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Symptoms of new inflammatory condition in children potentially linked to coronavirus

Parents in Kent are being advised to look out for the side effects of a new disease in children thought to be related to the coronavirus.

Symptoms of the rare inflammatory condition include abdominal pain, diarrhoea, vomiting, a rash and chest pain.

Dr Julian Spinks speaks out about the new inflammatory disease

It is being compared to Kawasaki disease - which is uncommon but affects children under five and causes a high temperature, a rash and swollen glands - and also toxic shock syndrome.

Around 20 children in the UK and a small number across Europe are thought to have had the condition, as well as some in the US.

Some required intensive care treatment.

Dr Julian Spinks, a Medway GP, explained: "About two and half per cent of all coronavirus cases are in children. So there are thousands who have caught it in the UK.

"This new condition is affecting a very small number, probably less than 20 in the UK but it also has been found in places like Italy.

Dr Julian Spinks
Dr Julian Spinks

"It's been labelled at the moment an inflammatory condition but it does resemble a couple of other medical conditions, one is toxic shock syndrome and the other is quite a rare condition called Kawasaki disease."

Dr Spinks explained the three main symptoms are abdominal pain, diarrhea and vomiting, and the third where the heart is affected and this can cause chest pain or breathlessness.

He said: "So if your child has any of these you need to seek help.

"It does remind us that actually children can catch all sorts of conditions even not coronavirus.

"So we still need to be alerted to the the fact that your child might be deteriorating."

Doctors are looking out for early signs of the disease
Doctors are looking out for early signs of the disease

The Royal College of Paediatrics and Child Health (RCPCH) have set out a working definition of the new illness - which has been dubbed paediatric multisystem inflammatory syndrome.

They hope that by more clearly describing what is currently known about the condition, doctors will be able to identify potential cases as quickly as possible to begin effective treatment.

Dr Mike Linney, paediatrician and RCPCH Registrar, said: "This new case description aims to include a range of all the possible symptoms and diagnostic information which doctors can use to make decisions about how to treat a child who may have the condition.

"There is no one sign or symptom which alone would indicate that a child has the condition. Doctors can use the definition to look for a pattern of combined symptoms.

"All of these children were extremely unwell, with features suggestive of sepsis such as a persistently high temperature coupled with rapid breathing, cold hands and feet and sleepiness.

"The other symptoms varied greatly in the different cases."

A study that took place in the Lombardy region of Northern Italy reports a rise in the number of children with the new disease.

Before the Covid-19 outbreak, a hospital treated around one case of Kawasaki Disease every three months. Between 18 February and 20 April 2020, 10 children were treated for symptoms of the disease.

In antibody tests on the children, eight appeared to have already had the coronavirus while the other two had not.

Only a small number of children have had the new condition
Only a small number of children have had the new condition

Dr Lucio Verdoni, author of the report from the Hospital Papa Giovanni XXIII in Bergamo, Italy, said: "We noticed an increase in the number of children being referred to our hospital with an inflammatory condition similar to Kawasaki Disease around the time the SARS-CoV-2 outbreak was taking hold in our region.

"Although this complication remains very rare, our study provides further evidence on how the virus may be affecting children."

But the RCPCH has stressed that it remains unclear whether the new syndrome is caused by Covid-19.

Professor Russell Viner, president of the RCPCH said of the new study: "Although the Article suggests a possible emerging inflammatory syndrome associated with Covid-19, it is crucial to reiterate - for parents and health-care workers alike - that children remain minimally affected by SARS-CoV-2 infection overall.

"Understanding this inflammatory phenomenon in children might provide vital information about immune responses to SARS-CoV-2 and possible correlates of immune protection that might have relevance both for adults and children.

"In particular, if this is an antibody-mediated phenomenon, there might be implications for vaccine studies, and might also explain why some children become very ill with Covid-19, while the majority are unaffected or asymptomatic."

Dr Liz Whittaker, clinical lecturer in paediatric infectious diseases and immunology, at Imperial College London, said the fact that the syndrome was occurring in the middle of a pandemic, suggests the two are linked.

"You've got the Covid-19 peak, and then three or four weeks later we're seeing a peak in this new phenomenon which makes us think that it's a post-infectious phenomenon," she told the BBC.

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