Serious Inflammatory Condition Possibly Related to CoViD-19 Affecting Children?

Child with mask — children seriously affected?
Image by Adalhelma from Pixabay

There’s still a lot we don’t know about CoVID-19 and so much is uncertain around the continuing pandemic. One of the points we are fairly certain about though, concerns how the coronavirus affects children. All information scientists have gathered so far has showed that the virus affects children much less than every other age group. Child deaths and critical cases have been very few and most children appear to have only mild symptoms. The reason for this is unclear, but this was also observed in the past with the other two coronaviruses that spread among humans in recent years, SARS and MERS.

During the last few weeks however, some countries have seen a rare but serious inflammatory condition presenting in children significantly more often than usual. Speculations are starting this week to mount about its possible connection to the coronavirus and the issue is getting wider media attention.

Click-bait reporting on medical issues

You may have seen headlines like “Children die with new Covid-19 syndromeor “Dozen children left fighting for life with ‘corona-related syndrome’” and rightfully reacted with intense stress and worry for your children. My advice as a medical doctor is do not trust shocking news headlines, especially in such novel, rapidly evolving and uncertain situations.

Given how little we know about CoViD-19 and this new possible development in particular, those headlines could be everything from partly inaccurate to purely false. It is an irresponsible and lousy, but very profitable way of reporting, especially when it comes to medical news. The titles above are slightly altered and I provide no link to the related articles, because I do not want to give any more clicks to such opportunistic and unreliable news sources. Here is a more measured and reasonable approach instead.

But let’s get to the actual facts we have thus far.

A dangerous syndrome

First things first: What exactly are we talking about and what does it look like? The syndrome is described as “similar to toxic-shock syndrome and Kawasaki disease”, which sounds scary but obviously means little to non-medical professionals. What has been observed is a systemic inflammatory reaction in children that affects mainly:

  • the gut, producing abdominal pain and diarrhea, otherwise common gastrointestinal symptoms seen for example in food poisoning, not particularly dangerous so long the child is adequately hydrated.
  • the heart, causing swelling around the heart and arrhythmias, which can prove fatal if not treated promptly.
  • the blood vessels, which together with a poorly functioning heart can lead to ineffective circulation to the rest of the body — the medical term for this is circulatory shock. A particular form caused by bacterial toxins is called toxic shock syndrome. This is by definition life-threatening and requires immediate intensive care.

A rare syndrome

All this sounds very serious, but before we start panicking and locking-up children in their homes, let’s see what else we know. The most important question being how many cases are there?

We are actually talking about a very limited number of cases. What’s worrisome for pediatricians is the fact that such a serious clinical condition is very rare in children so that even a handful more cases than usual can be considered alarming. But for the general public, this is a relatively minor issue. Dr. Sanjay Patel, a consultant in pediatric infectious diseases at Southampton Children’s Hospital in the UK, tried to put this into perspective in a recent BBC interview:

“This has generated a huge amount of alarm, (but) we’re talking about a tiny number of cases. Less than 10 children in the U.K. have been admitted to intensive care units with this shock-like condition that we’re calling an inflammatory condition, and that’s out of about 11.5 million under-16-year-olds in the U.K., so that’s absolutely tiny numbers.”

The syndrome is not clearly defined either, as it behaves similarly to other systemic inflammatory diseases. Cases of Kawasaki disease for example, a disease that can most notably affect the coronary arteries of the heart (no relation to the virus here), can have about the same presentation. So it’s impossible to say which is which, when we have so early no idea about the possible mechanism.

A coronavirus syndrome?

The question that of course generates the most buzz, is the one we have no real answers for. All we have right now are speculations and working theories. Whether it is somehow linked to the coronavirus remains to be seen. Some of the children with this condition have tested positive for CoViD-19 and others haven’t.

Pediatricians need to take the possibility seriously in any case, because that is the most dangerous scenario. But until we can prove some kind of link, the answer for everyone else is simply “could be”.

I know, it doesn’t make your heart race. But then again, we all need to find ways to calm down more than anything else. Right?

Keep calm and away from the click-bait. There’s a lot of it floating around.

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MD | Pediatric Resident | Blogger

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Yannis Georgiadis

Yannis Georgiadis

MD | Pediatric Resident | Blogger

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