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Up to 100 children a week are being hospitalized with a rare disease that can emerge weeks after Covid-19, leaving them in intensive care, doctors said.
In a phenomenon that worries pediatricians, 75% of the children most affected by pediatric multisystemic inflammatory syndrome (PIMS) were black, Asian or belonging to ethnic minorities (BAME). Nearly four in five children were previously healthy, according to an unpublished case snapshot.
When PIMS emerged in the first wave of the pandemic, it caused confusion among doctors, concern among NHS chiefs, and alarm among parents. It was initially thought to be Kawasaki disease, a rare disease that mainly affects infants and infants. But PIMS has been recognized as a separate new post-viral syndrome that one in 5,000 children contracts about a month after having Covid, regardless of whether they had symptoms.
It often involves skin rashes, a temperature of up to 40 ° C, dangerously low blood pressure and abdominal problems, and in severe cases its symptoms are like those of toxic shock or the life-threatening condition of sepsis. Two children are believed to have died of PIMS since the pandemic began.
While specialists do not believe that the frequency of the disease has increased relative to cases in the general community, the figures are higher than in the first wave, and hospitals are believed to have admitted up to 100 young people per week during the second wave, compared to about 30 a week last April.
It is believed that between 12 and 15 children have fallen ill every day since the beginning of January. Cases have emerged in many places, but most have occurred in London and the south-east of England, areas where the new Kent variant of the coronavirus has caused a sharp increase in infections.
Evidence compiled by Dr. Hermione Lyall, infectious disease expert in children and clinical director of children’s services at the Imperial College Healthcare NHS Trust in London, has highlighted the disproportionate impact the disease is having on children of origin BAME.
Part of a presentation he made at a recent webinar attended by more than 1,000 pediatricians showed that, in a “first national report” of 78 PIMS patients who ended up in intensive care, 47% were of Afro-Caribbean origin and 28% of Asian origin: between five and six times greater than the 14% of the UK population that is BAME.
Dr Liz Whittaker, PIMS spokesperson for the Royal College of Pediatrics and Child Health, said: “We are doing research to understand why this population is affected. Genetics can be a factor. But we are concerned that it is a reflection of how this is a disease of poverty, which disproportionately affects those who cannot avoid exposure due to their occupation, multigenerational households and overcrowded housing.
Separate data compiled by Evelina’s Dr. Marie White showed that 60% of the 107 PIMS cases they had treated as of January 13 were black African or Caribbean children.
Dr Habib Naqvi, director of the NHS Observatory of Race and Health, called for research on the much higher risk of BAME children of contracting PIMS. “Clearly, urgent research is now needed on why black and Asian children are overrepresented and more vulnerable to PIMS.
“We are concerned by these early findings and know that structural inequalities in health can affect the lives of people of ethnic minority origins throughout their lives.”
Lyall’s dataset, based on figures from 21 of the 23 pediatric intensive care units (PICUs), also revealed that 78% of the patients had no underlying disease and until the PIMS was in good health, which pediatricians said it was “very worrying”; the average age of children receiving PIMS is 11, but ranges from 8 to 14; two thirds (67%) were children; only 22% had Covid when their PIMS emerged, while the rest already had it; and nearly one in four of those who end up in a PICU develop a heart condition called coronary artery dilation, which is potentially fatal.
Other data presented by experts at the webinar showed that a small number of children with this disease see their brain affected and suffer confusion, lethargy, disorientation, begin to behave in unusual ways and, in rare cases, suffer a stroke. Additionally, in a study of 75 children, eight had suffered from heart problems, including myocarditis and ventricular dysfunction.
Most of the children with PIMS have been taken to one of the 23 hospitals in the NHS network with PICUs, such as Evelina and Great Ormond Street Children’s Hospitals in London and Birmingham Children’s and Women’s Hospital. According to the model of Evelina’s doctors, cases will peak next Monday and then begin to decline.
Whittaker said parents should not be alarmed by the increase in hospitalizations because the recent incidence of PIMS is proportional to the greater impact of the pandemic on adults in recent weeks. “PIMS can be very serious. But we have seen fewer seriously ill children [in the second wave] because there is earlier recognition and treatment, ”he said.
“It is still rare, and we don’t think parents need to worry, as it is much more likely not to affect their children than them. The numbers are low and [PIMS] it would not be a reason to prevent schools from opening. Middle ages [of onset] it’s nine years old. We would not close the playgrounds. “
