The UK has been seeing a rise in children falling ill with inflammation syndrome. According to NHS chief medical officer Professor Chris Whitty, they are investigating the reports “as a matter of urgency” as the syndrome might be linked to the coronavirus.
Not all children with this syndrome in the past month have tested positive for Covid-19 but the number is disproportionally high. The symptoms appear as a rare progression of the coronavirus and some of the affected kids have been found to have a swelling in their hearts.
The alert of this problem became a concern after doctors recorded a sharp rise of infants admitted into intensive care with a “Kawasaki-like disease.”
Health Secretary Matt Hancock said he was “very worried” as children were so far thought of as the safest group of people from the Covid-19 pandemic.
Health chiefs at the NHS said in a joint statement to the country’s GPs (general practitioners) that “There is growing concern that a [COVID-19] related inflammatory syndrome is emerging in children in the UK.”
“Over the last three weeks, there has been an apparent rise in the number of children of all ages presenting with a multi-system inflammatory state requiring intensive care across London and also in other regions of the UK.”
Prof Stephen Powis, medical director for NHS England said during a press conference that “We have become aware in the last few days of reports of severe illness in children which might be a Kawasaki-like disease.”
“Both Chris (Whitty) and I are aware of that, and we have asked our experts, I have asked the national clinical director for children and young people to look into this as a matter of urgency.”
The Paediatric Intensive Care Society (PICS) also shared the warning and urged people to share it as quickly as possible.
Are children a “risk group” all of a sudden?
So far, children were largely unaffected by the coronavirus. That was viewed as a crucial silver lining to the whole nightmarish situation in which there are already over 200,000 people dead across the world. The resilience shown by youngsters against the disease has continued to baffle doctors as that age group is usually a “super spreader” of respiratory viruses such as the flu.
This inflammation syndrome is still a rarity, fortunately, so children worldwide are still to be viewed as a relatively safe group.
Some of the symptoms of the syndrome include cardiac inflammation, stomach pains, and other “gastrointestinal symptoms”, including vomiting and diarrhea.
According to Prof Whitty: “This is a very rare situation but I think it is entirely plausible that this is caused by this virus, at least in some cases.”
“Because we know that in adults who of course have much more disease than children do, big problems are caused by an inflammatory process and this looks rather like an inflammatory process, a rather different one.”
“Therefore, given that we have got a new presentation of this at a time with a new disease, the possibility – it is not a definite, we need to look for other causes as well – but the possibility that there is a link is certainly plausible.”
In the initial alert, the symptoms of the disease were described as similar to those of Toxic shock syndrome (TSS) – a severe illness associated with infections and with blood markers similar to those of a severe Covid-19 case.
During the press conference, Whitty said that it is “entirely plausible” the inflammation syndrome’s spike is related to Covid-19 and that the experts should look into the numbers as quickly and extensively as possible.
What about the children who tested negative?
Some of the kids didn’t seem to have Covid-19 according to their initial tests even though they were in the minority. This only served to raise further questions and complicate the diagnosis.
It’s also still unclear how many children in total have had this syndrome nor how many have died of it. Even the average age of the children is yet to be determined.
What’s even more distressing is that this news comes right after the announcement that schools in the UK are to be reopened in June.
What are the possible implications of this?
So far, only 9 people under the age of 19 have died in a hospital from Covid-19 out of 18,420 reported deaths.. Since then, that number has risen to but the number of child deaths is still considered to be extremely low – ~0.05%.
If the inflammation syndrome condition ends up being common, however, this can present a whole new danger to the whole pandemic.
Up until now, scientists believed that the low number of children with the disease was due to the lack of age-related lung problems. According to the NHS memo, cases like these have only started appearing in the past three weeks but that could be because the syndrome is slow to develop. Alternatively, it may end up being rare which is why we’re only noticing it at the peak of the pandemic.
Dr. Elizabeth Whittaker, a pediatrician at St. Mary’s Hospital in London stated that there are similar reports from other countries.
“Our Italian and Spanish colleagues also report it. Numbers are small but significant. We want primary care/A&E to be vigilant so those affected are in the right place to get appropriate supportive care if needed,” Dr. Whittaker said.
Dr. Michael Griksaitis, a pediatrician at the University Hospitals Southampton NHS Foundation Trust added that “If it’s COVID-19 or not is to be seen. It is a phenomenon pediatric intensive care units [are] seeing across [the] UK at the moment, and I also hear from other international centers.”
People online are still asking the medical professionals to be more precise in their explanations and recommendations. So far, the condition is described as similar to both Kawasaki disease and TSS, but not much is added in terms of concrete and solid conclusions,
Professor Simon Kenny, NHS national clinical director for children and young people has said that “Thankfully Kawasaki-like diseases are very rare, as currently are serious complications in children related to COVID-19.”
“But it is important that clinicians are made aware of any potential emerging links so that they are able to give children and young people the right care fast.”
“The advice to parents remains the same: if you are worried about your child for whatever reason, contact NHS 111 or your family doctor for urgent advice, or 999 in an emergency, and if a professional tells you to go to a hospital, please go to a hospital.”
While the NHS has so far been unable to specify what the total number of cases has been, most specialists agree that we’re still talking about only “a handful of cases”.
Professor Adilia Warris, a pediatric infectious diseases specialist at the University of Exeter has reaffirmed that it’s still very possible that the condition is not related to Covid-19.
As she explained it, this syndrome is “a multi-system inflammatory state” which results from the production of cytokines. It’s what’s known as a “cytokine storm” – a condition that we’ve discussed before on the subject of coronavirus.
During such a “storm” in our system, proteins start attacking healthy tissue and that can lead to blood vessel damage and leaks, as well as low blood pressure.
The Paediatric Intensive Care Society (PICS) has also issued a statement on their website reassuring parents that while scientists are examining the situation “as a matter of urgency”, there’s no need for panic. It’s a lengthy statement but it did say that:
“It is important to highlight that, both in the UK and in other countries, there have still been very few cases of critically unwell children with COVID-19 admitted to pediatric intensive care units.”