As if it was not enough that novel pandemic COVID-19 was affecting millions of people cutting across the global boundaries, the disease, albeit few in children, is manifesting with symptoms of rare diseases.
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In a World Health Organisation report, it was found that reports from Europe and North America have described clusters of children and adolescents requiring admission to intensive care units with a multisystem inflammatory condition with some features similar to those of Kawasaki disease and toxic shock syndrome.
The report further said: "Case reports and small series have described a presentation of acute illness accompanied by a hyperinflammatory syndrome, leading to multiorgan failure and shock.13-15 Initial hypotheses are that this syndrome may be related to COVID-19 based on initial laboratory testing. A Children have been treated with anti-inflammatory treatment, including parenteral immunoglobulin and steroids."
Are the Indian kids, suffering from COVID-19, showed some of these symptoms?
Speaking to IANS, a professor from Kalawati Saran Children's hospital in Delhi said "Yes. There are children who are presenting Kawasaki-like illness and Toxic Shock Syndrome during this pandemic but if their tests happen to be positive for COVID, it is not very clear whether it is due to COVID-19 or if they already had the disease and tested positive."
She said that these symptoms have, However, not been seen in newborns. "Kids also have mayo cardiac diseases involvement. They do not necessarily show classic flu like illness but fever is there. As far as toxic shock syndrome is concerned, it is a bacterial infection. Therefore it is a very complex medical situation to ascertain whether the child already had the disease or it developed due to COVID-19."
The WHO report also said, "There is an urgent need for collection of standardized data describing clinical presentations, severity, outcomes, and epidemiology. The WHO has developed a preliminary case definition and case report form for multisystem inflammatory disorder in children and adolescents. The case definition will be revised as more data become available" said the WHO. According to the preliminary case definition, children and adolescents from 0-19 years of age with fever for more than 3 days and two of the five symptoms:
- Rash or bilateral non-purulent conjunctivitis or muco-cutaneous inflammation signs (oral, hands or feet)
- Hypotension or shock
- Features of myocardial dysfunction, pericarditis, valvulitis, or coronary abnormalities (including ECHO findings or elevated Troponin/NT-proBNP)
- Evidence of coagulopathy (by PT, PTT, elevated d-Dimers)
- Acute gastrointestinal problems (diarrhoea, vomiting, or abdominal pain) should be identified as suspected or confirmed cases both for the purpose of providing treatment and for provisional reporting and surveillance
