Kawasaki-like Disease: Covid-19 Could Trigger Novel Inflammation In Children

Kawasaki-like Disease: Covid-19 Could Trigger Novel Inflammation In Children Doctors from several countries report seriously ill children with certain inflammations. Is there a connection with Covid-19? A study brings more clarity.

There are reports worldwide of severe inflammation in children associated with a corona infection.

Now, a study from Bergamo, the center of the pandemic in Italy, sheds light on the characteristic features of the rare inflammatory disease that resembles the so-called Kawasaki syndrome.

As the doctors report in the specialist journal ‘The Lancet’, this could actually be connected to Covid-19 – but the doctors emphasize that only a small proportion of younger patients are affected.

Corona infection is usually mild in children. But in a few cases, the condition appears to lead to symptoms reminiscent of Kawasaki syndrome, a rare childhood disease.

This syndrome leads to an overreaction of the immune system, which is probably caused by bacteria or viruses.

Adults already know that the coronavirus can also cause such an overreaction. A direct connection between Kawasaki and Covid-19 has not yet been established.

However, there are now reports from several countries about children with inflamed blood vessels, rashes, and fever – symptoms that at least resemble Kawaski’s disease.


A study from Italy shows an accumulation of Kawasaki symptoms

Doctors at Papa Giovanni XXIII Hospital in Bergamo have now compared the cases of children who showed such symptoms between February 18 and April 20 with Kawasaki cases in the region from five years before the pandemic started.

In total, there were 19 cases of Kawasaki between January 2015 and mid-February this year.

In the two months since then, 10 children with Kawasaki-like symptoms have been treated, which the study authors say corresponds to a 30-fold increase – with the doctors themselves pointing out that it is difficult to draw valid conclusions based on such small numbers.

Eight of the ten children who were hospitalized after February 18 were tested positive for Sars-CoV-2 in an antibody test.

All of the children in the study survived, but those who fell ill during the pandemic showed more severe symptoms than those from the previous five years. Heart complications occurred in six of the children, and five showed signs of toxic shock syndrome.

In addition, more of them had to be treated with steroids than in the group before the pandemic broke out. Another difference: The children who fell ill during the corona wave were on average older than those who had previously been diagnosed with Kawasaki.

Because of these differences, the authors advocate classifying the inflammatory disease as a “Kawaski-like syndrome”.

In fact, the Italian study, like a similar summary from Great Britain, shows different courses that only partially correspond to a typical Kawasaki syndrome, but often represent a so-called atypical Kawasaki syndrome, emphasizes Johannes Hübner, deputy head of the children’s clinic at the University of Munich, in an independent classification.

“Atypical Kawasaki syndrome shows some very non-specific symptoms that we see in many viral infections, such as fever and a rash.” 

Children relatively rarely affected by the coronavirus

Russell Viner, president of the British Royal College of Pediatrics and Child Health, also reassures: “Although the article suggests a possible emerging inflammatory syndrome related to Covid-19, it is important – both for parents and for healthcare workers – to reappear emphasize that overall children are minimally affected by the Sars CoV-2 infection. “

Understanding the phenomenon in children could, however, provide important information about immune responses to Sars-CoV-2 that could be relevant for adults and children, according to Viner.

“Especially when it is an antibody-mediated phenomenon, it can impact vaccine studies and also explain why some children get Covid-19 seriously while the majority are unaffected or asymptomatic.”Kawasaki-like Disease: Covid-19 Could Trigger Novel Inflammation In Children