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Pediatrician on Kawasaki disease and covid-19
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Photo: Alexander Donka / Karolinska Institute
Jonas F. Ludvigsson
In several countries, doctors have warned that children have sought hospital care for severe inflammatory symptoms similar to those experienced by Kawasaki disease, an unusual condition.
Some of the children have also been sick on covid-19 and now experts are investigating a relationship.
Here, pediatrician Jonas F Ludvigsson talks about Kawasaki’s disease and how concerned he should be as a parent.
Physicians in heavily affected northern Italy have reported an unusually large number of cases of children under the age of 9 with a severe form of what appears to be Kawasaki disease, which is an unusual inflammatory syndrome affecting the heart, among other things.
Similar cases have also occurred in Spain, France and the United Kingdom.
“Some of the children who died did not have underlying diseases,” UK Health Minister Matt Hancock told LBC Radio.
Italian and British experts are now investigating whether there is a link between the coronavirus and whether young children have severe inflammatory diseases, who have come to hospitals with high fever and inflamed arteries, writes The Guardian.
But what exactly is Kawasaki disease and how scared should you be? Jonas F. Ludvigsson, a pediatrician at Örebro University Hospital and a professor at the Karolinska Institute, finds out. Meet several children per year who are affected by the disease.
What is Kawasaki disease? And how big is the mortality?
According to Jonas F Ludvigsson, Kawasaki disease is a very unusual condition.
– It is an inflammation that affects, among other things, the blood vessels. The disease is a rare cause of high fever and is especially seen in young children up to the age of five. We see around 30-50 cases per year in Sweden.
– Mortality is low, probably 1-2 percent of those affected by the disease die. In Sweden this would correspond to 1-2 children every three years.
What causes the disease? Does the sick person infect others?
– You don’t know what causes the disease, but you don’t think it’s contagious. In most pediatric clinics in the country, she has a couple of children a year with the disease and I have never seen any siblings of affected patients. However, I suppose it is a virus behind Kawasaki, but this is speculation.
How is Kawasaki treated?
– We treat the child with immunoglobulins, sometimes with cortisone. In addition, we provide medications that protect the heart since the disease can affect the coronary arteries. Therefore, we often also do an ultrasound of the heart.
What is the relationship between the doctors seen between Kawasaki and Covid-19?
– There have been UK reports of some cases where children have symptoms similar to those of Kawasaki. Some of them have also been positive for covid-19, others have not. With this, one has to wonder if covid-19 is really driving Kawasaki. It can only be a coincidence.
– The thing to remember is that we have had Kawasaki disease in society for 50 years. Only now has covid-19 emerged, so it may not be the only corona virus behind. A country like the UK should have around 15-20 Kawasaki cases per month in normal cases. It may be that the cases they have seen now are just the cases they would have had anyway. Furthermore, it is one of the most affected countries with covid-19 in the United Kingdom.
There have been reports of children with inflammation of the heart muscle, including France, some of whom have been positive for covid-19. What can you say about them?
– It may be the same type of illness reported in the UK. There, this has been described as Kawasaki, but the cases seen in the Paris area appear to be more of an inflammation of the heart muscle. If it is pure inflammation of the heart muscle and not Kawasaki, I am less surprised. Today we already know that viruses can trigger inflammation of the heart muscle (doctors generally call them perimyocarditis). It could also coincide with the age of the children who in the French case were 5 to 15 years old, while the children with Kawasaki are more often younger than that, under 5 years old.
Should parents be concerned that their children are affected?
– I don’t think you should worry about Kawasaki or inflammation of the heart muscle if you have children. Given how many children are likely to have covid-19 at this time, this is still a rare case. But if you have a child who has a very high fever, noticeably tired, or has a lot of chest pain, you should seek attention whether or not covid-19 is in circulation.
Note. By publishing this article, the situation may have changed as new insights are constantly added.
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