at Boston Children’s Hospital. “Although Kawasaki disease can damage the heart and blood vessels, the problems usually go away in five to six weeks, and most children make a full recovery,” the doctor explained. Still, “rarely, but sometimes, damage to the coronary arteries persists,” Newburger said, noting that in developing countries, the syndrome is the leading cause of acquired heart disease in children, requiring immediate treatment.
In the rest of the United States, where the pandemic grew later than in New York, NBC found until Thursday 21 cases of children infected with the new coronavirus who had symptoms of Kawasaki. “We are all awaiting extensive testing to make sure it is associated with covid-19,” explained Audrey John, director of the department of infectious diseases at the Children’s Hospital of Philadelphia. There, between five and ten cases were found. It is “certainly suspicious,” the doctor added to US television.
In recent years, Kawasaki syndrome has been linked to outbreaks of seasonal flu, for example. Chinese researchers have found that Kawasaki seasonality accompanies that of the flu. In 2009, the H1N1 pandemic also seemed to be related. Coronaviruses are completely different from influenza viruses, but it is not impossible that they also have a correlation with the Kawasaki cases.
However, at least one child has already died with similar symptoms in the UK. And Evelina Children’s Hospital in London recorded “an unprecedented group of eight children with hyperinflammatory shock,” a description similar to Kawasaki’s, over a ten-day period in mid-April: they generally receive only one or two cases per week, read in Lancet.
