generalspeaking

Post-Covid Hyperinflammmatory Syndrome in Children

"All of us are watching closely what the experience in other centres is so we can be prepared when and if we see a case in the Ottawa area."
"Now that there is one report published and more reports coming, it seems more clear that this is very likely related to COVID-19 and something that we need to be prepared for."
"As we move toward reopening society in small steps, I think we need to be very careful and very cautious and be as ready as we can to deal with what may happen."
"I still think the primary group of people we need to worry about are the elderly and people with chronic illnesses that have shown to be predisposing for severe COVID infection." 
"[It is a reminder that] prevention is better than the cure [simple steps like washing hands and social isolation to prevent infection]."
Dr.Jason Brophy, infectious disease specialist, Children's Hospital of Eastern Ontario

The mysterious syndrome concerning the medical community dealing with the global pandemic that appears to be targeting children, and apparently related to COVID-19, has been seen in children in the United Kingdom, Montreal and New York, among other places that have had the misfortune to see the disease overwhelm their populations. Called multi-system inflammatory syndrome, or hyperinflammatory shock, this new threat to children who were initially thought to be immune to the effects of the novel cornavirus, now appears to be a post-infection syndrome related to COVID.

None of the children tested positive for COVID-19, who were part of a survey described in a paper out of the United Kingdom.  An over-reaction of the body's immune system appears to be responsible for the inflammation affecting multiple body systems, explained Dr.Brophy, where children exhibit symptoms similar to Kawasaki disease, known to cause inflammation in blood vessels throughout the body. Children under the age of five are typically those so affected. Signs of toxic shock are identified as well in these children.

Prolonged fever, a rash, red and swollen hands and feet, red eyes and a red tongue, are typical symptoms of Kawasaki disease, and these are the symptoms that are now appearing in young children diagnosed with hyperinflammatory shock. A cluster of eight cases of COVID-linked hyperinflammatory syndrome in children aged between four and 14 were described in their study by researchers in the United Kingdom.

All of the affected children had been in intensive care, and one of the eight children perished from the effects of the syndrome, according to the paper published last week in The Lancet. Symptoms exhibited by the children included relentless fevers, rashes, conjunctivitis, pain in arms and legs, along with gastrointestinal illness progressing to shock. Cardiovascular abnormalities and gastrointestinal symptoms were also seen in these children.

Of the children in the U.K. study, two tested positive for COVID-19. All the child patients however, had COVID antibodies, leading to the understanding that they had all at some point been infected with the novel coronavirus, and the further theory that the debilitating, painful and in some cases deadly condition was related to an aftermath onset of COVID. There is still so much to learn about COVID-19 itself, much less its alternate effects that medicine has yet to catch up with it.


Canadian Paediatric Society spokeswoman Genevieve Brouillette noted a study is currently underway for the purpose of tracking how many children are being affected by COVID-19 in Canada and becoming seriously ill. The focus has been the situation as it affects the elderly in society and those people with underlying health problems, as the most at risk for severe complications from the novel coronavirus disease. The mast majority of deaths in Canada and elsewhere in the world has been seen occurring in long-term care homes and facilities housing the elderly.

Intravenous immunoglobulin, made from blood, holding antibodies that help fight infections can be used as treatment of the new syndrome affecting some children. So few cases of COVID-19 have been seen among children and youth it seems unlikely that many post-infection cases will arise in Ottawa, commented Dr.Brophy. With just one to two percent of the population in Ottawa believed to have been infected it appears that the city is getting off lightly. But as some brilliant minds have observed on other occasions, it isn't over until it's over.

Reports of clusters of the syndrome post-infection in some children describe a tiny proportion of any population, young or old, and should logically, not be a matter of undue concern. In the greater scheme of the pandemic's infection rate and symptoms, this new discovery of hyperinflammatory syndrome affects a vanishing rare cluster of children, not at all typical of what has occurred up to the present.

On the other hand, this SARS-CoV-2 virus has revealed itself to a strangely puzzling disease, one whose trajectory and total effect continues to elude the analytical expertise of medical specialists all of whom are doing their best to fully understand its presentation and its implications, all of whom are hoping that with continued study of its morbid properties, familiarity will ensue and greater confidence in possible treatment options, and finally a vaccine to rescue humanity from its sinister clutches.