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In April, NHS doctors were told to be on the lookout for a rare but dangerous reaction in children.
This was caused by the illness of eight children in London, including a 14-year-old who died. They were hospitalized with similar symptoms (including high fever, rash, red eyes, swelling, and widespread pain) that initially looked like sepsis. Some of those patients tested positive for Covid-19, sparking conversations in the medical community about whether there could be a new inflammatory syndrome that could be an extreme reaction to Covid among very young patients.
Some of these cases have been compared to a rare inflammatory heart disease called Kawasaki, the symptoms of which are similar to sepsis and toxic shock.
“For the doctors who care for these children, they present themselves as if they have sepsis,” explained Dr. Patel. “They have a fever and abnormal blood tests, but when further investigation is done, they recognize that there is also an inflammatory component that is affecting parts of the body: You may have a rash, red eyes, or heart inflammation.”
These symptoms have been compared to the overactive immune response known as a “cytokine storm” that has been seen in adults with Covid-19. In these cases, it appears that it is the body’s immune response and not the virus itself that is life-threatening.
Dr. Patel said there are some similarities between these pediatric cases and what has been observed in various adult cases, but it is too early to say for sure. “The timing and the dynamics are not exactly the same. So in adults, you often have seven days of Covid symptoms and then potentially get worse and that’s when the cytokine storm occurs.
“The deadlines are not so clear with this. It may be a similar phenomenon, but at this point it is too early to say that we have too few patients with this to draw firm conclusions. ”
It is important to note that these cases are very rare events.
Is this only happening in the UK?
In early May, three children in the US were also being treated for inflammatory symptoms believed to be related to the coronavirus. All three, who are between six months and eight years old, had a fever and inflammation of the heart and intestine.
Dr. Patel said that a small number of these new cases have also been identified in Europe. “We have been talking to Italian and Spanish colleagues and they have had extremely small amounts of something similar: this inflammatory presentation in children. But we have not yet been clear if it is due to Covid.
“Half of the children tested negative for Covid in our viral tests, so there is still a lot to learn.”
When should I dial 999?
The RCPCH (Royal College of Paediatrics and Child Health) advises you go directly to the nearest emergency department or call 999 if your child …
- It becomes pale, mottled, and feels abnormally cold to the touch.
- You have pauses in breathing (apnea), have an irregular breathing pattern, or begin to grunt
- You experience great difficulty breathing, are agitated, or are unresponsive.
- It turns blue around the lips.
- You have a seizure or seizure.
- You become extremely distressed (cries inconsolably despite distraction), confused, very lethargic (difficult to wake up), or unresponsive.
- You develop a rash that does not go away with pressure (use the ‘glass test’).
- You have testicular pain, especially in teens.
How can I treat my child’s mild coronavirus symptoms at home?
If your child is well enough to be cared for at home, RCPCH experts recommend that parents treat symptoms of fever or pain related to Covid-19 with acetaminophen or ibuprofen.
The Human Medicines Commission’s Working Group of Experts on Coronavirus has concluded that there is insufficient evidence to establish a link between the use of ibuprofen or other non-steroidal anti-inflammatory drugs (NSAIDs) and the worsening of Covid-19. Catrin Barker, Chair of the RCPCH Medicines Committee and Chief Pharmacist at Alder Hey Children’s Hospital, says: “Our advice to parents is that acetaminophen or ibuprofen can be used to treat their children if they have symptoms of Covid-19, such as fever and headache, and should follow NHS advice if they have questions or if symptoms worsen. ”
